ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW, Ethnicity, Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama ENDOW Ethnicity Needs Decision of Women UAB UAB DOPM Division of preventive medicine Beth Lewis Carol Lewis Beth Lewis Trena Johnsey Rex Bomhold Rex Bomhold NIH NIH NIH UAB DOPM DR. BETH LEWIS ENDOW ENDOW ENDOW ENDOW ENDOW http://www.dopm.uab.edu/index.html http://www.dopm.uab.edu/cardia/index.html http://www.dopm.uab.edu/coere/index.html http://www.dopm.uab.edu/index.html http://www.uab.edu/index.html http://www.yahoo.com http://www.netscape.com HOME PAGE HOME HOME HOME HOME ENDOW ENDOW ENDOW UAB UAB UAB DOPM DOPM DOPM DPM DPM DPM DPM DOPM UAB UAB University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham University of Alabama at Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Birmingham Alabama Alabama Alabama Alabama Alabama Alabama Alabama Program AGENDA Community Prevention Research in Women's Health Conference Co-sponsored by:Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; the National Institutes of Health, National Heart, Lung and Blood Institute’s Women’s Health Initiative, the American Heart Association Council on Epidemiology and Prevention; and the University of Alabama School of Medicine, Divisions of Continuing Medical Education and Preventive Medicine Masur Auditorium National Institutes of Health Bethesda, Maryland October 26-27, 2000 Certified for 11 hours in Category 1 credit Thursday, October 26, 2000 8:00 a.m. Welcome /Opening Remarks Moderator: Loretta P. Finnegan, MD, Medical Advisor to the Director Office of Research on Women's Health, National Institutes of Health Speakers: Ruth L. Kirschstein, MD, Acting Director, National Institutes of Health Claude Lenfant, MD, Director,National Heart, Lung and Blood Institute Janet L. Collins, PhD, Deputy Director,Centers for Disease Control and Prevention Vivian W. Pinn, MD, Director,Office of Research on Women's Health, National Institutes of Health Lynda S. Doll, PhD, Director, Prevention Research Centers, Centers for Disease Control and Prevention 9:00 a.m. Plenary Session I: Cardiovascular Disease Moderator: Denise G. Simons-Morton, MD, PhD, Leader, Prevention Scientific Research Group, Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute Speakers: Diane M. Becker, ScD, MPH, John Hopkins University "Reducing CVD Risk Among Black Women" Carol E. Cornell, PhD, University of Alabama at Birmingham "Peer Support Intervention for Cardiovascular Disease Risk Among African-American Women" Discussant: Stephen P. Fortmann, MD, Stanford University School of Medicine Center for Research in Disease Prevention 10:45 a.m. Break 11:00 a.m. Poster session 12:00 noon Lunch 1:00 p.m. Plenary Session II, Physical Activity Moderator: Elaine Stone,PhD,National Heart, Lung and Blood Institute Speakers: Ba rbara E. Ainsworth, PhD, MPH, University of South Carolina "Assessment of Moderate Physical Activity Among Women" (CAPS) Louise Masse, PhD, University of Texas - Houston "Women on the Move" Ross C. Brownson, PhD, Director, St. Louis University, School of Public Health, Prevention Research Center "Environmental and Policy Interventions to Increase Physical Activity Among Minority Women ages 40-75 " Discussant: Andrea Kriska, MD, University of Pittsburgh, Department of Epidemiology, Graduate School of Public Health 2:45 p.m. Break 3:00 p.m. Plenary Session III, Diabetes Moderator: Lynda A. Anderson, PhD, Leader, Prevention Scientific Research Group, Centers for Disease Control and Prevention Speaker: Thomas C. Keyserling, MD, MPH, University of North Carolina - Chapel Hill "Improving the Delivery of Diabetes care to Women in Minority Groups" Discussant: Robert M. Anderson, EdD, University of Michigan, Department of Medical Education 4:00 p.m. Plenary Session IV, Organizations with Scientific Interests in Women's Health Moderator: Robert A. Wild, MD, Professor, University of Oklahoma, Health Medical Center National Osteoporosis Foundation, Sandra Raymond Robert Wood Johnson Foundation (invited) Lilly Foundation for Women's Health (invited) American Heart Association, Lori Mosca, MD, MPH, PhD 5:00 p.m. Poster Session Friday, October 27, 2000 8:00 a.m. Plenary Session V, Menopause, HRT and Healthcare Decision-Making: Moderator: Lynne S. Wilcox, MD , MPH, Director, Division of Reproductive Health, Centers for Disease Control and Prevention "ENDOW, Ethnicity, Needs & Decision of Women" Speakers: Cora E. Lewis, MD, MSPH, University of Alabama at Birmingham Carla J. Herman, MD, MPH, University of New Mexico Robert E. McKeown, PhD, University of South Carolina Janet Y. Groff, MD, PhD, University of Texas - Houston Discussant: Susan L. Hendrix, DO, Associate Professor, Obstetrics & Gynecology Director, Women's Health Initiative, Wayne State University/Hutzel Hospital 9:30 a.m. Break 9:45 a.m. Plenary Session VI, Me nopause and Hysterectomy Research Moderator: Wanda K. Jones, DrPH, Deputy Assistant Secretary for Health Office of Women's Health, Department of Health and Human Services Speakers: "Study of Women Across the Nation" (SWAN) Project , Sheryl Sherman, MD, Director, Clinical Endocrinology and Osteoporosis Research, National Institute on Aging "Conventional Complimentary Alternative Menopause Practices" (CCAMP). Saralyn Mark, MD, Senior Medical Advisor, Office of Women's Health, Department of Health and Human Services Agency for Healthcare Research and Quality - Hysterectomy Trials: A. Eugene Washington, MD, MSc, Professor and Chair, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco 11:30 a.m. Poster Session 12:30 p.m. Lunch 1:30 p.m. Plenary Session VII, Osteoporosis Moderator: Patricia L. Riley , CNM, MPH,Director, CARE-CDC Health Initiative, Office of Global Health, Centers for Disease Control and Prevention Speakers: Brenda M. Devellis, PhD, and Susan Blalock, PhD, University of North Carolina at Chapel Hill "Addressing the Effectiveness of Community Outreach Intervention for Women in Improving Osteoporosis Prevention Behaviors" Discussant: Joan McGowan, MD , Chief, National Institutes of Arthritis & Musculoskeletal and Skin Diseases, National Institutes of Health 2:30 p.m. Plenary Session VIII, Contribution of the WHI/CPS to Prevention Research and Changing Behaviors in Minority Women Introduction: Vivian W. Pinn, MD, Office of Research on Women's Health, National Institutes of Health Speaker: Shiriki Kumanyika, PhD, MPH, RD , Associate Dean for Health Promotion and Disease Prevention, University of Pennsylvania, School of Medicine,Center for Clinical Epidemiology and Biostatistics 3:30 p.m. Closing Remarks Cora E. Lewis, MD, MSPH, Associate Professor of Medicine University of Alabama at Birmingham, Division of Preventive Medicine All material on this server Copyright & COPY; 1999+ by the publishers involved. All rights reserved. Abstraction WEB EX PRESS, **** ERROR *** ABSTRACT WEB EXPRESS ***ERROR*** An Error Was Found In Your Abstract Submission... Probably you either left one or more of the required fields on the form blank. You should fill in all required fields; these are highlighted in green. Click your browser's "Back" button to return to the registration form, then correct any errors and resubmit it. If you continue to have problems, please email tjohnsey@dopm.uab.edu abspnumb Community Prevention Research in Women's Health Conference "Featured Original Research" poster session (including abstracts) Thursday, October 26, 2000, 11:00 am Program Number Authors Title P1 Eyler, AA. Wilcox S, Matson-Koffman D, Evenson K, Snaderson B, Wilbur J, Young D, Vest J A Review of Determinants of Physical Activity Among Women of Different Racial/Ethnic Populations P2 Housemann, R, Baker, O'Neall, Luke, Brownson R, A Theory-Driven Demonstration of Factors Influencing Walking and Walking Trail Use Among Women in Rural Communities P3 Matson-Koffman, D Wattingney WA, Bazzarre T, Mosca L, Redberg R, Schmid T Predictors of Successful Change in Physical Activity Level in Women: The American Heart Association 1999 Choose to Move Program P4 Ainsworth, BE LaMonte MJ, Drowatzky KL, Cooper RS, Thompson RW, Irwin ML, Whitt MC, Gilman M Evaluation of the CAPS Typical Week Physical Activity Survey (TWPAS) Among Minority Women: SIP 22W P5 Moore, WE, Oman RF, Eichner JE The Intermethod Reliability of a Self-Assessed and a Shortened One-Mile Walk Test P6 LaMonte, MJ. Ainsworth BA, Whitt MC, Cooper RS, Drowatzky KL, Thompson RW, Irwin ML, Gilman M Accuracy of a Four-Week Physical Activity History (FWH) Among Minority Women: SIP 22W P7 Wilcox, S, Richter DL, Henders KA, Ainsworth BA, Greaney M The Determinants of Physical Activity in Rural African American Women Ages 20 to 50 Years P8 Wilbur, JoEllen, Chandler P, Miller A Measuring Adherence to a Women's Walking Program P9 Wolf HJ, Brett JA, Melanson EA, Marshall JA Physical Activity Patterns in Second Graders and Their Families in a Rural Biethnic Community in Southern Colorado P10 Littleton, MaryAnn, Cornell CE, Pulley L, Mukherjee, S The Relationship between Stress, Coping and Cardiovascular Disease Risk in African-American Women Living in Rural Alabama P11 Littleton, MaryAnn, Cornell CE, Pulley L, Mukhergee S Validation of Stress and Coping Measures Used to Study the Relationship between Stress coping and Cardiovascular Disease Risk P12 Plach, SK Social Role Quality, Physical Health and Well-being in Women After Heart Surgery P13 Williams AM, Wold J African Women: Urban and Rural Work Site Prevention of CVD P14 Benedict S, Belton L, Tessaro I, Campbell M, Kelsey K, DeVellis B Health Works for Women P15 Wheeler, K, Lewis CE, Williams, OD, Sidney S, Kiefe CI, Hulley S Oral Contraceptives and Cardiovascular Disease Risk in African-American and White Woman: the CARDIA Study P16 Ping Sun, Dwyer James H. Can Female Hormones Reduce Smoking Induced Atherogenesis P17 Roehm, JB, Wegen, J, Boccuzzi, SJ. Gender similarities in Lipid-lowering Pharmacologic Management in Newly Treated Diabetes P18 Simkin-Silverman Laurey, Boraz Miriam A, Milas N. Carole Kuller Lewis H Weight Gain Prevention During Menopause: Dietary and Physical Activity Profile of Successful Women P19 Nembhard, WN., Davis SK, liu Y Obesity, Extreme Obesity and Associated Social Factors Among Women of Color: the Third National Health and Nutrition Examination Survey, 1988-1994 P20 Parker, DR, Laster TM, Windsor R, Wilkins J, Upegui D, Heimdal J The Accuracy of Self-Reported Smoking Status Assessed by Cotinine Test Strips P21 Calogerakis Cheryl B. Women's Health: Interventions for Smoking Cessation P22 Patterson F, Gray TS, Miller SM The Development of a Targeted Printed Cancer Education material (PCEM) to Promote Smoking Cessation among Women at Risk for Cervical Cancer P23 Cherrington, A, Wheeler K, McCreath H, Lewis CE Association of Alternative Medicine Use and Hysterectomy: The ENDOW Study P24 Richter, DL, McKeown RM, Greaney M Hysterectomy: What Women Want to Know P25 Harri s, MJ, Richter DL, McKeown RM, Saunders R, Watkins K, Parra-Medina D, Lewis, CE Racial differences in predictors of hysterectomy status among women who have similar signs and symptoms: A model of determinants P26 Covington, CY Development of a PAP Process for Breast Cancer: Intervention Trial to Enhance Nipple Aspirate Fluid Yield and Cellularity P27 Geller, SE, Derman R Knowledge, Attitudes and Risk Factors for Osteoporosis Among African American and Hispanic Women P28 Salina. DD, Leandak LM, Razzano L, Hamilton, Marie Developing Community Linkages and Social Support to Reduce the Risk of HIV Among Inner City Women P29 Holt, BY, Syme L, Tabnak F, Sun R. Tager I STD Infections Among Low Income, Urban Women: A Multilevel Assessment of Factors that Help Some Women Remain Healthy P30 Salder, AG, Booth BM, Cook BL, Doebbeling B Repeated Violence Against Women During Military Service: Effects on Health Status and Outpatient Medical Utilization P31 Salder, AG, Booth BM, Cook BL, Torner JC, Doebbeling B The Military Environment: Risk Factors for Women's Non-Fatal Assaults Community Prevention Research in Women's Health Conference The abstract submission deadline is Friday, July 28, 2000. Any abstract that is in the areas of prevention research in women's health and/or commuity prevention research will be considered. Abstracts are restricted to 250 words and should fit into one of the following categories CVD, Cancer, Osteoporosis, Rheumatic/Musculoskeletal, Menopause/menstrual/Hormone Replacement Therapy, Physical Activity, Health Behavior/psychosocial, Smoking, Nutrition/Obesity, Health Services, Infectious diseases/HIV, Diabetes, Medical Decision-making, and Hysterectomy Research. All abstracts will be poster presentations and a total of three poster sessions will be held during the conference. Abstracts will be considered that represent original work, data that have not been previously presented or published, or data that have been published or presented within the 12 months previous to the conference. - Online A bstract Submission Form - (The online submission is a four step process, you must complete each step to advance) or - Adobe Acrobate format Abstract Submission Form (to be printed, filled out and faxed)- Or, abstract forms and instructions can also be requested by fax at (205) 934-7959. Attn: Trena Taylor Johnsey Assistant to Cora E. Lewis, MD, MSPH University of Alabama at Birmingham Division of Preventive Medicine 1717 11th Avenue South, MT 730 Birmingham, AL 35205 Phone (205)934-6383 Community Prevention Research in Women's Health Conference ABSTRACT SUBMISSION FORM: *** Abstract Deadline extended until July 28, 2000 *** Please complete the following form and click on the submit abstract due by July 28, 2000. All GREEN ITEMS REQUIRED Name: Dr.Mr.Ms.Mrs. First Middle Initials Las t Orgainzation: Address: City Prov/State Zip Country Daytime Phone Number ()-ext. Fax Number ()- E-Mail: First Author:List any conflicts of interest Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 2nd Author:List any conflicts of interest. Grants/Research Support NoYesifYes, State: Consultant NoYesifYes,State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 3rd Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 4th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 5th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: C onsultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 6th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 7th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 8th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: Abstract Title: Please format the abstract as follows: (Limit total to 250 words) Rationale Objectives Methods Results Conclusion Classification:Cardiovascular DiseaseCancerOsteoporosisRheumatic/MusculoskeletalMenopause/menstrual/Hormone Replacement TherapyPhysical ActivityHealth Behavior/psychosocialSmokingNutrition/ObesityHealth ServicesInfectious diseases/HIVDiabetesMedical Decision-makingHysterectomy Direction to Conference Advertisements American Journal of Public Health (May 2000, Vol. 90, No 5) JAMA (May 24/31, 2000) Journal of Women's Health & Gender-Based Medicine (May 2000, Volume 9, Number 4) (June 2000, Volume 9, Number 5) (July/August 2000, Volume 9, Number 6) All material on this server Copyright © 1999+ by the publishers involved. All rights reserved. APHA1999 Presentation at the APHA 1999 Annual Meeting November 7-11 1999 Chicago, Illinois The ENDOW Study: Ethnicity, Needs, and Decisions of Women Cora E. Lewis, MD, MSPH, University of Alabama at Birmingham, Suzanne G. Folger, PhD, Centers for Disease Control and Prevention The ENDOW Study: Attitudes toward Menopause in a Multi-ethnic Robert E. McKeown PhD, University of South Carolina Ethnic & Geographic Variation in Women’s Use and Attitudes Toward Hormone Replacement Therapy Carla J. Herman, MD, MPH, University of New Mexico Women’s Preferences for Involvement in Medical Decisions Jan Y. Groff, MD, PhD, University of Texas-Houston Untitled Document ENDOW  Awards ENDOW award winning video entitled: Hysterectomy: The Decision is Yours Written and Produced by: Hall & Foushee Communications, Inc Minneapolis, MN Bronze TELLY award receipt International Silver CINDY award receipt The purpose of this 15-minute video, entitled Hysterectomy: the Decision is Yours, is to educate women in effective ways of communicating with their health care providers about hysterectomy, and to teach decision making skills that women can use in making decisions about these surgeries. The target audience is women who have been told that they may need a hysterectomy or who have conditions for which hysterectomy is a treatment option. For a copy of this award winning video please contact: Trena Taylor Johnsey, BA University of Alabama at Birmingham Division of Preventive Medicine 1717 11th Avenue South, MT 730 Birmingham, Alabama 35205 (205) 934-6383 E-mail: tjohnsey@dopm.uab.edu overview Intervention Materials Page 2 overview Page 1 Page 3  overview Page 2 Page 4 overview Page 3 Page 5 overview Page 4 Page 6 overview Page 5 Intervention Materials blank ENDOW RESTRICTED AREA Study Group Conference Call Minutes January 8, 1999 at 11:00 am CDT MINUTES: STUDY GROUP CONFERENCE CALL Attendees: Dr. Robert McKeown, and Donna Richter, University of South Carolina; Dr. Carla Herman, Ina Bawaya, and Dr. Clo Mingo, University of New Mexico; Dr. Jan Groff, University of Texas - Houston, Chris Galavotti, and Suzanne Folger, CDC, Dr. Beth Lewis, Dr. Dale Williams, Dr. LeaVonne Pulley, Dr. Carol Cornell, Shannon Houser, Dr. Heather McCreath, Dr. Roma Williams and Trena Johnsey, University of Alabama at Birmingham. Agenda : Return to ENDOW home page. All material on this server Copyright COPY; 1997-99 by the publishers involved. brochure Program Description and Objectives: The Community Prevention Research in Women's Health Conference will showcase results from the 11 Women's Health Initiative Community Prevention Studies, research projects funded by the National Institutes of Health and the Centers for Disease Control and Prevention. The projects employed innovative intervention and evaluation methods to address health needs of women, with a focus on minority women. Venue: The conference will be held at the Masur Auditorium, Na tional Institutes of Health, Bethesda, MD. It will begin on Thursday, October 26, at 8:00 am with opening remarks from the National Heart, Lung, and Blood Institute, National Institutes of Health,and Centers for Disease Control and Prevention. Sessions will follow