Objective Previous studies have found increased rates of depression in women aged 45 to 54 years, but the factors that influence these rates are not understood. It was assessed whether higher rates of depressive symptoms were associated with menopausal status, climacteric symptoms, and use of hormone replacement therapy. Design Cross-sectional survey. Setting Community sample. Methods Data are from 581 women ages 45 to 54 years who were interviewed by telephone between October 1998 and February 1999. Measures Depression was measured with the abbreviated CES-D, a depressive symptoms screening measure. Women's reported perception of menopausal stage, frequency of periods in the preceding 12 months, and history of oophorectomy were used to classify their menopausal status into four categories: (1) no indication of menopause; (2) close to menopause; (3) had begun menopause; and (4) had completed menopause. Results There were 168 women (28.9%) who reported a high level (≥10) of depressive symptoms when the abbreviated CES-D was used. In a logistic-regression analysis, significant factors associated with increased depressive symptoms included physical inactivity, inadequate income, use of estrogen/progesterone combination, and presence of climacteric symptoms (trouble sleeping, mood swings, or memory problems). Menopausal status was not associated with depressive symptoms. Conclusions In this sample of women age 45 to 54 years, climacteric symptoms but not menopausal status were associated with higher rates of depressive symptoms.
<b><i>Background/Aims:</i></b> National guidelines endorse using evidence-based tools to identify those at risk for hereditary breast and ovarian cancer (HBOC). This study aimed to evaluate whether women deemed not to be at increased risk of being a <i>BRCA</i> mutation carrier; the majority of those screened, recall, understand and accept the implications of these results for breast cancer risk. <b><i>Methods:</i></b> We conducted an online survey with women (<i>n</i> = 148) who screened negative on a brief HBOC screener. <b><i>Results:</i></b> While women tended to accept HBOC screener as accurate (range 9–45; mean 32, SD 5.0), less than half (43%) accurately recalled their result. Only 52% understood that they were at low risk of carrying a mutation, and just 34% correctly understood their breast cancer risk. African American women were less likely to recall (33 vs. 53% respectively, OR 0.5, <i>p</i> = 0.03), understand (42 vs. 63% respectively, OR 0.4, <i>p</i> = 0.02), and accept (mean 31 vs. 33 respectively, β –2.1, <i>p</i> = 0.02) the result compared to Whites. <b><i>Conclusions:</i></b> Our findings show that those at low risk of carrying a <i>BRCA1/2</i> mutation had limited understanding of the distinction between mutation risk and breast cancer risk. Theory-based communication strategies are needed to increase the understanding of the implications of being at low risk for hereditary cancers.
In 1994, as part of their participation in the University of North Carolina Alumni Heart Study, 1101 women aged 45–51 years answered questions about their menopausal status and current use of hormone replacement therapy (HRT). Little is known about the use of HRT in younger women. We were interested in determining both patterns of HRT use and patient characteristics associated with HRT use in this cohort of women approaching the average age of menopause. After excluding women with breast, endometrial, and ovarian cancer, we studied 1080 women. These women identified themselves as: "There is no indication that I am near menopause" (stage 1, n = 326), "I think I may be close to or in the beginning stages of menopause but am not sure" (stage 2, n = 410), "I have begun menopause" (stage 3, n = 202), and "I have been through menopause" (stage 4, n = 142). The overall rate of HRT use was 22% (0% in stage 1, 8% in stage 2, 52% in stage 3, and 76% in stage 4). Both patterns of HRT use and patient characteristics associated with HRT use differed based on the woman's perception of her menopausal stage. In logistic regression models, where HRT use was the outcome variable, independent predictors of HRT use included stage of menopause, having had a hysterectomy, having had a bilateral oophorectomy, no family history of breast cancer, having had a pelvic examination in the last year, being married, and not participating regularly in physical exercise. A woman's perception of her stage in the process of reproductive aging correlates with her use of HRT. Informed decision making about HRT use should be tailored to the individual's perception of her menopausal stage.
Perceived stress and depressive symptoms were examined as correlates and predictors of smoking cessation during pregnancy in a sample of 819 pregnant smokers (454 baseline smokers and 365 baseline quitters). Women who quit early in pregnancy had lower levels of stress and depressive symptoms than baseline smokers. Adjusting for level of addiction and other demographic factors related to stress and depressive symptoms eliminated the significant association between depressive symptoms and smoking cessation. Lower levels of stress and depressive symptoms were not predictive of cessation in later pregnancy. Prenatal healthcare providers should continue to assess level of addiction and provide targeted intensive cessation interventions. Interventions that reduce stress and depression may also be of benefit to women who are continuing smokers in early pregnancy.
ABSTRACT: The family milieu provides a potential context for integrating smoking cessation and prevention activities to complement school‐based efforts. In this study, surveys were mailed to caregivers of elementary school children to assess demographics, smoking characteristics and attitudes, and receptivity to and preferred format for health promotion programs. Fifty‐three percent (n=276) of 501 caregivers responded. Among smokers, most did not want their children to smoke, and they wanted to quit themselves; 91% considered it important to involve their children in their smoking cessation attempts; and 70% expressed willingness to participate in health promotion for the entire family. Written materials either mailed home or brought home from school were the preferred program formats. These findings suggest the feasibility of a program in which adults and children work together at home on smoking cessation and prevention activities that might increase the effectiveness of school‐based smoking prevention messages.
<b><i>Purpose:</i></b> In this brief report, we ask whether women’s interpretation of breast cancer risk based on their low likelihood of carrying a <i>BRCA1/2</i> mutation is associated with their information-sharing behavior, and whether misinterpretation is associated with motives for sharing the result. <b><i>Methods:</i></b> Women in mammography clinics who completed a brief family history assessment and deemed to be at low likelihood of carrying a <i>BRCA1/2</i> mutation were asked to complete a 1-time online survey between June 2016 and January 2017. <b><i>Results:</i></b> One-third (44/148) of women shared their family history screen result with someone in their social network. Result information was shared largely with a first-degree female relative to express feelings of relief (77%, 33/43). There were no differences in likelihood of sharing based on breast cancer risk interpretation. However, women who misinterpreted the implications of the result for general breast cancer risk reported more motives to share the result with their social network than those who accurately interpreted their breast cancer risk. <b><i>Conclusions:</i></b> As family history-based screening for hereditary breast cancer is broadly implemented, the communication needs of the majority of women who will be unlikely of carrying a <i>BRCA1/2</i> mutation must be considered. The motives of women who misinterpreted the implications of this result for breast cancer risk suggest the possibility that miscommunication could be spread to the broader family network.
