Rigby Alison J, Ma Jun, Stafford Randall S
Division of Pediatric Endocrinology and Diabetes, and the Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305-5208, USA.
Menopause. 2007 Sep-Oct;14(5):853-8. doi: 10.1097/GME.0b013e3180333a33.
Findings from the Women's Health Initiative (WHI) failed to confirm previous expectations about the net benefits of menopausal hormone therapy and have resulted in reduced use of these medications. The aim of this study was to evaluate women's awareness and knowledge concerning the risks and benefits of hormone therapy.
A nationally representative survey was completed for a sample of 781 women (ages 40-60 y, mean 49 y) drawn from the Knowledge Networks Internet panel 24 months after publication of the first WHI findings, in June 2004. Responses were weighted to reflect the demographics of the US population. The main outcome measures were awareness of WHI and knowledge of its findings. An aggregate score was constructed to assess women's knowledge of the impact of hormone therapy on seven key disease outcomes. Logistic regression determined the independent predictors of (1) WHI awareness and (2) a positive aggregate knowledge score, reflecting appropriate responses about risks and benefits.
Only 29% of women were aware of the WHI results. Only 40% of women had a positive aggregate knowledge score. Aside from awareness of WHI and independent of other factors, knowledge scores were lower for African American women (odds ratio, 0.4; 95% CI: 0.2-0.6) and among women with less education (odds ratio, 0.5; 95% CI: 0.3-0.9). Knowledge was greatest for breast cancer and osteoporosis outcomes and most limited for colorectal cancer and memory loss.
Surveyed women had limited awareness and knowledge of the WHI results, suggesting limited diffusion. Targeting younger, less educated, and African American women is warranted.
妇女健康倡议（WHI）的研究结果未能证实此前关于绝经激素治疗净效益的预期，导致此类药物的使用减少。本研究旨在评估女性对激素治疗风险和益处的知晓情况与知识水平。
在2004年6月首次公布WHI研究结果24个月后，从知识网络互联网小组抽取了781名女性（年龄40 - 60岁，平均49岁）作为样本，完成了一项具有全国代表性的调查。对回答进行加权处理以反映美国人口的人口统计学特征。主要结局指标是对WHI的知晓情况及其研究结果的知识水平。构建了一个综合得分来评估女性对激素治疗对七种关键疾病结局影响的了解程度。逻辑回归确定了（1）对WHI的知晓情况和（2）反映对风险和益处的恰当回答的综合知识得分呈阳性的独立预测因素。
只有29%的女性知晓WHI的结果。只有40%的女性综合知识得分呈阳性。除了对WHI的知晓情况外，且独立于其他因素，非裔美国女性的知识得分较低（优势比为0.4；95%置信区间：0.2 - 0.6），受教育程度较低的女性也是如此（优势比为0.5；95%置信区间：0.3 - 0.9）。对乳腺癌和骨质疏松症结局的知识了解最多，对结直肠癌和记忆力减退的知识了解最有限。
接受调查的女性对WHI结果的知晓情况和知识水平有限，表明传播范围有限。有必要针对年轻、受教育程度较低的非裔美国女性开展工作。