throughout both days covering topics in CVD, Physical Activity, Diabetes, Osteoporosis, Medical Decision-making, Menopause, HRT and Hysterectomy Research. Sessions will showcase one or more of the WHI/CPS projects. Other invited speakers will present information from projects of interest in women's health. Leaders in the fields of prevention research will be discussants. Conference Highlights: Presentations from invited studies such as the Study of Women across the nation (SWAN), Conventional Complementary Alternative Menopause Practices (CCAMP), and Agency for Healthcare Research and Quality - Hysterectomy Trials. Commintment of Foundations to Prevention Research in Women's Health Poster Sessions will be held on both days for WHI/CPS project displays and additional accepted abstracts. Abstract submissions are invited for poster sessions on prevention research in women's health and/or commuity prevention research. Continuing Education Credits: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) by the University of Alabama School of Medicine, Divisions of Continuing Medical Education and Preventive Medicine and the National Institutes of Health, National Heart, Lung and Blood Institute's Women's Health Initative; and the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion and the American Heart Association Council on Epidemiology and Prevention. The University of Alabama School of Medicine, Divisions of Continuing M edical Education and Preventive Medicine and the National Institutes of Health, National Heart, Lung and Blood Institue's Women's Health Initiative; and the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion and the American Heart Association Council on Epidemiology and Prevention are accredited by the ACCME to provide continuing Medical education to physicians. The University of Alabama School of Medicine designates this activity for up to 11 hours in category 1 credit towards the AMA Physicians Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. "UAB is an equal opportunity/affirmative action institution." Certificates of participation will be provided to all attendees. Objectives: Attendees will: Review effective methods of assessing physical activity in women. Discuss methods for preventing cardiovascular disease through risk modification, including dietary, physical activity, and smoking cessation interventions. Outline methods for osteoporosis prevention through appropriate screening and nutritional interventions. Describe methods for managing diabetes mellitus in minority women. Promote shared health care decision-making between diverse groups of women and their health care providers Co-sponsored by: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; the National Institutes of Health, National Heart, Lung and Blood Institute’s Women’s Health Initiative, the American Heart Association Council on Epidemiology and Prevention; and the University of Alabama School of Medicine, Divisions of Continuing Medical Education and Preventive Medicine, and the UAB Center for Health Promotion October 26 -27, 2000 Masur Auditorium National Institutes of Health Bethesda, Maryland Abstract submissions:The abstract submission deadline is July 28, 2000. Any abstract that is in the areas of prevention research in women's health and/or commuity prevention research will be considered. Abstracts are restricted to 250 words and should fit into one of the following categories CVD, Physical Activity, Diabetes, Osteoporosis, Medical Decision-making, Menopause, HRT and Hysterectomy Research. All abstracts will be poster presentations and a total of three poster sessions will be held during the conference. Abstract forms and instructions can be requested by fax at (205) 934-7959. Registration: There is no conference registration fee. Attendees should register for the conference by contacting Adventure Travel by mail at Adventure Travel, 1810 Merchants Drive, Birmingham, AL 35244, attn: Angela Vernon, by e-mail at angelav@adtrav.com., by phone at 1-800-635-7139 or by fax at (205) 444-5004 . Registration for the Community Prevention Research in Women's Health Conference allows attendees to participate in the conference from Thursday, October 26 at 8:00 am until Friday, October 27 at 4:00 PM including breakfast,and breaks for both days. Hotel Accommodations: The conference has reserved a limited block of rooms for invited guests and conference participants at special reduced rates. Rooms will be available until all are filled or until the cut-off-date of September 15, 2000. To take advantage of these rates, and other travel discounts including airfare, you may contact Adventure Travel, 1810 Merchants Drive, Birmingham, AL 35244, attn: Angela Vernon, by e-mail at angelav@adtrav.com. by phone at 1-800-635-7139 or by fax at (205) 444-5004. These rooms are single and double occupancy and are subject to state and local taxes in effect at the time of the conference. The Pooks Hill Marriott is located just minutes from the NIH campus. The Holiday Inn Bethesda is located just minutes from the metro and the NIH campus. All material on this server Copyright © 1999+ by the publishers involved. All rights reserved. overview Intervention Materials Page 2 overview Page 1 Page 3 overview Page 2 Page 4 overview Page 3 Page 5 overview Page 4 Page 6 overview Page 5 Intervention Materials CDCNIH1999 CDC/NIH Special Interest Projects Community Prevention Study February 2, 1999 Title: ENDOW: Ethnicity, Needs and Decisions of Women (SIP 25W) Participating Institutions and Principal Investigators: University of Alabama at Birmingham, Field Center and Coordinating Center PI: Cora E. Lewis, M.D., M.S.P.H. University of New Mexico, Field Center PI: Carla Herman, M.D. University of South Carolina, Field Center PI: Robert McKeown, Ph.D. University of Texas at Houston, Field Center PI: Jan Groff, M.D., Ph.D. Address: Cora E. Lewis, M.D., M.S.P.H. Division of Preventive Medicine Department of Medicine University of Alabama at Birmingham 1717 11th Avenue South, Room 734 Birmingham, AL 35205 1) Project ai ms Endow is a multicenter, collaborative project with the following specific aims: A) to examine the factors that influence women’s choices and how women approach decisions regarding hysterectomy, oophorectomy and postmenopausal hormone replacement therapy (HRT), with special emphasis on exploring the potential roles of cultural identity and ethnicity, B) to develop materials and dissemination strategies to enhance women’s decision-making regarding hysterectomy, oophorectomy and HRT, and C) to evaluate developed interventions in communities. 2) Methodology The project is a 5-year multicenter study to be conducted in three phases: Phase I - to examine with qualitative and quantitative data the factors that influence women’s choices and how women approach decisions regarding hysterectomy, oophorectomy and postmenopausal hormone replacement therapy (HRT), with special emphasis on exploring the potential roles of cultural identity and ethnicity; Phase II - to use the information from Phase I in development of interventions to enhance women’s decision-making regarding hysterectomy, oophorectomy and HRT, and to develop dissemination strategies for these materials; Phase III - to evaluate intervention materials and dissemination strategies. 3) Progress Phase I activities: C Developed collaborative structure, including a steering committee and relevant subcommittees (publications, qualitative, survey development, data management and intervention development). C Developed focus group guides for common qualitative data collection across centers. C Conducted 78 focus groups with 485 women, 32% African-American, 32% Hispanic/Mexican-American, 23% nonHispanic white, 12% Native American and 1% other or unknown, as well as individual interviews and focus groups with men and providers in some sites. C Analyzed and used focus group data to inform development of a survey including core items common to all participating sites, as well as items spe cific to one or more sites, given the unique characteristics of the different populations. Core data include: sociodemographics, reproductive history and intentions, menopausal status and attitudes, satisfaction with and access to medical care, hysterectomy outcome expectations and normative beliefs, HRT outcome expectations and normative beliefs, autonomy preference index, and assessment of overall health status. C Developed sampling strategies and common training protocols for core data collection. The centers planned for community and clinic- or hospital-based recruitment of women, with some centers planning for a sample of male partners. C Developed English, Spanish, and Navajo language versions of the survey. C Conducted pretesting and test/retest surveys. C Implemented survey in the field. C Developed in implemented data management and analysis procedures for common dataset ENDOW Survey Activities to Date Survey Activity Total African-American Hispanic Native American Non-Hispanic White Other Test/Retest 278 88 101 0 87 2 Survey 2641 773 377 385 1106 ??? Total 2919 861 478 385 1193 ??? Phase II activities: C Began exploration of intervention materials and dissemination strategies to be used, considering the unique needs of the different population groups represented. Materials considered include video tapes, pamphlets, community-based educational and support group programs, and possibly computer-based technologies (e.g., CD-ROM) Obtained supplementary funding for video tape development, and awarded subcontract for development activities with outstanding health education media group. 4) Future plans and time line. Future plans include completion of the survey data activities, analysis and reporting of survey results, further development of interventions and dissemination strategies, and evaluation. Time line: Year 1 (1995-1996) C Establish collaboration, design and implement focus group data collection, begin focus group data analysis Year 2 (1996-1997 ) C Continue focus group data analyses, design and implement survey, begin planning for intervention development Year 3 (1997-1998) C Complete survey data collection, conduct analyses of survey data, continue intervention and dissemination plan development Year 4 (1998-1999) C Continue analyses of survey data, complete intervention and dissemination plan development Year 5 (1999-2000) C Evaluate interventions and dissemination plans 5) Contribution to prevention in minority women ENDOW will develop interventions to facilitate more informed health care decision-making regarding choices faced by many women: decisions surrounding hysterectomy and HRT. In addition, we will collect important information on the decision-making preferences and communication skills of diverse groups of women which will likely prove generalizable to other aspects of women’s health care. Cindy International silver CINDY award winner Title of Entry: Hysterectomy: The Decision is Yours Written and Produced by: Hall & Foushee Communications, Inc Minneapolis, MN CINDY, an acronym for "Cinema in Industry," began in 1959 as an industrial film competition. It was originally created by the Industry Film Producers Association (IFPA), an American professional organization. Later, this group became the Informational Film Producers of America and, in 1984, the Association of Visual Communicators (AVC). Today the twice-a-year CINDY Awards are proudly presented by the International Association of Audio Visual Communicators (IAAVC), a non-profit group representing theatrical, broadcast, non-broadcast, and interactive media professionals throughout the world. As the market for industrial films has evolved into video and other media formats over the years, CINDY has changed dramatically. Interactive media was added in 1985, making CINDY the first interactive media competition in the world. Today CINDY cntinues to honor the informational media producer but has expanded to embrace all production professionals. The International Cinema in Industry (CINDY) award has developed into the premier international audio-visual competition for both linear and interactive media. Out of nearly 3400 entries in the Spring 2000 Edition of the 42nd annual cinema in industry competitions, our award winning entry placed in the top 15% of all programming entered. This year, CINDY entries included web sites, CD-Roms, audio tapes and video tapes came from 28 countries world wide. A host of formats are represented in the competition, including film, video, audio, multi-image, and interactive multimedia. Preliminary panels view all entered productions and advance the top scoring entries to Blue Ribbon panels which decide final awards. Productions advancing to Blue Ribbon panels will receive an award. The purpose of this 15-minute video, entitled Hysterectomy: the Decision is Yours, is to educate women in effective ways of communicating with their health care providers about hysterectomy, and to teach decision making skills that women can use in making decisions about these surgeries. The target audience is women who have been told that they may need a hysterectomy or who have conditions for which hysterectomy is a treatment option. Participating Institutions: University of Alabama at Birmingham, Field Center and Coordinating Center University of New Mexico, Field Center University of South Carolina, Field Center University of Texas at Houston, Field Center Executive Producers: Cora E. Lewis, M.D., M.S.P.H., University of Alabama at Birmingham Carla Herman, M.D., University of New Mexico Robert McKeown, Ph.D., University of South Carolina Janet Y. Groff, M.D., Ph.D., University of Texas - Houston The ENDOW Investigative Team Coordinating Producers: Donna Richter, EdD, University of South Carolina Carol E. Cornell, PhD, University of Alabama at Birmingham Janet Y. Groff, MD, PhD, University of Texas - Houston Patricia Dolan-Mullen, DrPH, University of Texas - Houston Clo Mingo, PhD, University of New Mexico Ina Baway a, MFA, University of New Mexico Video Coordination Team Adriana Linares, M.D., MPH, University of Texas - Houston Rachel Saunders, University of South Carolina Special thanks to all those individuals who were interviewed. Sponsored by: The ENDOW (Ethnicity, Needs, Decisions of Women) Project is a collaborative effort supported by the Women's Health Initiative, National Institutes of Health, and the Prevention Research Centers Program, Centers for Disease Control and Prevention. Copyright 1999 The Board and Trustees of the University of Alabama at Birmingham cmeObject Objectives Attendees will: Review effective methods of assessing physical activity in women. Discuss methods for preventing cardiovascular disease through risk modification, including dietary, physical activity, and smoking cessation interventions. Outline methods for osteoporosis prevention through appropriate screening and nutritional interventions. Describe methods for managing diabetes mellitus in minority women. Promote shared health care decision-making between diverse groups of women and their health care providers. Type of CME Activity This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) by the University of Alabama School of Medicine, Divisions of Continuing Medical Education and Preventive Medicine and the National Institutes of Health, National Heart, Lung and Blood Institute's Women's Health Initiative; and the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion and the American Heart Association Council on Epidemiology and Prevention. The University of Alabama School of Medicine, Divisions of Continuing Medical Education and Preventive Medicine and the National Institutes of Health, National Heart, Lung and Blood Institute's Women's Health Initiative; and the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion and the American Heart Association Council on Epidemiology and Prevention are accredited by the ACCME to provide continuing medical education to physicians. The University of Alabama School of Medicine designates this educational activity for up to 11 hours in Category 1 credit towards the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. "UAB is an equal opportunity/affirmative action institution." Certificates of participation will be provided to all attendees. Course Director: Cora E. Lewis, MD, MSPH, Division of Preventive Medicine, UASOM Planning Committee: University of Alabama at Birmingham, School of Medicine, Center for Health Promotion Cora E. Lewis, MD, MSPH, Associate Professor, Division of Preventive Medicine (Program Chair) Carol E. Cornell, PhD, Assistant Professor, Division of Preventive Medicine James M. Raczynski, PhD, Professor, Division of Preventive Medicine Trena Taylor Johnsey, BA, OAII, Division of Preventive Medicine, (Program Assistant) National Institutes of Health Loretta P. Finnegan, MD, Medical Advisor to the Director, Office of Research on Women’s Health Centers for Disease Control and Prevention Lynda S. Doll, PhD, Director, Prevention Research Centers Antonia J. Spadaro, EdD, RN, Research Support Officer Lynda A. Anderson, PhD, Health Scientist University of South Carolina Barbara E. Ainsworth, PhD, MPH, Director, Prevention Research Center St. Louis University Ross C. Brownson, PhD, Director, Prevention Research Center List of Faculty: Barbara E. Ainsworth, PhD, MPH, University of South Carolina Lynda A. Anderson, PhD, CDC Pamela Anderson, MD, Lilly Foundation for Women's Health Robert M. Anderson, EdD, University of Michigan Diane M. Becker, ScD, MPH, John Hopkins University Susan J. Blalock, PhD, University of the Pacific Ross C. Brownson, PhD, St. Louis University Janet L. Collins, PhD, CDC Brenda M. Devellis, PhD, University of North Carolina, Chapel Hill Carol E . Cornell, PhD, University of Alabama at Birmingham Lynda S. Doll, PhD, CDC Loretta P. Finnegan, MD, NIH Stephen P. Fortmann, MD, Stanford University Janet Y. Groff, MD, PhD, University of Texas -Houston Linda B. Haas, Susan L. Hendrix, DO, Wayne State Carla J. Herman, MD, MPH, University of New Mexico Wanda K. Jones, DrPH, HHS Nora L. Keenan, PhD, Centers for Disease Control Thomas C. Keyserling, MD, MPH, University of North Carolina - Chapel Hill Ruth L. Kirschstein, MD, NIH Andrea Kriska, MD, University of Pittsburgh Shiriki K. Kumanyika, PhD, MPH, RD, University of Pennsylvania Lee A. Learman, MD, PhD, University of California, San Francisco Claude Lenfant, MD, NHLBI Cora E. Lewis, MD, MSPH, University of Alabama at Birmingham Saralyn Mark, MD, HHS Louise Masse, PhD, University of Texas - Houston Joan McGowan, MD, NIAMS Robert E. McKeown, PhD, University of South Carolina Lori Mosca, MD, MPH, PhD, New York Presbyterian Hospital Sandra Raymond, NOF Donna L. Richter, DrPH, University of South Carolina Patricia L. Riley, CNM, MPH , CDC Sheryl Sherman, MD, NIA Denise G. Simons-Morton, MD, PhD, NHLBI Elaine Stone, PhD, NHLBI Vivian W. Pinn, MD, NIH Robert A. Wild, MD, University of Oklahoma Lynne S. Wilcox, MD, MPH, CDC All material on this server Copyright & COPY; 1999+ by the publishers involved. All rights reserved. columbia Presentation at the 1st International Conference on Women, Heart Disease and Stroke May 7-10, 2000 Victoria, British Columbia, Canada Preferences and beliefs of African-American and white women regarding hormone replacement therapy: The UAB ENDOW Study. Cora E. Lewis, MD, MSPH, University of Alabama at Birmingham Community Community Prevention Research on Women's Health Conference October 26-27, 2000 Bethesda, MD The ENDOW Study: Ethnicity, Needs, and Decisions of Women Cora E. Lewis, MD, MSPH University of Alabama at Birmingham The Role of Qualitative Data in the ENDOW Study Carla Herman, MD, MPH University of New Mexico Preliminary Analysis of Mental and Physical Health Outcomes of H ysterectomy Experience: The South Carolina Data Robert E. McKeown, PhD University of South Carolina Women's Preferences for Involvement in Medical Decisions Janet Y. Groff, MD, MSPH, PhD University of Texas - Houston ENDOW Interventions Development and Initial Results Donna L. Richter, EdD University of South Carolina contact ENDOW, Ethnicity, Needs, Decisions of Women Coordinating Center Division of Preventive Medicine University of Alabama at Birmingham 1717 11th Avenue South, Room 730 Birmingham, AL 35205 Phone: (205)934-6383 Fax: (205) 934-7959 Email: webendow@dopm.uab.edu For more information you may contact: Trena Taylor Johnsey, BA Email: Tjohnsey@dopm.uab.edu coorctrdir ENDOWCoordinating Center Address: University of Alabama at Birmingham Division of Preventive Medicine 1717 11th Avenue South, MT 730 Birmingham, AL 35205 Principal Investigator: Cora E. Lewis, (Beth), MD, MSPH (205) 934-6383 office (205) 934-7959-fax E-mail: clewis@dopm.uab.edu Project Assistant: Trena Taylor Johnsey, BA Phone: (205) 934-6383 alternative: 934-2294 Fax: (205) 934-7959 E-mail: tjohnsey@dopm.uab.edu Data Manager: Heather McCreath, PhD Phone: (205) 934-0786 E-mail: hmccreath@dopm.uab.edu O. Dale Williams, PhD MT 505 Phone: (205) 934-0786 Fax: (205) 934-0777 E-mail: odalew@dopm.uab.edu Statisticians: Shannon Houser E-mail: shouser@dopm.uab.edu Darlene Graham E-mail: dgraham@dopm.uab.edu ctnspcabs ENDOW Center-Specific Published Abstracts All publications listed below have been published and/or presented to the publicby study investigators. Participating study sites: University of Alabama at Birmingham (UAB), University of New Mexico (UNM), University of South Carolina (USC), University of Texas - Houston (UTH) First author is always contact author Number Site/Authors Title Meeting/Dates Presentation Type 17 UNM Herman, CJ, Goetz TE, Stidley CA, How well-informed and open to health promotion are women about menopause and hormone replacement therapy? Overall results and ethnic differences in the New Mexico ENDOW Study APHA 129th Annual Meeting October 21-25, 2001 Atlanta, GA Oral 16 UTH Linares AC, Phillips K, Groff, JY Attitudes toward HRT and hysterectomy: Comparison of lesbians with a community sample of minority women APHA November 12-16, 2000 Boston, MA Oral 15 UAB Lewis CE, Cornell CE, Pulley L, Littleton MA, McCreath HE, Williams OD Intervention Pilot Study ENDOW Alabama Community Prevention Research on Women’s Health Conference October 26-27, 2000 Bethesda, MD Poster 14 UTH Groff JY, Tortolero G, Byrd T, Linares AC, Cantor S, Mullen PD Preferences for Involvement in Medical Care: Perceptions of Women vs Physicians Community Prevention Research on Women's Health Conference October 26-27, 2000 Bethesda, MD Poster 13 USC Richter DL, McKeown RE, Greaney ML Hysterectomy: What Women Want to Know Community Prevention Research on Women's Health Conference October 26-27, 2000 Bethesda, MD Poster 12 UAB Lewis CE, Pulley L, McCreath H, Cornell C, Wheeler K, Williams OD Preferences and beliefs of African-American and white women regarding hormone replacement therapy: The UAB ENDOW Study First International Conference on Women, Heart Disease and Stroke May 7-10, 2000 Victoria, British Columbia Poster 11 UTH Lees E, Shelton A, Groff JY California Beliefs and Attitudes toward Hysterectomy among Middle-aged Lesbians American Society on Aging March 20, 2000 San Diego, CA 10 USC Richter DL, McKeown, RE, Greaney, ML Menopause and Meaning: Women's Expectations and Experiences of Menopause APHA November 7-11, 1999 Chicago, IL Oral 09 UTH Groff JY, Tortolero G, Byrd T, Mullen PD, Cantor S Minority Women's Preferences for Involvement in Medical Care - The University of Texas - Houston ENDOW Project North American Primary Care Research Group Annual Meeting November 1999 Oral 08 UTH Lees E, Shelton A, Groff JY, Beliefs and Attitudes Toward Hysterectomy Among Middle-aged Lesbians American Society on Aging San Diego, CA March 20, 2000 Poster 07 UTH Cantor SB, Byrd T, Groff JY, Reyes Y, Dolan-Mullen P, The Translation Process in Survey Research: A Cost Analysis 20th Annual Meeting of the Society for Medical Decision Making October 1998 Cambridge, MA Poster 06 UNM Herman CJ, Morgan EA, Coriz M, Whalawitsa M, Mingo C The Effect of Traditionality on Menopausal Symptoms Indian Health Service Research Program 10th Annual Conference Albuquerque, NM April 1998 Oral 05 UTH Reyes Y, Groff JY The Effect of Acculturation on Patient Confidence in Patient -Physician Interactions and Patient Satisfaction with Medical Care Among Hispanic Women in Harris County, Texas National Association of Hispanic and Latino Studies, National Conference, Houston, TX February 11, 1998 Oral 04 USC McKeown RE Beyond Paternalism: The Perspective of the Participant and the Need for Reciprocity in Decision Making American College of Epidemiology, Pre-Conference Workshop, Cambridge, MA September 21, 1997 Oral 03 UNM Mingo C, Herman CJ, Chao A, Germain L, Morgan E, Coriz M, Whalawitza M Storytelling and Women’s Health Indian Health Service Research Program/ 9th Annual Conference April, 1997 Oral 02 USC McKeown RE, Khushf G, Richter DL Decision Making in Bioethics and Theories of Health Behavior: Invitation to Dialogue APHA New York, NY November 20, 1996 Oral 01 USC Ricbter DL, McKeown RE, Croker A Ethnic Variations in Attitudes Toward Menopause APHA New York, NY November 19, 1996 Oral All material on this server Copyright; 1997-2001 by the publishers involved. ctnspcpap ENDOWCenter-Specific Published Papers All publications listed below have been published and/or presented to the public by study investigators. Participating study sites: University of Alabama at Birmingham (UAB), University of New Mexico (UNM),University of South Carolina (USC), University of Texas - Houston (UTH) First author is always contact author Number Site Title Authors Published Journal 07 UTH Relationship between Acculturation and Preferences for involvement in Medical Care Among Hispanic Women Tortolero G, Byrd T, Groff JY, Linares AC, Cantor SB 06 USC Women's perceptions of alternative therapies for the treatment of menopausal symptoms or as alternative to hysterectomy Richter DL, Corwin SJ, Rheaume CE, McKeown RE In press, Journal of Women & Aging 05 UAB A Qualitative Study of Women's Hysterectomy Experience Williams R, Clark AJ Journal of Women's Health and Gender-Based Medicine 2000:9(2) S15-S25 04 UNM Women's Stories: Ethnic Variations in Women’s Attitudes and Experiences of Menopause Hysterectomy and HRT Mingo C, Herman CJ, Jaspers M Journal of Women’s Health and Gender-Based Medicine 2000:9(2)S27-S38 03 USC The Role of Male Partners in Women’s Decision-making Regarding Hysterectomy Richter DL, McKeown RE, Corwin SJ, Rheaume C, Fraser J Journal of Women’s Health and Gender-Based Medicine 2000:9(2)S51-S61 02 UTH Decision-making Processes, Beliefs and Attitudes Toward Hysterectomy: A Focus Group Study with Urban African-Americans, Hispanics, and Low-income White Women in Texas Groff JY, Dolan-Mullen P, Byrd T, Shelton AJ, Lees E, Goode J Journal of Women’s Health and Gender-Based Medicine 2000:9(2)S39-S50 01 UTH The Translation Process in Survey Res earch: A Cost Analysis Cantor SB, Byrd T, Groff JY, Mullen PD, Reyes Y Am. J. Public Health 1998 dataverins MANUSCRIPT VERIFICATION SUBMISSION INSTRUCTIONS As part of the ENDOW manuscript approval process, the Coordinating Center reviews and verifies the findings presented in each paper to ensure consistency and accuracy in ENDOW publications. The purpose of this memorandum is to inform you of the verification process. If the person who performs the statistical analyses is not you, the first author, please share this memo with that person as it contains information that may influence the analysis process as well as the preparation of the verification materials. Verification Process Overview After the Coordinating Center has received a complete set of materials from you (see details below), we use the current version of the distributed data to confirm that the data set used for analyses was created correctly. Elements we evaluate include the merging of the component data sets, exclusions of participants from the analyses, definitions of new variables, and proper handling of missing values. We also compare the data set creation programs to the text of the manuscript to ensure the manuscript accurately describes the basis of the analyses. Once the data set is verified, we reproduce the analyses performed. As part of this step, we confirm all values reported in tables, figures, and text. In additi on to confirming specific numeric values, we review the description of analyses performed and results obtained, including findings that are discussed but for which values are not reported. When we have completed the verification of your manuscript, we will notify you in writing of any discrepancies between your reported findings and our analyses. Step 1: Instructions for Data Set Verification a. Data Set Verification Prior to Analyses Many of the problems encountered during verifications involve the data set rather than the analyses. Hence, you may handle your verification using two steps: (1) a data set verification prior to analyses and (2) a manuscript verification. After creating your data set (merging component data, making exclusions, and creating all necessary variables) but before performing your analyses, you may have the Coordinating Center verify your data set. The following materials should be submitted for the verification: 1. By e-mail as text file attachment or on MS-DOS formatted diskette(s), labeled with first author and ENDOW paper number: a. All programs used for data set creation, thoroughly documented. This includes programs that make exclusions and create new variables; b. A text file that lists and describes all files included with the e-mail or on the diskette; and 2. A draft of the Methods section, including a description of exclusions and created variables. If the draft does not explicitly state how missing and "Don’t Know" responses are handled for variables, also include a description of those decisions. 3. The name, telephone number, and e-mail address (if available) of the first author and the programmer. A checklist of these items is attached to this memo to facilitate your submission. Our experience is that many of the problems with verifications occur during this stage. Thus, early verification of the data set can eliminate the need to rerun analyses. Our intention is to make this a fast process that will ultimately lead to quick turnaround on final verificatio n. While most analyses of ENDOW data will be done on SAS and result in programs to be used in SAS, other analysis package may be used. Instructions regarding non-SAS analyses can be found on page 3. b. Data Set Verification as part of Manuscript Verification If you choose to wait until your manuscript is completed to have the data set verified, please follow the instructions outlined below. Step 2: Instructions for Manuscript Verification When your manuscript is complete but prior to submission to a journal, you should submit the following materials to the Coordinating Center: 1. By e-mail as text attachment or on MS-DOS formatted diskette(s), labeled with first author and ENDOW paper number: a. All programs used for data set creation, thoroughly documented. This includes programs that make exclusions and create new variables; b. All programs used for analyses, thoroughly documented. This includes analyses that are discussed in text only; and c. A text file that lists and describes all files on the diskette. 2. The manuscript, including all tables, figures, and appendices, annotated with program names for discussed analysis. In addition, please write on each figure the values used to create the figure or attach a page that clearly lists the values (e.g., a spreadsheet). 3. A complete description of any analyses conducted by hand, including reference if possible. 4. The name, telephone number, and e-mail address (if available) of the first author and the programmer. 5. The verification checklist, signed and dated by you indicating that the packet is complete and ready for submission. Please note that, even if you have already had your data set verified, it is necessary to submit all programs again in case any changes were made to the data set during the analysis phase. Analysis Using Programs Other that SAS While ENDOW data are distributed for use with SAS, other software packages are sometimes used to perform part or all of the analyses for a manuscript. When this is the case, program code may not be sufficient to allow us to duplicate your analyses. Please include the following: 1. All documentation to describe how the data set was created (particularly important when the software is interactive). Please include information about how missing and "Don’t Know" responses were handled. 2. A text file containing a list of all ENDOW variables used in the analyses, using the actual SAS variables names from the distributed data. 3. A text file containing names and formulae for all created variables, including formats, reformats, and recodes. Again, please use the actual SAS variable names from the distributed data when noting these details. 4. A text file containing exclusions in terms of the SAS variable names from the distributed data. 5. All programs used for analyses. If the package does not generate programs for analyses, text files containing code-like statements that correspond to the analyses done and using ENDOW variable names. 6. For calculations done in spreadsheets, please provide us with the formulate used for the calculations. Analyses Using Non-Core Data Manuscripts using data not distributed as part of the core data set need to be verified if two or more centers are used. If data from only one center are used, it is suggested that the manuscript be verified but not required. If the center-specific are not already on file at the Coordinating Center, you should provide these data along with the other verification materials. Other Useful Information Authors are encouraged to call or e-mail the Coordinating Center at any time to discuss issues or questions regarding data set creation. While the documentation distributed with the data is intended to be complete, questions often arise. An important check you should perform is to make sure that the programs you plan to submit do in fact run. Sometimes programs submitted to us have been cut and pasted from larger programs and do not run on their own. Verifications are assigned to various Coordinating Center st aff depending upon their current task load. After we receive all necessary materials, it will take approximately three weeks for us to complete your verification. This time line is extended if we require further information from you. The verifications staff at the Coordinating Center vary in their experience, but all have had graduate training in statistics. Thus, we may include suggestions and/or comments in the completed verification that we think may help clarify your analyses and make your manuscript stronger. Attached Materials Attached to this memo are some additional materials we hope you will find useful. First, we have summarized the materials needed for verifications in a checklist. Please use this checklist when preparing the packet you will send to us and sign and date it once you are sure the packet is complete. When you are ready to send the packet, please carefully package the diskette(s) and mail the packet to Eva Chirapongse at the Coordinating Center: ENDOW Coordinating Center 1717 11th Avenue South, Suite 505 Birmingham, AL 35205 (205) 934-0786 echirapongse@dopm.uab.edu Second, we have included some sample SAS programs complete with the type of documentation we would like to have in programs you submit. Finally, we have included a couple of example manuscript pages illustrating the type of annotation we need. If you have any questions regarding the verification process or this memorandum, please contact the Coordinating Center at (205) 934-0786. ENDOW DATA SET VERFICATION CHECKLIST 1. All programs that make exclusions, thoroughly documented. 2. All programs that create variables, thoroughly documented. 3. A text file that lists and describes all files included with the submission. 4. An MS-DOS formatted diskette or e-mail message with text attachments containing Items 1-3, labeled with first author and ENDOW paper number. 5. Confirm that submitted programs run. 6. Draft of the Methods section, including description of exclusions and created variables. If the draft does not explicitly state how missing "Don’t Know" responses are handled for variables, also include a description of those decisions. 7. Name, telephone number, and e-mail address (if available) of both the first author and the programmer. ENDOW MANUSCRIPT VERIFICATION CHECKLIST 1. All programs that make exclusions, thoroughly documented. 2. All programs that create variables, thoroughly documented. 3. All programs that perform analyses, thoroughly documented, including documentation of the portion of the manuscript to which the analyses pertain. 4. A text file that lists and describes all files included with the submission. 5. An MS-DOS formatted diskette containing Items1-4, labeled with first author and ENDOW paper number. 6. Confirm that submitted programs run. 7. Annotated manuscript, including values noted on figures or a separate sheet listing figures’ values. 8. Complete description of any analyses conducted by hand, including reference if available. 9. Name, telephone number, and e-mail address (if available) of both the first author and the programmer. _________________________ ________________________________ Signature of First Author Date Signed overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisio ns Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page o verview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page Next page overview The Wise Woman's Guide to Making Decisions Booklet: Last page In tervetion page Dir-long ENDOW Site Directory - Long Version (Including all study personnel, project role, and complete mailing addresses in alphabetical order) Name Site Project Role Address Byrd, Theresa, RN, DrPH UTH - El Paso Co-Investigator School of Public Health 1100 North Stanton, Suite 110 El Paso, TX 79902 (915) 747-8504 Phone (915) 747-8512 Fax Cantor, Scott, PhD UTH Co-Investigator Anderson Cancer Center Department of Medical Specialties Section of General Internal Medicine 1515 Holcombe Blvd. Box 40, MR 1004 Houston, TX 77030-4095 (713) 500-4521 Phone (713) 745-3674 Fax Coker, Ann, PhD USC Co-Investigator Department of Epidemiology & Biostatistics Sumter & Greene Street Columbia, SC 29208 (803) 777-6647 Phone (803) 777-2524 Fax Cornell, Carol E., PhD UAB Investigator Division of Preventive Medicine 1717 11th Avenue South, MT 401 Birmingham, Al 35205 (205) 934-8960 Phone (205) 975-6753 Fax Dolan-Mullen, Patricia, DrPH UTH Co-PI Finnegan, Loretta P., MD NIH Medical Advisor to the Director Office of Research on Women's Health Building 1, Room 208 9000 Rockville Pike Bethesda, MD 20892 (301) 402-1770 Phone (301) 402-1798 Fax Folger, Suzanne PhD CDC Technical Advisor 4770 Buford Hwy, NE Mailstop K34 Atlanta, GA 30341-3724 (770) 488-5603 Phone (770) 488-5965 Fax Groff, Janet Y., MD, PhD UTH PI Family Practice & Community Medicine 6431 Fannin 2.112 MSB Houston, TX 77030 (713) 500-7590 Phone (713) 500-7598 Fax Herman, Carla J., MD, MPH UNM PI Epidemiology and Cancer Control 2325 Camino de Salud, NE Albuquerque, NM 87131-5306 (505) 272-5630 Phone (505) 272-8572 Fax Johnsey, Trena T., BA UAB Project Assistant Division of Preventive Medicine 1717 11th Avenue South, MT 730 Birmingham, Al 35205 (205) 934-6383 Phone (205) 934-7959 Fax Lewis, Cora E., MD, MSPH UAB PI Division of Preventive Medicine 1717 11th Avenue South, MT 734 Birmingham, Al 35205 (205) 934-6383 Phone (205) 934-7959 Fax Linares, Adriana, MD UTH Coordinator 7000 Fannin Street Houston, TX 77030 (713) 500-9604 Phone (713) 500-9570 Fax Littleton, MaryAnn UAB Project Coordinator Division of Preventive Medicine 1717 11th Avenue South, MT 401 Birmingham, Al 35205 (205) 934-8960 Phone (205) 975-6753 Fax McCreath, Heather, PhD UAB Data Cordinator Division of Preventive Medicine 1717 11th Avenue South, MT 505 Birmingham, AL 35205 (205) 934-0786 Phone (205) 934-0777 Fax McKeown, Robert E., PhD USC PI Department of Epidemiology & Biostatistics Sumter & Greene Street Columbia, SC 29208 (803) 777-6220 Phone (803) 777-2524 Fax Phillips, Kimberly UTH 6431 Fannin 2564B Houston, TX 77030 (713) 500-9640 Phone (713) 500-9750 Fax Pulley, LeaVonne, PhD UAB Investigator Director, Survey Research Unit School of Public Health Department of Health Behavior 1665 University Blvd, Ryals Bldg, Rm 215 Birmingham, Al 35205 (205) 975-5705 Phone (205) 934-325 Fax Richter, Donna L., EdD USC Co-Investigator Chair, Department of Health Promotion & Education Sumter and Greene Street Columbia, SC 29208 (803) 777-7096 Phone (803) 777-6290 Fax Shelton, Andrea, PhD UTH Co-Investigator Houston, TX 77030 (713) 500-9273 Phone (713) 500-7598 Fax Tortolero, Guillermo, MD, PhD UTH Co-Investigator Anderson Cancer Center Department of Gynecologic Oncology 1515 Holcombe Blvd, Box 67 Houston, TX 77030-4095 (713) 745-2352 Phone (713) 792-7586 Fax Williams, O. Dale, PhD UAB Investigator Division of Preventive Medicine 1717 11th Avenue South, MT 505 Birmingham, AL 35205 (205) 934-0786 Phone (205) 934-0777 Fax dir ENDOW Directory Coordinating Center Staff Directory of Sites Directory of Investigators - short version Directory of Investigators - long version Direction to Conference Masur Auditorium is located in Building 10 (Clinical Center)which is highlighted in Red below. Directions from the Pooks Hill: 5151 Pooks Hill Road, turn toward Bethesda, MD which will be a RIGHT hand turn.You will see the NIH on the RIGHT hand side, drive to South Drive and TURN RIGHT (the Clinical Center or Building 10 (they are the same) is 2 1/2 blocks) - follow this road without going off it & you will go straight to it.Once inside there is a person who can tell you exactly where to go. *** FOR A PRINTABLE VERSION GO HERE *** Directions from the Holiday Inn: Map of Local Area: Map of Metro Lines All material on this server Copyright & COPY; 1999+ by the publishers involved. All rights reserved. Direction to Conference Masur Auditorium is located in Building 10 (Clinical Center)which is highlighted in Red below. Directions from the Pooks Hill: 5151 Pooks Hill Road, turn toward Bethesda, MD which will be a RIGHT hand turn.You will see the NIH on the RIGHT hand side, drive to South Drive and TURN RIGHT (the Clinical Center or Building 10 (they are the same) is 2 1/2 blocks) - follow this road without going off it & you will go straight to it.Once inside there is a person who can tell you exactly where to go. Directions from the Holiday Inn: Map of Local Area: Map of Metro Lines All material on this server Copyright & COPY; 1999+ by the publishers involved. All rights reserved. foundations Foundations Lilly Centre for Women's Health National Osteoporosis Foundation American Heart Association American Diabetes Association All material on this server Copyright © 1999+ by the publishers involved. All rights reserved. ENDOW Viewing this page requires a browse r capable of displaying frames. overview Study-wide Intervention Materials (used by all study sites) ENDOW Brochures: English (Slide Show) Spanish (Slide Show) The Wise Woman's Guide to Making Decisions Booklet (Slide Show): Available on-line in English version only The Decision is Yours "Talking to your doctor" Booklet (Slide Show): Available on-line in English version only Hysterecomy: The Decision is Yours Video: (under construction) For information on any of the above please contact: Trena Taylor Johnsey, BA University of Alabama at Birmingham Division of Preventive Medicine 1717 11th Avenue South, MT 730 Birmingham, Alabama 35205 (205)934-6383 E-mail: tjohnsey@dopm.uab.edu investigator ENDOW Project Directory (Including all Study personnel - short list) Name E-mail Phone Fax University of Alabama at Birmingham Carol E. Cornell, PhD Ccornell@bmu.dopm.uab.edu (205)934-8960 (205) 934-6753 Eve Chirapongse Echirapongse@dopm.uab.edu (205)934-0786 (205) 934-0777 Shannon Houser, Shouser@dopm.uab.edu (205)934-0786 (205) 934-0777 Trena Taylor Johnsey, BA Tjohnsey@dopm.uab.edu (205)934-6383 (205) 934-7959 Cora E. Lewis, MD, MSPH Clewis@dopm.uab.edu (205)934-6383 (205) 934-7959 Heather McCreath, PhD Hmccreath@dopm.uab.edu (205)934-0786 (205) 934-0777 LeaVonne Pulley, PhD Lpulley@hb.soph.uab.edu (205)975-5705 (205) 934-9325 O. Dale Williams, PhD Odalew@dopm.uab.edu (205)934-0786 (205) 934-0777 University of New Mexico Carla J. Herman, MD, MPH Cherman@salud.unm.edu (505)272-5630 (505) 272-6986 University of South Carolina Molly Greaney, MPH, CHES Mmgreane@sph.sc.edu (803)777-5563 Robert E. McKeown, PhD Rmckeown@sophe.sc.edu (803)777-6220 (803) 777-2524 Donna Richter, EdD Drichter@sophe.sc.edu (803)777-7096 (803) 777-6290 University of Texas - Houston Theresa Byrd, RN, DrPH Tbyrd@utep.edu (915)747-8504 (915) 747-8512 Scott Cantor, PhD Sbcantor@mdanderson.org (713)745-4521 (713) 745-3674 Janet Y. Groff, MD, PhD Jgroff@fpcm.med.uth.tmc.edu (713)500-7590 (713) 500-9602 Adriana Linares, MD, MPH Sph1774@utsph.sph.uth.tmc .edu (713)500-9602 (713) 500-9750 Patricia Dolan-Mullen, DrPH Pdmullen@utsph.sph.uth.tmc.edu (713)500-9658 (713) 500-9750 Kimberly Phillips Sph191@sph.uth.tmc.edu (713)500-9640 (713) 500-9750 Andrea Shelton, PhD Ashelton@utsph.sph.uth.tmc.edu (713)500-9273 Guillermo Tortolero, MD, PhD Gtortoleo@notes.mdacc.tmc.edu (713)500-2352 (713) 500-7586 CDC Suzanne Folger, PhD Sxg1@cdc.gov (770)488-5395 (770) 488-5965 NIH Loretta P. Finnegan, MD Lf61d@nih.gov (301)402-1770 (301) 402-1798 jspon Joint Sponsors Centers for Disease Control and Prevention National Center for Chronic Disease and Prevention and Health Promotion National Institutes of Health National Heart, Lung and Blood Institute's Women's Health Initiative American Heart Association Council on Epidemiology and Prevention University of Alabama School of Medicine Division of Continuing Medical Education Division of Preventive Medicine UAB Center for Health Promotion All material on this server Copyright & COPY; 1999+ by the publishers involved. All rights reserved. Untitled Document ENDOW Community Prevention Research in Women's Health Conference ABSTRACT SUBMITION FORM: *** Abstract Deadline extented until July 28, 2000 *** Please complete the following form and click on the submit Abstraction due by June 15, 2000. All GREEN ITEMS REQUIRED Name: Dr.Mr.Ms.Mrs. First Middle Initials Las t Orgainzation: Address: City Prov/State Zip Country Daytime Phone Number ()-ext. Fax Number ()- E-Mail: Abstraction Title: AUTHORS First Author:List any conflicts of interest Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or material support NoYesif Yes, State: 2nd Author:List any conflicts of interest. Grants/Research Support NoYesifYes, State: Consultant NoYesifYes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 3rd Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 4th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesi f Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 5th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesfont size=-1>if Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 6th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 7th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: 8th Author:List any conflicts of interest. Grants/Research Support NoYesif Yes, State: Consultant NoYesif Yes, State: Stock Shareholder (directly purchased) NoYesif Yes, State: Honorarium NoYesif Yes, State: Other financial or matherial support NoYesif Yes, State: Abstract Title: Abstract Rationale: Please do it this way blah,blahblah,blahblah,blahblah, blahblah,blahblah,blahblah,blahblah,blah blah,blah Abstract Objectives: Abstract Methods: Abstract Results: Abstract Conclusion: Please select a clasification category:Cardiovascular DiseaseCancerOsteoporosisRheumatic/MusculoskeletalMenopause/menstrual/Hormone Replacement TherapyPhysical ActivityHealth Behavior/psychosocialSmokingNutrition/ObesityHealth ServicesInfectious diseases/HIVDiabetesMedical Decision-makingHysterectomy M000107 ENDOW Steering Committee Conference call, January 7, 2000 Attendees: Suzanne Folger, PhD, CDC, Beth Lewis, MD, Heather McCreath, PhD, Dale Williams, PhD, Carol Cornell, PhD, LeaVonne Pulley, PhD, Shannon Houser, Trena Johnsey, University of Alabama at Birmingham, Adrianna Linares, MD, University of Texas - Houston, Carla Herman, MD, University of New Mexico, Donna Richter, DrPH, and Robert McKeown, PhD, University of South Carolina The minutes from the December 3, 1999 steering conference call minutes were approved without corrections. CDC Report: Dr. Folger reported the CDC, Office of Women’s Health has requested her to prepare an ENDOW study progress report. Dr. Folger will report on the following ENDOW year 4 accomplishments and plans for year 5: 1) The Journal of Women’s Health special issue will be published within the next few months. 2) The ENDOW survey was completed. 3) A Survey analysis file was created and data analysis is now progress, with some data analysis presented at the APHA meeting. 4) Video tapes and brochures in both English and Spanish have been developed; and 5) Plans for the final year of the study are to create additional intervention education materials, evaluate intervention materials, and dissemination strategies, and continue analysis of survey data. Dr. Lewis suggested Dr. Folger include the published study data manuscripts and presentations in her report which are located on the public website. February 1, 2000 NIH update – Dr. Finnegan: Dr. Lewis reported that she has the year 2 focus group numbers and ethnicity breakdowns. Dr. McCreath will provide the completed survey numbers, but each PI should forward the numbers and ethnic breakdown of the additional year 4 focus groups and interviews completed during intervention development. Dr. Herman will forward to the CC a copy of the New Mexico Outreach and Education Report in terms of numbers, but it does not breakdown ethnicity. Dr. Herman suggested using 50% Navajo and 50% Anglo. Dr. McKeown will forward to the CC South Carolina numbers for male and provider interviews. Dr. Williams suggested presenting manuscript development and completion information. Dr. Lewis ask each PI to review ENDOW public website to make sure that all published data either by manuscript or presentation has been reported correct ly. Please forward any corrections to Trena. Publication activities: Journal of Women's Health issue: Dr. Richter reported that she has received page proofs and galley sheets for the Journal of Women’s Health special addition to be published in February 2000. Since the deadline for publication is so tight, Dr. Richter will proof all articles and return to the journal. The steering committee agreed. PRC meeting: Dr. Lewis reported that both ENDOW abstracts entitled "Hysterectomy in a multiethnic sample of women: the ENDOW Study" and "The Use of Qualitative Data in the Development of an Intervention Tool: the ENDOW Project" were accepted as oral presentations on Wednesday, February 2, 2000 in different meeting sessions. Trena will update the public website to reflect Dr. Lewis’s presentation entitled "Hysterectomy in a multiethnic sample of women: the ENDOW Study" and Dr. Richter’s presentation "The Use of Qualitative Data in the Development of an Intervention Tool: the ENDOW Project" at the PRC meeting, February 2, 2000. The ENDOW steering committee meeting will be Tuesday, February 1, 2000, 8:00 am -12: 00 PM. APHA presentation deadline: The APHA abstract deadlines are February 1-3, 2000. The Women’s Caucus deadline is February 1, 2000. The Epidemiology section is February 2, 2000. Dr. Richter will submit her abstract entitled "The Use of Qualitative Data in the Development of an Intervention Tool: the ENDOW Project" to the APHA. Trena will add the abstract entitled "The Use of Qualitative Data in the Development of an Intervention Tool: the ENDOW Project" submitted to the APHA to the publication grids on the public website as pending. Data management activities: Open-ended coding: Dr. McCreath reported that her hard drive crashed and she has been recreating the open-ended coding. Original coders should expect to receive spreadsheets from the CC sometime within the next week, with turnaround by the middle of January 2000 if possible. Dr. McCreath reported that Ms. Altobelli raised another question conce rning Texas HRT questions. Dr. McCreath will contact Dr. Linares for clarification before forwarding revised spreadsheets to original coders. Dr. McKeown reported that M. Harris, the South Carolina doctoral student who is working on her dissertation using ENDOW data, has found areas where she believes that information is missing. Dr. McKeown asked Ms. Harris to compile a list of problem areas before forwarding to the CC for clarification. Dr. McCreath stated that after Ms. Harris's list is received at the CC, a data management committee conference call might be needed should the questions requiring consideration by the committee. Intervention activities: Video: Both the English and Spanish videos have been forwarded for closed captioning. Please forward any comments regarding the English version of closed captioning to Trena. The Spanish will follow after comments from the English are received. Brochures: Brochures are ready for printing; however, the purchase order must be revised due to the Spanish version costing more. Both the video and brochures should be ready for distribution at the PRC meeting in February. Closed captioning: Hall & Foushee stated that the closed-captioning people would keep the ideas but reduce the number of words. T-shirts: A mockup has been received, but suggestions were made by the printers to make the shirts appear less plain. The suggestion was made to put the same saying on the back with the logos. The front would have the wording " The decision is mine" and "la decision is mine" and the back would have the same wording with the logos in the middle. ENDOW in the middle of the 3 angel logo will be removed. Trena will fax the mockup to each PI for review and comments should be sent to Trena. The next intervention conference call will be Thursday, January 20, 2000 @ 12:00 CST. Intervention site reports: South Carolina: Dr. Richter reported that intervention development is in process, but the number of community sessions has been cut to 3. Collaboration between Alabama and South Carolina is in progress in order to develop same content interventions. Dr. McKeown reported a new person has been brought on board to help with the evaluation. Alabama: Dr. Cornell reported that Ms. Littleton email an updated intervention development draft, reflecting content developed between what South Carolina, Alabama and Texas has developed. The evaluation stage is less well developed, but this is normal since content has to be developed first. A total of 5 CHA sessions in the community will be done. Texas: Dr. Linares reported that Texas has been meeting with a post-doctoral student who is going to do her dissertation on the ENDOW project using community health care workers at two different sites. Dr. Linares reported that intervention-mapping plans have begun on both the dissertation and study evaluation plans. Dr. Linares reported that Dr. Groff is developing a