title: Effectiveness of an integrative health-care model for climacteric-stage women.
abstract: OBJECTIVE
  To evaluate an integrative health-care model (IHCM) with an empowerment approach for self-care in terms of improving health-related quality of life (HR-QoL) and lifestyle.
  
  
  METHODS
  We conducted a field trial with one intervention (IHCM) and one comparison group receiving usual care (UC), with ex ante and ex post measurements. The IHCM was provided for 3 months to each woman in the first group, with follow-up of both groups at 3 and 6 months. The differences in differences estimator was used to assess the effect of intervention, adjusting for clinically important covariates in the framework of a generalized linear regression model.
  
  
  RESULTS
  A total of 380 women (IHCM 190 and UC 190) participated in the study. The differences in differences estimator between IHCM and UC for aerobic physical activity was 81 and 87 min/week at 3 and 6 months, respectively; for consumption of dairy products, fruit and vegetables the estimator was 4.8, 6.6 and 9.4 servings per week respectively at 3 months, and 3.9, 6.3 and 9.7 servings at 6 months. The effect of IHCM on HR-QoL at 3 months was greater for the domains of vasomotor, somatic symptoms and sleep problems (11.7, 10.0 and 13.2 points, respectively); at 6 months the differences of major positive change were observed in the domains of memory/concentration, vasomotor symptoms and sleep problems (12.2, 10.4 and 10.8 points, respectively).
  
  
  CONCLUSIONS
  The results support the importance of patient-centered health care during the climacteric stage, within integrative care programs with an empowerment approach.
authors.affiliation: Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, México DF.
authors.forename: S V
authors.initials: SV
authors.lastname: Doubova
authors.forename: C
authors.initials: C
authors.lastname: Infante-Castañeda
authors.forename: P
authors.initials: P
authors.lastname: Espinosa-Alarcón
authors.forename: S
authors.initials: S
authors.lastname: Flores-Hernández
authors.forename: I
authors.initials: I
authors.lastname: Martinez-Vega
authors.forename: R
authors.initials: R
authors.lastname: Pérez-Cuevas
mesh_terms: D001288:Attention; D003611:Dairy Products; D004032:Diet; D015444:Exercise; D005260:Female; D005638:Fruit; D019584:Hot Flashes; D006801:Humans; D055048:Integrative Medicine / Q000379:methods*; D008019:Life Style; D008568:Memory; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009752:Nutritional Status; D018802:Patient-Centered Care; D011788:Quality of Life; D012648:Self Care; D012893:Sleep Wake Disorders; D012944:Social Support; D011795:Surveys and Questionnaires; D014675:Vegetables