C-B2-04: Helping Women be a Part of the Answer: Cognitive Interviews to Assess Attitudes on Hormone Therapy

Background/Aims: In 1993, the Women’s Health Initiative (WHI) began to recruit postmenopausal women to be part of the answer by participating in a study assessing benefits and risks of hormone therapy (HT). From these trials, a complicated picture emerged. Some of this information has made it to the media and it is important to understand how this has shaped women’s perceptions of HT. The purpose of this study was to use cognitive interviews to gain a detailed understanding of how a group of women’s opinions of HT are shaped, what their opinions are, and to test their knowledge of the risks and benefits of HT. Method: Ten subjects who were menopausal were recruited by letter prior to a visit at a rural women’s health clinic. A survey was administered to gauge women’s opinions, attitudes, and the source of their knowledge. Then, retrospective probing was used to explore the answers given by the women. A qualitative analysis of the interviews was conducted and surveys were evaluated. To verify the accuracy of the women’s self report, their responses relating to past medical history, HT exposure, menopause status, hysterectomy status, and demographics were compared to their electronic health records. Results: Ten subjects between the ages of 54 and 65, with a mean age of 58, completed interviews. The survey contained 27 questions and took an average of eight minutes to complete while the interviews lasted approximately 45 minutes. All participants preferred response options not asking for specific numbers, indicating it was not something they generally paid attention to. Although 8 out of 10 women answered that taking HT increased a women’s chances of developing breast cancer, more than half still thought that it positively affected a women’s quality of life and overall health. A recurring theme was the idea that hormone therapy was a personal choice and its benefits or harm depended on the individual’s circumstances taking it and her physician’s advice. Conclusions: In general, the women seemed to value their physician’s advice and their personal experiences over other information they had encountered. Their knowledge of HT’s actual risks according to the research from the WHI studies was limited. Understanding what shapes a woman’s perception of HT, and what they know may make patient education concerning the risks and benefits associated with HT more effective, helping women make the most appropriate decisions for their own health.