decision-making balance sheet. New Mexico: Dr. Herman reported that Ms. Bawaya has been on vacation, slowing their progress. However, Dr. Herman reported that New Mexico would be very interested in the CHA training materials to use with lay health advisors in Gallup. Dr. Herman will bring samples of developed materials, which are being used, in Gallup to the February meeting. Each site should bring drafts of intervention evaluation materials to the February meeting for review. Future conference calls and meetings: The next face-to-face steering committee meeting will be Tuesday, February 1, 2000 in Atlanta, GA, 8:00am - 12:00 noon. The agenda will focus on intervention materials and evaluation tools with updates on data. The next ENDOW presentation will be in the Tuesday, February 1, 2000 12:00 noon - 5:00 PM at the NIH up-date with Dr. Finnegan. Dr. Lewis and Dr. Richter will present ENDOW abstracts on Wednesday, February 2, 2000, 10:30 am - 12:00 noon scientific sessions. The Community Prevention Research in Women's Health Conference is October 26-27, 2000 in the Washington DC area at the NIH Mazur Auditorium. A preliminary progra m will be presented at the NIH up-date with Dr. Finnegan in Atlanta. The ENDOW session will be on, October 27, 2000 and the moderator will be Dr. Susan Hendrix who is the PI of the WHI Detroit site. Dr. Hendrix is a gynecologist who is active in the menopause society. There is a new women’s health journal debuting in Fall 2000, which Dr. Hendrix will be editing and she asked if the ENDOW project would be interested in submitting to the journal as well as other projects involved with the conference. An abstract competition will be held for poster presenters at the conference. May 23-24, 2000 ENDOW steering committee meeting will be in Santa Fe, NM. Dr. Herman will explore hotel availability and forward information to Trena. A Meeting to prepare for the Community Prevention Research in Women’s Health Conference will be held in Charleston, SC, and September 18-19, 2000. Dr. Richter will explore hotel availability and forward information to Trena. M000201 ENDOW Steering Committee Meeting, February 1, 2000, Atlanta, GA Attendees: Suzanne Folger, PhD, CDC, Beth Lewis, MD, Dale Williams, PhD, Carol Cornell, PhD, LeaVonne Pulley, PhD, MaryAnn Littleton, Trena Johnsey, University of Alabama at Birmingham, Jan Groff, MD, Patricia Dolan-Mullen, DrPH, and Adrianna Linares, MD, University of Texas - Houston, Carla Herman, MD and Ina Bawaya, University of New Mexico, Molly Greany, Donna Richter, DrPH, and Robert McKeown, PhD, University of South Carolina The minutes from the January 7, 2000 steering conference call minutes were approved without corrections. CDC Report: Dr. Folger reported the Office of Women's Health requested an update in order to be able to compile an informational research packet to show what types of research are currently funded through the Office of Women's Health. The following was supplied: ENDOW - Ethnicity, Needs, and Decisions of Women ENDOW is a 5-year multi-center study with study sites at the University of Alabama at Birmingham (Field Center and Coordinating Center), University of New M exico, University of South Carolina, and University of Texas at Houston. ENDOW is a multi-cultural study with African-American, Hispanic, American Indian, and non-Hispanic white participants. The research goals of ENDOW are: 1) to explore ethnic, geographic, and cultural/acculturation variations in attitudes and decision making concerning hysterectomy, oophorectomy, and use of hormone replacement therapy (HRT), and 2) to develop community-based intervention materials appropriate for different sociocultural groups that will enhance women's decision making. The study is being conducted in three phases. During Phase I, data were collected through focus groups and an interviewer-administered survey to characterize the populations and to identify factors that may be relevant to the research goals. These data were utilized in Phase II to guide development of community-based intervention materials and to plan dissemination strategies. The primary aim of Phase III of the project is to evaluate the interventions and dissemination strategies. Additional analyses of the qualitative and quantitative data collected during the study are also planned. Notable are two recent accomplishments that highlight ENDOW and demonstrate the level of interest in the scientific community. First, results of analyses of qualitative data from ENDOW will be published in early 2000 in a special issue of the Journal of Women's Health & Gender-Based Medicine. Second, a series of ENDOW papers focusing on initial results of quantitative survey data were presented in a special interest epidemiology section at the 1999 annual meeting of the American Public Health Association. Some of the results presented included the following: a) ethnic differences were found in most pre-operative conditions (preceding hysterectomy), but hysterectomy prevalence did not differ across ethnic groups; b) the extent to which participants viewed menopause as a medical condition (as opposed to a natural process) and preference for HRT varied somewhat by ethnicity; c) HRT usage and the extent to which participants understood the risks and benefits of HRT varied by ethnic group and education level; d) participants of all ethnic groups expressed a strong desire for medical information and were interested in being involved in medical decision making. Dr. Folger also supplied another requested report: Cultural Differences in Health Practices: Menopause and choices about hysterectomy and/or hormone replacement therapy will be faced by most women in mid-life. Some studies have found differences between ethnic/racial groups in the age at which a hysterectomy is performed, predisposing conditions and diagnoses, the likelihood of complications, and length of hospitalization following surgery. Together with the NIH Office of Women's Health, CDC is supporting studies to examine how women of different ethnic groups approach decisions about hysterectomy and about HRT use, and to develop community-based interventions to facilitate such decision-making. The steering committee approved the updates with minor corrections. Third paragraph add decision-making communication, HRT - hysterectomy, and menopause. Data management activities: Dr. Williams reported that Dr. McCreath is continuing to make progress on all the open-ended coding issues. Dr. Williams will check with Dr. McCreath on the HRT questions regarding the Texas data. Dr. Herman reported that the New Mexico paper regarding HRT is on hold until the Texas data questions are resolved. Dr. Williams reported that Dr. McCreath is still working with Dr. McKeown's group on the issue of missing data. The CC found that most of the data is missing, by design and was not collected on the survey. Intervention activities: Video: The English video is complete and the Spanish video has been returned to Hall & Foushee for minor corrections. It will be re-forward on Friday, February 4, 2000. Brochures: The brochures are complete and have been shipped to each site T-shirts: The T-shirts have been sent to the printers and will be shipped wi thin the next month. Website: The steering committee agreed that a counter should be added to the website. Intervention site reports: South Carolina: Dr. Richter reported that intervention development is in process and will begin around April 1, 2000. Four Community leaders (2 African-American and 2 white) will do the community workshops, 2 Healthcare professionals (1 African-American and 1 white) will be used. A total of 8 workshops (4 African-American and 4 White) will be held. Each workshop will be conducted by a team that is race matched consisting of 1 healthcare professional and 2 community leaders. The pretest will be done on both groups. Everyone will get the intervention. The post-test will be done on both groups The workshop content will be on HRT-Hysterectomy, Menopause and Decision-making communication. Physical activity will be woven into all sessions. All trainers will be paid and training will last for about 1 day. The community sessions will be free and all materials will be free to participants. New Mexico: Dr. Herman reported that the women are responding well to all interventions in the Gallop area. These classes have been going on for about 1 1/2 years now. The women that are being reached are not interested in any class that is labeled menopause; however, if they attend a class and menopause is mentioned that is ok. The concept that going through menopause is an honor because you reach a new high as an elder is not really practiced now by the Navajo. A community advisory board has been established and is very committed to reaching and informing women. The class topics are based on what the women ask for such as weight loss, and financial management, etc. A mailing list of about 2500 women has been compiled and is rotated on a monthly basis with 500 each month. Dr. Herman reported that the New Mexico group would be participating in a Health fair this Spring using the ENDOW video and brochures. Dr. Herman reported that they are trying to negogiate with the hospital to take on the Gallop extention office as a project to fund past the upcoming year. Dr. Herman reported that she has been working on a CD Rom on decision-making around HRT in both Spanish and English with information on exercise, diet, and lifestyle modification. It would be available in October 2000. Dr. Herman will forward all sites a copy of the CD Rom. Texas: Dr. Groff reported that Texas will conduct a one time community session lasting about 1 1/2 hours. It is entitled: "Working together with your doctor" and covers communicating and decision-making. They hope to evaluate the effectiveness of this intervention in changing women's communication. Using naturally occurring groups of women from churches within two communities, one strongly African-American and the other Hispanic will be used. Each group will be conducted by a community health advisor who is trained by study staff. Each advisor will be given a notebook consisting of a video and other materials including national and local brochures. The community health advisor training will begin sometime in March/April. Each participant will receive $20.00 and a T-shirt for participation. A total of 180 women will be done, 90 from the naturally occurring community setting and 90 from the 2 primary clinics at UT. The 90 women in the clinic setting will have a pretest/post test using a notebook that is taken home by the participant including a video and other brochures and then each participant will be contacted for follow-up by phone in 2 weeks. Alabama: Dr. Cornell reported that Alabama is using a training program consisting of 5 facilitated peer discussion group sessions in the West Jefferson community. A total of 20-40 women will be recruited for this training program to be conducted by trained facilitators/moderators over a 5-month period. At each of the 5 monthly sessions each approximately 2 hours in duration, food will be provided. During each monthly session, participants will be asked to express their opinions, reveal their perceptions of session topics and complete que stionnaires at the beginning and end of the session to help determine how effective the session is in conveying information. At the first session, women participating in this training program will be asked the following question. "How many sessions do you feel you must attend in order to complete the training program?" Study investigators feel that women will probably agree that attending 4 out of 5 group training sessions constitutes program completion. At the completion of the training program each woman will be given a certificate of completion and a T-shirt. Handouts will be distributed at each session. Alabama, Texas and South Carolina are continuing to work together to develop core intervention materials A face-to-face meeting for the intervention committee will be set on the upcoming intervention conference call on Thursday, February 17, 200 @ 10:00 CST. Trena will check with Dr. McCreath to see if she can be on the call. Publications: Dr. Richter reported that the ENDOW articles will be published in the Journal of Women's Health & Gender-Based Medicine in February. Dr. Lewis asked everyone to go to the ENDOW website and make corrections on the publication lists. Future conference calls and meetings: The next steering committee call will be March 6, 2000 @ 11:00 CST. May 23-24, 2000 ENDOW steering committee meeting will be in Santa Fe, NM. Each site should let Trena know who is attending so that reservations can be made. A Meeting to prepare for the Community Prevention Research in Women’s Health Conference will be held in Charleston, SC, and September 18-19, 2000. Dr. Richter will explore hotel availability and forward information to Trena. The Community Prevention Research in Women's Health Conference is October 26-27, 2000 in the Washington DC area at the NIH Mazur Auditorium. A preliminary program will be presented at the NIH up-date with Dr. Finnegan in Atlanta. The ENDOW session will be on, October 27, 2000 and the moderator will be Dr. Susan Hendrix who is the PI of the WHI Detroit sit e. Dr. Hendrix is a gynecologist who is active in the menopause society. There is a new women’s health journal debuting in Fall 2000, which Dr. Hendrix will be editing and she asked if the ENDOW project would be interested in submitting to the journal as well as other projects involved with the conference. An abstract competition will be held for poster presenters at the conference. M000310 ENDOW Steering Committee Conference Call, March 10, 2000 Attendees: Suzanne Folger, PhD, CDC, Beth Lewis, MD, Dale Williams, PhD, Carol Cornell, PhD, Heather McCreath, PhD, LeaVonne Pulley, PhD, MaryAnn Littleton, Trena Johnsey, University of Alabama at Birmingham, Jan Groff, MD, and Adrianna Linares, MD, University of Texas - Houston, Carla Herman, MD, University of New Mexico The minutes from the February 1, 2000 Meeting were approved without corrections. Publication Activities: Dr. Lewis reported that the Journal of Women's Health and Gender Based Medicine special issue is out. Copies should be delivered to each site within the next couple of weeks. Dr. Lewis reported that the submitted UAB site-specific abstract to the First International Conference on Women, Heart Disease and Stroke was accepted as a poster presentation. Dr. Lewis asked everyone to go to the ENDOW website and make corrections on the publication lists. Data management activities: Dr. McCreath reported that two new analysts have been hired in the CC for Year 5. Dr. McCreath reported that Darlene is doing the double check on the Texas HRT data. The CC will make sure that the variable corresponds correctly and report any differences to the committee via email. Dr. McCreath reported that she has been working on the second time around open-ended coding. She has been applying the steering committee decisions regarding coding made at the October meeting, and re-coding responses that were combined or split. After completion, Dr. McCreath will re-distribute the coding to the original coders for approval; if no changes occur it will be included in the data set. Dr. McCreath questioned Dr. Pulley about the missing data including the religiosity data requested by Dr. McKeown's student. Dr. Pulley reported that she has hired a new staff person who is PhD trained and very good with computers who is working on this issue now and should be able to distribute that information within the next two weeks. Dr. McCreath reported that the CC staff will be available to do analysis for all sites during Year 5. Intervention activities: Video: The English and Spanish videos are complete and have been distributed to each site. Brochures: The English and Spanish brochures are complete and have been distributed to each site. T-shirts: The T-shirts have been distributed to each site. Website: The steering committee agreed that a counter should be added to the website. Intervention site reports: Dr. Pulley reported that the intervention committee had a conference call on March 7, 2000. The committee discussed the knowledge questions, determining which ones were stronger than others. The committee discussed whether knowledge questions should be included at all. The committee decided demographic variables to be used in common and those to be site specific. The committee discussed the items that could be core given that the interventions are so different. The committee discussed in detail what each site is interested in retaining. Texas will use a one-session format. Alabama will conduct a five session format and is interested in gathering data that can be used to inform later sessions. The intervention committee decided that core questions need to be very short and that each site can add the time as needed for their site-specific. Face-to-face Intervention meeting: A face-to-face intervention meeting will be held in Birmingham, March 13-14, 2000. Trena will contact Dr. Richter about the time she has available on Tuesday to discuss issues. Future conference calls and meetings: The next steering committee call will be April 6, 2000 @ 11:00 CST. May 23-24, 2000 ENDOW steering c ommittee meeting will be in Santa Fe, NM. A Meeting to prepare for the Community Prevention Research in Women’s Health Conference will be held in Charleston, SC, and September 18-19, 2000. The Community Prevention Research in Women's Health Conference is October 26-27, 2000 in the Washington DC area at the NIH Masur Auditorium. A preliminary program was presented at the NIH up-date with Dr. Finnegan in Atlanta. The ENDOW session will be on October 27, 2000 and the moderator will be Dr. Susan Hendrix, who is the PI of the WHI Detroit site. Dr. Hendrix is a gynecologist who is active in the menopause society. A conference call will be held in the Summer with all participating WHI SIP investigators. Contacts have been made with the Journal of Women's Health and Gender-Based Medicine, JAMA, and APHA for advertising. M000407 ENDOW Steering Committee Conference Call, April 7, 2000 Attendees: Suzanne Folger, PhD, CDC, Beth Lewis, MD, Dale Williams, PhD, Carol Cornell, PhD, Heather McCreath, PhD, LeaVonne Pulley, PhD, and, Trena Johnsey, University of Alabama at Birmingham, Jan Groff, MD, and