title: Women's responses to a mailed hormone replacement therapy workbook.
abstract: OBJECTIVE
  Effectively communicating information about the complex decisions that face women at midlife, including whether to use hormone replacement therapy (HRT), is an ongoing challenge. Although numerous decision-making tools exist, few have been evaluated. The objective of this study was to examine women's use of a workbook designed to promote informed HRT decision-making.
  
  
  METHODS
  We developed a workbook to prepare women to discuss HRT, osteoporosis, heart disease, and breast cancer with their providers. To evaluate the workbook, women aged 45-65 years were randomly assigned to one of three groups: (1) workbook plus baseline and 6-month surveys, (2) workbook and 6-month survey, or (3) no workbook with both surveys. Results are based on the responses of 580 women in groups 1 and 2 (response rate, 84.2%).
  
  
  RESULTS
  At 6 months, 79% of women recalled receiving the workbook, of whom 51% read all or most of it, 35% skimmed or read part of it, and 14% did not read it. The percentages of women completing self-assessments were 55% osteoporosis; 56% heart disease; 58% breast cancer; 57% advantages and disadvantages of HRT; and 52% personal preferences about HRT. As a result of the workbook, 10% made an appointment with their providers, and 12% had a discussion about HRT with their providers. Use of the workbook was not associated with menopause symptoms, attitudes about or use of HRT, hysterectomy, or provider discussions about menopause and HRT.
  
  
  CONCLUSIONS
  This simple approach of using a mailed workbook holds promise as a successful mechanism to prepare women to discuss HRT and other related health issues with their providers.
authors.affiliation: Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA. newton.k@ghc.org
authors.forename: K M
authors.initials: KM
authors.lastname: Newton
authors.forename: A Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: D S
authors.initials: DS
authors.lastname: Buist
authors.forename: K M
authors.initials: KM
authors.lastname: Delaney
authors.forename: L A
authors.initials: LA
authors.lastname: Anderson
mesh_terms: D003657:Decision Making; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations