Learning Objective #1: Understand the factors menopausal women with mobility impairments must consider when deciding to take hormone therapy

Learning Objective #2: Increase informed decision-making among menopausal women with mobility impairments

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Many menopausal women face uncertainty about the decision to take hormone therapy in the face of the 2002 discontinuation of the Women's Health Initiative. For women with mobility impairments, the choice can be especially complicated because their inactivity may put them at increased risk for thrombosis and osteoporosis. Using the Ottawa Decision Support Framework, this study compared the effects of two types of educational materials for menopausal women with mobility impairments. The nationwide sample consisted of midlife women (average age of 53 years) with disabling conditions such as post-polio, spinal cord injury, and multiple sclerosis. The majority were college graduates, but only 36% were working and 41% indicated they were not working because of their disability. Fifty-nine percent use mechanical assistance most or all the time. At pretest, 60% indicated that they had received too little – or no – information about the possible risks and benefits of hormone therapy. Women were randomly assigned to two groups: one received the North American Menopause Society's Menopause Guidebook and the other received a decision support booklet tailored to the concerns of women with mobility impairments. While both groups rated the materials easy to read, the group who received the materials tailored to women with disabilities rated it somewhat more relevant to the concerns of women with physical impairments (t=1.83, p<.07). There was no difference between groups; both groups significantly increased their HT knowledge (F=234.26, df=1/175, p<.001, partial eta squared=.57) and decreased their decisional conflict (F= 97.65, df=1/168, p<.001, partial eta squared=.37) after receiving the materials. The percentage of respondents who were uncertain about the decision to take hormone therapy also decreased significantly (F=20.18, df=1/175, p<.001, partial eta squared=.10). These findings suggest that written educational materials can enhance informed decision-making among women with mobility impairments.