Adrianna Linares, MD, University of Texas - Houston, Ina Bawaya, University of New Mexico, Robert E. McKeown, PhD, Donna Richter, DrPH, and Molly Greaney, University of South Carolina The minutes from the March 10, 2000 Meeting were approved without corrections. Dr. Lewis reported that Hall & Foushee entered the ENDOW video for two awards. The video was chosen as a 'finalist" for a Telly Award which is similar to a second place finish. The other is still pending. Publication Activities: Dr. Lewis reported that the submitted UAB site-specific abstract to the First International Conference on Women, Heart Disease and Stroke was accepted as a poster presentation. Dr. McCreath reported that another round of analysis will be returned to UAB next week for the hysterectomy paper. Dr. Lewis asked everyone to go to the ENDOW website and make corrections on the publication lists. Data management activities: Dr. McCreath reporte d that Dr. McKeown had the following questions: Questions about different subsets of items asked of different women have been clarified. Open-ended questions - Dr. McCreath reported that a spreadsheet of the open-ended coding decisions from the October steering committee meeting was distributed on Thursday, April 6, 2000. The categories that were agreed upon were re-applied to the categories in the core dataset. Dr McCreath discussed whether another round of verification should be conducted on the open-ended coding. Dr. Pulley reported that she had begun to look at the spreadsheet and feels strongly that the coding should be verified again. The committee agreed that the coding should be verified again and segments will be distributed. Dr. McCreath reported that everyone should receive today a list of the truncated responses. Site-specific data - Dr. Pulley reported that the Alabama data has been retrieved and has been sent to Dr. McCreath for distribution. Dr. McCreath reported that the CC would need about 1 week to double check the data and will distribute to everyone the week of April 17, 2000. Scoring for the SF12 - Dr. McCreath will forward to Dr. McKeown the SF12 scoring today. Dr. McCreath reported that the remaining items would be coded by the CC and distributed to everyone by the end of the week of April 10, 2000. Dr. McCreath reported that the question regarding whether the HRT status in the Texas - HRT data was correct has been double-checked and it is fine. Dr. McKeown reported that the social support scale variables in the core dataset are reversed for the South Carolina data. Dr. McCreath reported that this was taken care of in programming. Dr. McCreath reported that the next version of the core dataset would have a disclaimer telling everyone to contact Dr. McCreath for the code if they want to do new analyses regarding social support. April 21, 2000 is the date for all open-ended coding to be completed and returned to the CC. Dr. McCreath reported that the next version of the dataset will b e released on May 8, 2000 in a zip file on the website. Dr. McKeown reported that he has received calls from reporters wanting input on the WHI-HRT, since they know USC is working on decision-making. Dr. McKeown reported that his response to them has been "This just shows that HRT is a very complex decision. That the information we have is changing. That there are some things that we know pretty well about benefits. Some things we know pretty well about risks, and other things there is a big question mark. This is a decision that is really shaped by the unique history, needs, characteristics and symptoms of a woman and her values and really needs to be worked out very carefully with her healthcare provider" Intervention activities: South Carolina: Dr. Richter reported that training for the community leaders conducting the intervention has been completed. The trainer training was used as a pilot test for the intervention materials and only a few changes need to be made. The research design where sessions will be held with a community person and a health provider and others will have only a community person. What South Carolina hopes to find is if both the sessions are equally effective or if one is more effective. There are a total of 5 sessions that can be conducted flexibly, one session a week for 5 weeks or 3 sessions in one day and 2 on another. How the sessions are conducted will be determined by the groups of women participating. Alabama: The 5 session program will begin on Saturday, April 8,2000 and will conclude in August. Each participant will receive a workbook, T-shirt and a certification of completion at the end of the program session. A total of 20-40 women will be recruited. Texas: Dr. Linares reported 10 women have been recruited and the sessions will begin May 8, 2000. Two parts of the intervention materials have been developed. A new person has been hired to help with the direct intervention materials. Two communities, Arces Homes and Aldene, one African-American and one Hispanic, will be use d. Two types of interventions, one in group and one individual which consist of a one time session will be conducted. In the group session, 5-10 women will participate with a leader, who will show the video and discuss the intervention materials that are developed. Individuals will be recruited from the clinics. There will be discussion for about 10-15 minutes and then the intervention materials will be given. The staff will contact them back in 2-3 weeks to conduct the post test. A total of 180 women consisting of 90 individuals and 90 in groups, 30 African-American and 30 Hispanics, 30 English and 30 Spanish speaking in each group. New Mexico: Ina reported that the Gallop center is ongoing. A new brochure entitled "Consider the Source" " about how to evaluate health information that you hear on the radio, TV, what you read in the newspaper has been developed. Ina will send these brochures to all the sites for distribution. They are discussing the possibility of conducting two more focus groups on the video. With these two focus groups they hope to find out what people think of the video and where it would be most useful. One of the focus groups will be done in the South Valley area which is primarily Hispanic from new immigrants to women who have lived in the state here for generations. Ina reported that one of their former interviewers is running "First Choice" located in the South Valley and has requested copies of the video, so they plan to use the video postcard with the video to get feedback. The South Valley location will be done in a group setting and then the video postcard questions will be handed out for feedback in order to correspond with the other sites. In common questions: Dr. Richter reported that the in-common questions for pre/post intervention agreed upon at the Birmingham intervention meeting should be distributed. Items included are demographic, participating with providers, self efficacy, communication with your doctor, decision-making Video postcard: The video postcard has been fi nalized and distributed to everyone by Dr. Cornell. Ina will forward the video postcard draft from Dr. Cornell to Trena for distribution. Decisional balance sheet: Dr. Groff will distribute the decision-making balance sheet in a draft form. Both the English and Spanish brochures will be on the website by the May meeting. The video will only have the title and a few shots. Face-to-face Intervention meeting: The ENDOW steering committee meeting will be May 22-23, 2000 in Santa Fe, NM. Future conference calls and meetings: The steering committee agreed to cancel the May and June conference calls due to the May meeting. A Meeting to prepare for the Community Prevention Research in Women’s Health Conference will be held in Charleston, SC, September 18-19, 2000. WHI Advisory Committee Meeting will be October 25, 2000. The advisory committee decided not to hear from all the studies will be asekd to present. They only want to hear from four, Barb Ainsworth, Ross Brownson, Carol Cornell and ENDOW. Dr. Lewis reported that she would summarize the ENDOW project for the committee. The Community Prevention Research in Women's Health Conference is October 26-27, 2000 in Bethesda, MD at the NIH Masur Auditorium. The ENDOW session will be on October 27, 2000. Dr. Lynne Wilcox will be the moderator and Dr. Susan Hendrix will be the discussant. A conference call will be held in the summer with all participating WHI SIP investigators. Abstract submission will be accepted for poster presentations. M000523 ENDOW Steering Committee Meeting Santa Fe, NM, May 22-23, 2000 Attendees: Beth Lewis, MD, Carol Cornell, PhD, Heather McCreath, PhD, LeaVonne Pulley, PhD, MaryAnn Littleton and, Trena Johnsey, University of Alabama at Birmingham, Jan Groff, MD, Pat Dolan-Mullen, DrPH, Theresa Byrd, PhD, and Adrianna Linares, MD, University of Texas - Houston, Ina Bawaya, Carla Herman, and Ella Yazzie, University of New Mexico, Robert E. McKeown, PhD, Donna Richter, DrPH, Belinda Reinger, and Molly Greaney, University of South Carolina, S uzanne Folger, PhD, CDC The minutes from the April 7, 2000 Meeting were approved without corrections. CDC Report: Dr. Folger reported that she emailed to all site PI's information regarding no-cost extensions are due on June 23, 2000. All paperwork should be submitted through the site PRC. Dr. Folger reported that Dr. Lynne Wilcox has returned as Director of the Division of Reproductive Health at the CDC. Project Timelines: Each site agreed that the collection of study data would be completed by October; therefore, a no-cost extension would be requested for data analyses for the most part. The Texas site will be conducting some post-test interviews in late September. Data management: Dr. McCreath reported that all individual site specific data have been received by the CC and that a new version of the core dataset will be distributed by mid-June. Verification Instructions: Dr. McCreath reported that verification analyses instructions would be distributed by May 26, 2000. Verification steps: Each author should send a copy of the manuscript and the SAS or SPSS code used to conduct the analyses. CC will review the code to ensure that exclusions and coding correspond with the discussion in the manuscript. As part of this step, the inverse of exclusions may be run to ensure no participants are inadvertently missed. CC will then re-run the analysis with the current version data and verify all results presented in the manuscript. Dr. McCreath reported that in addition to herself, Eva Chirapongse, and Darlene Graham will be conducting data verification for ENDOW. Dr. Williams can help with conceptual and statistical problems and act as a consultant for all data verification. The committee agreed that "analyses issues for discussion" should be added to the monthly agenda. Dr. McCreath reported that the one new problem detected with the dataset was the incorrect scoring of the SF-12. Response of "3" are not being correctly added to the final score. Corrections will be made in the next version of the dataset. Trunca ted responses: Transferred data still needs clarification on the symptom questions from SC. Since New Mexico coded before computer input, no truncated responses were entered as text, Ms. Altobelli will have to go back to the paper copy of the survey for a few responses. Open-ended coding: The open-ended coding has been completed, including quality control reviews, for the following items: Other treatments suggested by doctor (hysterectomized women only) Symptoms leading to hysterectomy or desire for hysterectomy Other surgical/medical treatments tried Other alternative healers tried Other alternative remedies tried Reason HRT was recommended Reason HRT was not taken when recommended Reason HRT stopped Dr. McCreath presented frequencies by ethnicity and site for some of the items that have had complete reviews. For the items still needing review, Dr. McCreath asked that they be sent to her as soon as possible. Dr. McCreath also asked for help from the committee regarding coding of the responses to the final item ("Before having a hysterectomy, what should a woman know?"). After extensive discussion, the group decided that proper coding and review of these responses will take extensive effort. The purpose of including the item was to inform the intervention materials. As these materials have already been developed, no further action will be taken with the coding at this time. Dr. McCreath will draft a proposal for review by Dr. Groff and Dr. Pulley for further work to be done with these data. If such work seems feasible, they will present the proposal to the Steering Committee. Dr. Groff questioned the Steering Committee as to whether the surveys collected from the convenience samples for lesbians should be included in the core. The Steering Committee agreed that these data (approximately 100 women) should be sent to the CC to be available for analyses, but in a separate dataset as the data collection methods are different from the core survey. Finally, each site discussed the resources available for analyses. N ew Mexico no longer has anyone to do analyses, so Alabama will provide analysis support for New Mexico. South Carolina and Texas will conduct their own analyses, although Texas will contact Dr. Dale Williams for analytic questions or validation. Dr. McCreath is working to conserve some monies to enable analysis effort support after September. Intervention update: South Carolina: The University of South Carolina has trained ten Women’s Health Advisors to facilitate workshops on women's health issues in Beaufort and Jasper Counties. The Community Health Advisors are African American and Caucasian women from the area who will be paired with women nurses who were also trained. The workshop has five separate sections and each covers a specific topical area. The sections are: What is menopause? What happens: Hysterectomy What Happens: Hormone Replacement Therapy Hysterectomy: the Decision is Yours Eating Healthy Pre and posttests for each session have been developed. Each session is designed to stand-alone or multiple sessions can be covered during a workshop. This flexibility allows for facilitators to present the workshop over an entire day or over a series of meetings. Materials for facilitators include lesson plans, overheads, and handouts for each session. All materials have been gathered into a large binder. At this point, a minimum of 12 workshops is planned. Each workshop will have two facilitators. A nurse will be present for each Woman's Health Advisors first workshop. Additional workshops may or may not have a nurse present as one area of research interest is to determine if the presence of a health care provider impacts learning. Participants will be recruited by the Women’s Health Advisors and the local ENDOW staff member. Facilitators have been asked to over recruit with the goal of eight to ten participants per workshop. All participants will receive a notebook of materials and an ENDOW T-shirt. Evaluation Plan: Use questions that will compare African-American women to White women. Trainers conducting the groups will be an ethnicity matched, but will recruit mixed ethnicity too. Dr. Richter reported that South Carolina has determined that the skills will not change because training is not long enough, but they hope to change the knowledge of these women. APHA: Dr. Richter reported that the APHA has an award deadline of May 31, 2000 for developed interventions and she is going to submit the already developed intervention materials such as the video, T-shirt, and brochures. The committee agreed to this plan. Texas: The Texas intervention will be conducted in two phases, clinic and community, recruiting a total of 180 women and concentrating on knowledge and attitudes. The WHA (Women Health Advisors) used in the intervention will have had to reside in the community for greater than 5 years and be over 35 years old. Education was not important. Kimberly Phillips is training all of the WHAs who will be participating in the intervention. Dr. Groff reported that an interventionist has been hired to help design the intervention. Individual intervention: The clinic component will consist of women who have come in to the clinic who will be given an intervention kit. They will be contact for follow-up at a later date. The individual intervention kit consists of the following: A copy of the video - video postcard Two brochures entitled: "Wise Woman's Guide to Making Decisions" and "The Decision is Yours (talking with your doctor)" T-shirt Each participant recruited will be given a box consisting of the above and a brief explanation of the study. Each participant will then be called in about three weeks by study staff after receiving the box for a follow-up questionnaire by phone. Group intervention: The community component will consist of a one session format lasting approximately 1 1/2 hours. Post testing will be done at the end of the session. New Mexico: Dr. Herman reported that the Gallop office would close on June 30, 2000 because of lack of funding. The Gallup Heath fair conducted earlier this year yeilded 212 women and 9 men. Each participant at the Healthfair talked to either Dr. Herman, Ina Bawaya or Ella Yazzie. T-shirts, and numerous brochures of interest were distributed. Dr. Herman reported that she, Ina Bawaya and Ella Yazzie were present to talk with all who visited. Dr. Herman reported that New Mexico was trying to set up a focus group to view the video and provide input. Dr. Herman reported that the CD Rom entitled "Making the Decision about Hormone Replacement Therapy " has been pilot test with 48 white, 20 Hispanic speaking and 40 Hispanic/English speaking women. Dr. Herman reported that the CD Rom would be tested in October 2000 and they were trying to achieve distribution by corporate sponsor presently. Alabama: Ms. Littleton reported that the following five sessions will be held: April 8, 2000 Introduction to Hysterectomy, Menopause, Hormone Replacement Therapy, and Menstrual Symptoms Dr. Sandral Hullett (Invited Speaker) May 13, 2000 Gathering the Information Needed to Make Informed Medical Decisions June 10, 2000 It’s Your Decision (Tools to help make decisions), Be Good to Yourself Session, (Invited Speakers and Demonstrations) July 8, 2000 Dispelling Myths about Changes Women go Through (Significant others are invited), Improving Relationships Session (Invited Speaker) August 12, 2000 Bringing It All Together (Wrap-up and Celebration) Ms. Littleton reported that the CHA (community health advisors) who are all from the community will be trained by study staff in each session topic prior to the session. A demographic questionnaire was handed out at the beginning of each session to those who were new to the sessions. Each woman who attends three of the five sessions will be given a session notebook, T-shirt, and a certificate at the session completion. Session 1 was conducted on April 8, 2000 and had an attendance of eighteen women with Dr. Sandral Hulcutt as the invited speaker. Session 2 was conducted on May 13, 2000 and had an attendance of twelve women including fiv e new women. Ms. Littleton reported that the women in the Riley community feel that the grandmothers of the community have the role of going out and informing younger women of how to make decisions. Intervention Instruments for evaluation: Post test: Alabama will conduct post testing at the end of each of the five sessions to get a feel for the session topic. Texas will conduct post testing in about three weeks after initial contact on the individual intervention and at the end of the session for the group setting. South Carolina will conduct post testing at the end of each session. Pre test: The committee agreed that a pre test would be conducted across all three sites, but the way it is conducted would be different. Alabama has already conducted a pre test in the beginning of their first session using the demographic handout developed at the Birmingham Intervention meeting. Texas will conduct the pre test in the group and individual setting. Program evaluation: Alabama will conduct program evaluation at the end of each session. Texas will conduct program evaluation at the end of the session or during the three week follow-up phone call for individuals. Action Item: Each site will circulate their individual questions or session evaluation items from their pre-post tests. Program/Session Evaluation: Should be targeted to the specific program style. Six decision-making questions will be asked in common across all three sites, as developed at the Birmingham Intervention meeting. Beliefs about medical care, confidence, talking with your doctors. Ask questions: Was this too much information for one session, was this too many sessions. Each site will get their data in some fashion. A g rid will be prepared to identify any wording differences. CC will develop a spreadsheet for the data collected. Texas will send their specific questions to the CC for instrument spreadsheet development. Only pilot testing will be done within the constraints of this study. New Mexico was dictated by the Navajo Nation to get into the community with education as a result of intervention. Two years of education has been done including other women health issues besides hysterectomy. What types of data management/analyses: The committee agreed to compile demographic data across all three sites and the core questions agreed upon at the Birmingham Intervention meeting. Tuesday, May 23, 2000 Community Prevention Research on Women's Health Conference: The ENDOW session will be on Friday, October 27, 2000 from 8:00 - 9:30 am. Moderator - Dr. Lynne Wilcox will present a five minute overview ENDOW presentations - 60 minutes total. Discussant - Dr. Sue Hendrix will then give a fifteen minute synopsis and field questions from the audience lasting about 10 minutes. WHI Advisory Committee Meeting: Dr. Lewis will inquire as to WHI Advisory committee membership in order for Dr. Herman to see if she should present Navajo data and the number of copies of handouts that should be prepared. The Community Prevention Research in Women's Health Conference presentations will be shortened for the Advisory committee, emphasizing key findings and the numbers of women participating in the various activities. Use the giving back to the community theme and how working with the community has gotten better since the beginning of the study. Possible presentation of Navajo overview if approved by the Navajo Nation - Dr. Herman will explore with the Navajo IRB. Outline of the WHI CPS Conference Presentation Overview - rationale of ENDOW - 10 minutes - Dr. Beth Lewis will present the overview of ENDOW. Design - Sites - populations Methods - Qualitative/Quantitative Summary of Qualitative - data collection - 10 minutes Who, when and what - Dr. Carla Herman will present the qualitative How informed the survey How informed the intervention Summary of survey data collection: 25 minutes Hysterectomy (case in point) - Dr. McKeown Decision-making - Dr. Jan Groff will present Brief on other data in time Intervention approach - 10 minutes - Dr Donna Richter wi ll present. Development Materials Approaches in different sites Brief summary of pilot evaluation and results Conclusions - future directions - 10 minutes - Dr. Beth Lewis will present. Community Prevention Research in Women's Health Conference props to be done by the ENDOW study: Displayed by the CC: Each site will bring 10 copies of the journal. A slide of the Journal cover will be made. Display the video during the poster presentation continuously Both Spanish and English brochures will be displayed. A T-shirt will be displayed. Publication grids including a booklet of presentations on the website TELLY Award Intervention materials for each site will be displayed specifically by site. New Mexico notebooks will be brought for display and one will be given to the advisory committee. Greatest hits: including pictures from the Alabama ENDOW sessions. Media Coverage articles from South Carolina will be displayed Publication activities: Each site will review the publication grids for the July 7, 2000 conference call. Publication guidelines will be put on the website. Dr. Herman will do a formal proposal for HRT paper using a 5 step plan. Drs. Cornell and Pulley will discuss plans for a decision-making paper. Future meetings and conference calls: Conference Calls: July 7, 2000 - 11:00 am CST August 11, 2000 - 11:00 am CST September 1, 2000 - 11:00 am CST October 6, 2000 - 11:00 am CST Meetings: September 18-19, 2000, Charleston, SC, ENDOW Steering Committee Meeting - DoubleTree hotel with a Saturday stay over October 25-26, 2000 - Bethesda, MD, "Community Prevention Research on Women's Health Conference" M000707 ENDOW Steering Committee Conference Call Friday, July 7, 2000, 11:00 am Attendees: Beth Lewis, MD, Carol Cornell, PhD, Heather McCreath, PhD, LeaVonne Pulley, PhD, Dale Williams, PhD, MaryAnn Littleton and, Trena Johnsey, University of Alabama at Birmingham, Adrianna Linares, MD, University of Texas - Houston, Carla Herman, MD, University of New Mexico, Robert E. McKeown, PhD , and Donna Richter, DrPH, University of South Carolina, Suzanne Folger, PhD, CDC The minutes from the ENDOW Steering Committee Meeting, May 23-24, 2000 were approved without corrections. Extensions: Dr. Lewis reported that Alabama would have some carryover money to continue to fund some level of analyst support and one steering committee meeting next year. New Mexico: Dr. Herman reported that Ina Bawaya left her position and Monica Weaver moved to Birmingham so some carry over money will be available for next year. South Carolina: Dr. McKeown requested carryover funds; however, it is dependent on whether the carryover funds from this year are received. Texas: Dr. Linares reported that the carryover from 1999 year 4 have been received and carryover funds have been requested for 2000, year 5. Data management: Verification Instructions: Dr. McCreath reported that verification of analyses instructions have been placed on the website. Coding: Dr. McCreath reported that Dr. Pulley found that some responses needed to be coded corresponding to the questionnaire categories, so the dataset distribution date will be July 15, 2000. Dr. McCreath reported that she would feel comfortable doing analyses on the available dataset for abstracts to be submitted to the July 28, 2000 deadline of the Community Prevention Research in Women's Health Conference. Intervention update: South Carolina: Dr. Richter reported that South Carolina has hit a snag in recruiting. The trained health advisors are having trouble assembling the groups because of vacations in the summer, but would be caught up by the end of September. Texas: Dr. Linares reported that all the intervention materials have been prepared and the groups and individuals will start next week. A total of 180 women will be surveyed. African-American women will have 60 in groups and 30 individuals. Hispanic - 30 will speak English and 30 will speak Spanish in groups and 15 will speak English and 15 will speak Spanish in individual sessions. All individuals will be recruited from t he clinic. The intervention will be discussion for no more than 15 minutes, conducting the pretest, explaining what the materials are, and inviting them to watch the video. 3 weeks later someone will contact them to see if they have watched the video and what they thought about the materials. APHA: Dr. Richter reported that all the developed intervention materials such as the video, T-shirt, and brochures were submitted to the APHA, however, no awards were won. New Mexico: Dr. Herman reported that the Gallop office closed on June 30, 2000 because of lack of funding. The video will be available at the Gallop library and the local video store. Dr. Herman reported that 2 focus groups were conducted with the video using the standard evaluation forms. 19 women attended (12 white, 6 Navajo, and 1 Hispanic) in the Gallop area and all found the video to be very useful. Alabama: Ms. Littleton reported that the 4th session entitled "exploring and dispelling myths" will be conducted on Saturday, July 8, 2000 and the 5th session will be held in August which will be a wrap up of all the previous sessions, including role plays. Certificates of completion will be given to those who attended at least 3 sessions. Second phase: Three one-session programs will be done in August in rural sites. One 2-hour session consisting of the video, two booklets developed by Texas ("Talking to Your Doctor" and "Wise Woman Guide to Decision making") with a pre/post test evaluation. Another one session program will be done in an urban site in September. Publication activities: Each site will review the publication grids for the August 11, 2000 conference call. Website: Each site will review the website and send any additional information that needs to be posted for their site-specific webpage. Future Conference Calls and Meetings: future Conference Calls: August 11, 2000 - 11:00 am CST September 1, 2000 - 11:00 am CST October 6, 2000 - 11:00 am CST Future Meetings: September 18-19, 2000, Charleston, SC, ENDOW Steering Committee Meeting - Doub leTree hotel with a Saturday stay over. Each PI should forward who will be attending from their site. Agenda items: Revisit the no-cost extension Up-date on intervention activities by site-possible site-specific intervention results Discuss publication plans - cross-site and individual site Conference presentations by all speakers including slides for the conference October 25, 2000 - WHI Advisory Committee Meeting: How many copies of information should be bought for handouts? The Community Prevention Research in Women's Health Conference presentations will be shortened for the Advisory committee, emphasizing key findings and the numbers of women participating in the various activities. Use the giving back to the community theme and how working with the community has gotten better since the beginning of the study. Dr. Lewis will present. Possible presentation of Navajo overview if approved by the Navajo Nation - Dr. Herman will explore with the Navajo IRB. October 26-27, 2000 Community Prevention Research on Women's Health Conference: The ENDOW session will be on Friday, October 27, 2000 from 8:00 - 9:30 am. Moderator - Dr. Lynne Wilcox will present a five-minute overview ENDOW presentations - 60 minutes total. Discussant - Dr. Sue Hendrix will then give a 15-minute synopsis and field questions from the audience lasting about 10 minutes. Outline of the WHI CPS Conference Presentation Overview - rationale of ENDOW - 10 minutes - Dr. Beth Lewis will present the overview of ENDOW. Design - Sites - populations Methods - Qualitative/Quantitative Summary of Qualitative - data collection - 10 minutes Who, when and what - Dr. Carla Herman will present the qualitative How informed the survey How informed the intervention Summary of survey data collection: 25 minutes Hysterectomy (case in point) - Dr. McKeown Decision-making - Dr. Jan Groff Brief overview of other data if time Intervention approach - 10 minutes - Dr Donna Richter Development Materials Approaches in different sites Brief summary of pilot evaluation and r esults Conclusions - future directions - 10 minutes - Dr. Beth Lewis Community Prevention Research in Women's Health Conference props to be dsiplayed by the ENDOW study: Displayed by the CC: Each site will bring 10 copies of the journal. A slide of the Journal cover will be made. Display the video during the poster presentation continuously Both Spanish and English brochures will be displayed. A T-shirt will be displayed. Publication grids including a booklet of presentations on the website TELLY Award Intervention materials for each site will be displayed specifically by site. New Mexico notebooks will be brought for display and one will be given to the advisory committee. Greatest hits: including pictures from the Alabama ENDOW sessions. Media Coverage articles from South Carolina will be displayed (other sites should provide any they have) - All articles should be placed on the website Each site will display their site-specific information and handout the in-common materials such as the brochures and have the video run the entire time. M000811 ENDOW Steering Committee Conference Call Friday, August 11, 2000, 11:00 am Attendees: Carol Cornell, PhD, Heather McCreath, PhD, Dale Williams, PhD, Mary Ann Littleton and, Trena Johnsey, University of Alabama at Birmingham, Adrianna Linares, MD, and Janet Groff, PhD, University of Texas - Houston, Carla Herman, MD, University of New Mexico The minutes from the July 7, 2000 Steering Committee Conference call were approved without corrections. Extensions: Dr. Groff reported that Texas received an approved no-cost extension letter, but the funds couldn't be used until December of 2000 since the project was ending but the center funding was continuing. Dr. Groff will forward the e-mail to Trena for distribution. Data management: Dr. McCreath reported that Version 2 of the core survey data was distributed on July 20, both Texas and New Mexico reported receiving the file. Dr. McCreath will resend Version 2 to Dr. Herman in New Mexico who was unable to read it. The CC is w orking on Version 3 of the core survey data to correct a few minor problems found in Version 2 while conducting analyses for the WHICPS abstract submission deadline. Dr. McCreath asked that all intervention data entered be forwarded to the CC. Dr. Herman reported that she had sent the New Mexico focus group data regarding the video to Trena. Trena will forward the New Mexico data to Dr. McCreath. Intervention: New Mexico: Dr. Herman reported that the video focus groups are finished and the data collection information had been forwarded to the CC. The Gallup office closed on June 30, 2000, but the video has been distributed to the Gallup library and the local video store for distribution. Alabama: Mary Ann reported the 4th session at Riley Community Center entitled "exploring and dispelling myths" was conducted on July 8, 2000 and was very successful. This session invited men and included a guest speaker who talked about relationships between men and women. The 5th Riley session entitled "wrapping it all up" will be conducted on August 12, 2000 with graduation for those who attended 3 of the 5 sessions and numerous role plays. Two 2-hour sessions were conducted in Pineapple, where 21 women attended and in Camden where 27 women attended. At each of these sessions, the video was shown and the "Talking to Your Doctor" and "Wise Woman Guide to Decision-Making" were used. Both of these sessions were very well received by all the participants. Another 2-hour session will be conducted on August 29, 2000 in the Uniontown area by the facilitators from the Riley community. A follow-up 2-hour session will be held in the Riley area for those women who could not attend the five-session group. Trena reported that Dr. Lewis placed the video in the UAB Russell Clinic for distribution. Texas: Dr. Linares reported 60 individual women from two clinics and 50 women in groups have been completed. The lay advisors reported difficulty in recruiting Hispanic women in both groups. This week study personnel will be more active in recruiti ng Hispanic women from Aldene for the groups. Dr. Groff reported that the intervention is going well. The groups are being very well received and the difficultity with the individuals has not been with recruiting but with the follow-up phone calls three weeks later due to the hot weather and people going on vacation. Publication activities: Each site will review the publication grids for the September meeting. Dr. McCreath reminded everyone to please review the verification instructions and distribute them to any programmers or analysts in preparation for completed manuscripts. Any analysis done at the CC will be verified by a second person. Dr. McCreath reported the analysis done for the "Community Prevention Research on Women's Health Conference abstract by Drs. Wheeler and Cherrington on "use of alternative remedies and therapies" will be turned into a formal paper proposal. Dr. Williams stated that if anyone has plans for papers which will need CC analysis please let her know as soon as possible. Website: Each site will review the website and send any additional information that needs to be posted to their site-specific webpage. Future Conference Calls and Meetings: Future Conference Calls: October 6, 2000 - 11:00 am CST Future Meetings: ENDOW Steering Committee Meeting-September 18-19, 2000, Charleston, SC. Agenda items: Revisit the no-cost extensions Up-date on intervention activities by site-possible site-specific intervention results Discuss publication plans - cross-site and individual site Conference presentations by all speakers including slides for the conference Archiving dataset issues. October 25, 2000 - WHI Advisory Committee Meeting: How many copies of information should be brought for handouts? The Community Prevention Research in Women's Health Conference presentations will be shortened for the Advisory committee, emphasizing key findings and the numbers of women participating in the various activities. Use the giving back to the community theme and how working with the community has gotten be tter since the beginning of the study. Dr. Lewis will present. Possible presentation of Navajo overview if approved by the Navajo Nation - Dr. Herman will explore with the Navajo IRB. Dr. Herman asked if Dr. Lewis could let her know if Linda B would be attending the conference. October 26-27, 2000 Community Prevention Research on Women's Health Conference: The ENDOW session will be on Friday, October 27, 2000 from 8:00 - 9:30 am. Moderator: Dr. Lynne Wilcox, ENDOW presentations - 60 minutes total. Discussant: Dr. Sue Hendrix will then give a 15-minute synopsis and field questions from the audience lasting about 10 minutes. Outline of the WHI CPS Conference Presentation Overview - rationale of ENDOW - 10 minutes - Dr. Beth Lewis will present the overview of ENDOW. Design - Sites - populations Methods - Qualitative/Quantitative Summary of Qualitative - data collection - 10 minutes Who, when and what - Dr. Carla Herman will present the qualitative How informed the survey How informed the intervention Summary of survey data collection: 25 minutes Hysterectomy (case in point) - Dr. McKeown Decision-making - Dr. Jan Groff Brief overview of other data if time Intervention approach - 10 minutes - Dr Donna Richter Development of materials approaches in different sites, brief summary of pilot evaluation and results Conclusions - future directions - 10 minutes - Dr. Beth Lewis Community Prevention Research in Women's Health Conference props to be dsiplayed by the ENDOW study: Displayed by the CC: The Journal of Women's Health & Gender Based Medicine Supplement A slide of the Journal cover will be made Display the video during the poster presentation continuously Both Spanish and English brochures will be displayed A T-shirt will be displayed Publication grids including a booklet of presentations on the website TELLY Award Site-specific: Site-specific intervention materials for each site will be displayed. New Mexico notebooks will be displayed and given to the advisory committee. Greatest hits: including pictur es from the Alabama ENDOW sessions. Media Coverage articles from South Carolina will be displayed (other sites should provide any they have) - All articles should be placed on the website if possible Each site will display their site-specific information. M000918 ENDOW Steering Committee Meeting September 18-19, 2000 Charleston, SC Attendees: Beth Lewis, Dale Williams, Carol Cornell, LeaVonne Pulley, MaryAnn Littleton and Trena Johnsey, University of Alabama at Birmingham, Jan Groff, Theresa Byrd and Guillermo Tortolero, and Patricia Dolan-Mullen, University of Texas - Houston, Carla Herman, University of New Mexico, and Suzanne Folger (via speaker phone), CDC, Robert McKeown, Donna Richter and Molly Greaney, University of South Carolina. The minutes from the August 11, 2000 conference call were approved without corrections. CDC report: Dr. Folger reported that all of the Women’s Health Initiative projects requested carryover funds. Each PI should contact Robert Hancock if carry-over notification has not been received. Dr. Folger reported that Dr. Lynda Doll, Director of the Prevention Research Centers will be presenting introductory remarks at the "Community Prevention Research in Women’s Health Conference." Dr. Doll would like community collaboration examples. Each PI will send a site-specific summary of their intervention materials. Dr. Folger reported that she participated on an August conference call with Dr. Finnegan who was concerned about why all the WHI SIPS had requested carryover funds. Dr. Folger will participate in another call with Dr. Finnegan on October 3 and would like to have some information from the PIs on how the WHI SIPS have grown and if continual funding activities are in the works. Trena will have the Spanish version of the intervention booklets entitled "The Decision is Your’s: Talking to Your Doctor" and "The Wise Woman Guide to Making Decisions," added to the ENDOW website. Each PI will check the publication grid on the website and will send corrections to Trena. Time lin es: Dr. Lewis reported that carry over funds were requested by the CC for investigator and analysis time, one steering committee meeting focusing on future directions, publications and data support funding. New Mexico - Dr. Herman reported that carryover funds were requested for publications. Since the Gallop office closed in June of 2000, videos have been placed in both of the two video stores and have been checked out in both Spanish and English. Dr Herman will be disseminating ENDOW information at "The Changing Women’s Conference" which is sponsored by the CDC. South Carolina- Dr. McKeown reported that carryover funds were requested for publication analysis and finishing up workshops. The Beaufort Community recruiter has resigned and a part-time recruiter will be taking over to finish up the workshops. Videos have been distributed to the libraries in Beaufort and Jasper counties. Texas - Dr. Groff reported that carryover funds were requested for paper analyses. Dr. Linares is now working for Dr. Tortolero who has agreed for her to volunteer her time to help with analysis. Dr. Groff reported that Dr. Linares would be presenting a poster on ENDOW Lesbian data at the APHA in November. Dr. Linares will email the title to Trena for the publication grid. Data management and analysis: Core survey data: Version 3 was distributed on September 7, 2000. This version corrects the minor problems found with version 2 within the variables created to represent coding of the open-ended of responses. Open-ended coding: All of the open-ended coding has been incorporated into the dataset. Several of the variables have very low frequencies, so they may need to be combined for anlaysis. The only item not coded is the last question " What should a woman know before having a hysterectomy?." At the May meeting, the steering committee decided not to code this item. However, the electronic version of the text is available to anyone who would like to work on it. Evaluation data: The CC will be pulling together the evaluation da ta for the summary presentations at the October conference. Please forward your data to the CC as soon as possible. Analyses: The CC is currently working on Dr. Lewis; hysterectomy paper, Dr. Herman’s HRT paper and Dr. Cherrington’s alternative remedies paper. Verifications: Dr. Williams reported that the verification instructions are available on the website as well as being distributed. Please contact the CC if any questions arise. Dr. Lewis reported that Dr. Andrea Cherringtion submitted an abstract to the "Community Prevention Research on Women’s Health Conference" which was accepted. She and Dr. Cherrington will be distributing a paper proposal on alternative remedies. Dr. Lewis will have Dr. Cherrington contact Dr. Herman regarding alternative remedy findings in the New Mexico data. Dr. Williams stated that the Navajo data should be archived at the CC even though it can’t be used without Navajo IRB approval. Site-specific Intervention Updates: South Carolina: Dr. McKeown reported two workshops have been done to-date with a total of 10 participants. In the 2-hour sessions: The video "Hysterectomy the Decision is Yours" was shown, the Texas booklets entitled "The Decision is Your’s Talking to Your Doctor" and "The Wise Woman Guide to Making Decisions" and participant role plays were done. If the workshops scheduled for Beaufort County don’t take place, the alternative will be to conduct workshops in the Columbia area. The South Carolina newspapers have had very positive reviews of the project and the articles will be displayed at the "Community Prevention Research on Women’s Health Conference". Texas: Dr. Groff reported that a comparison of individual vs group sessions was being done. 163 interviews (70 community/groups, 93 clinic/individual recruited from two clinics) have been conducted to date. The ethnicity breakdown is 95 African-American, 67 Hispanic and 1 white with a mean age of 50 years. 33 participants were born in Mexico, 43 % have greater than high school education, 61% have had a hyste rectomy, 90% have gone through or currently in menopause, 58% have used or are using HRT, 43% were recommend at some time to have a hysterectomy. The overall feedback from participants has been very good. Individuals from the clinic/individual sample are approached while waiting for a clinic visit. The group sessions were conducted in women homes and one was conducted in a church. Diabetes was the symptom of choice most of the time for the role-plays. A Lay health advisor conducted eachof the groups and a project person was present for support. Dr. Groff reported that a woman stated that she didn’t know that you could disagree with your doctor. After completing a group, one woman did see her doctor and reported "that she had a different experience with her doctor" when the study staff did the call back. New Mexico: Dr. Herman reported that the focus group conducted with more health care professionals present was more critical than the community women which were Navajo. Since the Gallop office closed, videos were placed in the 2 video stores in town and have actually been checked out in both English and Spanish. Dr. Herman said that she would be handing out ENDOW materials at the CDC conference entitled "The Changing Woman". Dr. Herman reported that around 12,000 contacts were made through the gallop office; however, these contacts would include the series of classes that had repeated attendance of the same women. Notebooks of the Gallop dissemination materials have been put together for the WHI advisory committee. The Navajo women thought that the information was of some importance. Alabama: One 5-session program was conducted. The first session had 18 women, the second had 12 women, the third had 11 women, the fourth had 33women and men and the fifth had women. Each woman attended 3 of the 5 sessions graduated the program and received a certificate. The four 2-hour sessions were conducted in Camden, Uniontown, Pineapple and Riley using the Texas brochures entitled "The Decision is Yours: Talking to Your Doctor" and "The Wise Woman Guide to Making Decisions" along with the video "Hysterectomy, The Decision is Yours" and role plays were conducted. A woman in one of the groups stated " Men need to be educated" Issues were raised during Ms. Littleton’s presentations about how to handle the Alabama data regarding the 5-session program since the pre-and post-session questionnaires are not identifiable. The UAB group will determine an analysis plan. The group next discussed intervention analyses: Individual versus group (Texas); 5 - session versus 2-hour individual groups (Alabama) Strategies would address the following general questions: What did the interventions do? Does any intervention of any kind make a difference or have any impact? Was these changes in knowledge and attitudes of interest to scientists? For women was this useful and did you learn anything? Intervention data analysis steps discussed include: Perceived need for intervention Focus group, survey (especially open-ended items from last question) Request for materials Do we have any evidence that the interventions work? Self-efficacy scale, belief scale, Autonomy preference scale/Behavioral intentions (Texas), Patient-provider communication beliefs. Do we have evidence that anybody wants it - perceived value of intervention? Data - perceived need, perceived value from general questions asked on Program/leaders/materials Quotes from open-ended questions (qualitative) Fine-tuning of intervention methods and strategies Post-session questions Potential Venues for Intervention Data discussed were: Grant application - preliminary data WHI CPS conference - oral and poster presentations WHI advisory committee Other meetings: APHA 2001, APA 2001 (invited), health promotion conference (dissemination materials) SOPHE(mid-year or 2001), Patient education conference 2001, (Groff), ? ATPM, SBM (rapid posters), Society of General Internal Medicine, Am Menopause Society Dr. Byrd will send information on the SOPHE conference. Publicat ions: American Family Physician, Journal of Health Promotion Practice, JGIM AJPH, Journal of Women’s Health and Gender Based Medicine, Health Education and Behavioral, Menopause, Health Education Research, JAMWA, Ethnicity and Disease, Public Health Reports Publication venues: Video development and evaluation (intervention mapping) Suggestions were either a health education or behavior journal Site-specific evaluation papers The committee agreed that another journal supplement would be good for intervention evaluation papers. Dr. Lewis suggested perhaps the new journal that Dr. Hendrix is starting after the 1st of the year. Perhaps Dr. Hendrix could write an editorial on the conference presentations since she is the ENDOW discussant Presentation venue: APHA 2001 (Women’s Health) - site specific intervention development and evaluation SOPHE - Video development (all centers represented) – Drs Groff and Richter will work on an abstract. The group next discussed intervention materials dissemination possibilities: CHA group-videos Use the Website for printed materials CME activities (would need to be developed) - workshop, website or conference call venues National clearinghouses - www4women, federal clearinghouse of consumer information, AHRQ guidelines, CDC websites, links to web search engines Media – distribute a common press release - National - Trena will check with UAB media relations on how to do this Video stores - how to get on shelves? The initial WHI CPS Conference presentation outline: Introduction - Lynne Wilcox, 5 min Overview and design – Beth Lewis, 10 min Summary of qualitative data – Carla Herman, 10 min Summary of survey data , 25 minutes - Hysterectomy – Robert McKeown - Decision-making – Jan Groff Intervention approach and summary – Donna Richter, 10 min Conclusions and future directions – Beth Lewis, 5 min Discussion - Sue Hendrix, 15 min Question and Answers - 10 min Each presentation was presented and comments were made regarding changes. The steering co mmittee decided after the presentations were completed that conclusions and future directions should be cut to less than 5 minutes, allowing the intervention presentation to be 20 minutes. The intervention presentation will include quotes from women who participated in the groups. Each PI will send pictures and quotes to Dr. Richter. Dr. Richter will include slides of the commonly developed materials. Dr. Groff will send Dr. Richter a slide of the intervention booklets developed by the Texas group. Conclusions achieved by the study are: Women want involvement in medical decisions Women want more and better information on hysterectomy and other health issues Women want improved communication with doctors Qualitative and survey data are consistent and enhance each other Pilot data suggest interventions as valuable Future directions for the study are: Continued design and testing of intervention tools needed for medical decisions and should be tailored for specific groups Development of information Testing of intervention effects in controlled trials focusing on multiple outcomes for medical decisions Dissemination strategies Future conference calls: Friday, October 6, 2000 Decisions to be made on the October 6 conference call at 11:00 CST: Each slide presentation will be discussed again and the decision will be made as to where to place the slides of the commonly developed materials. Each PI will develop a list of people who deserve authorship credit for the conference presentations and then make suggestions of the presentation for co-authorship for these individuals. Friday, December 8, 2000 Future meetings: October 25, WHI Advisory Committee October 26-27, 2000, Community Prevention Research on Women’s Health Conference, Bethesda, MD. April 23-24, 2000, Santa Fe, New Mexico Dr. Herman will explore meeting possibilities and contact Trena with the information. M001006 ENDOW Steering Committee Conference Call October 6, 2000 Attendees: Beth Lewis, Dale Williams, Heather McCreath, Caro l Cornell, LeaVonne Pulley, and Trena Johnsey, University of Alabama at Birmingham; Jan Groff, and Adrianna Linares, University of Texas - Houston; Carla Herman, University of New Mexico; Suzanne Folger, CDC; Robert McKeown, and Donna Richter, University of South Carolina. The minutes from the September 18, 2000 steering committee meeting were approved with minor corrections. Data management and analysis: Dr. McCreath reported that while doing Dr. Herman's analysis she determined that the CC still had not coded HRT users for Texas correctly, therefore, a new data set would be distributed this weekend. Dr. Herman reported that she will send the raw video evaluation data when she locates it. Publications: Dr. Lewis distributed a paper proposal based on the abstract for the "Community Prevention Research on Women's Health Conference" dealing with alternative remedies. The questions being tested are "how many people use them", "what types of people", "are there ethnic differences", and "are there education differences". Dr. Herman stated that if Dr. Cherrington wants the Navajo data for the paper and the re-survey which showed a much higher use when the interviewers asked specifics, she is welcome to it. Dr. Herman will mail the report on the alternative calls to Dr. Cherrington to see if she is interested in it for the paper. Dr. Herman is interested in serving as an author if Dr. Cherrington is interested in the Navajo. Dr. Richter reported that a manuscript has been drafted and is ready to be submitted based on the South Carolina qualitative data regarding alternatives. Dr. Richter is interested in being an author if Dr. Cherrington would like to use the South Carolina paper as a reference. Dr. Richter will forward the paper to Dr. Lewis. Dr. Richter will forward the information on the South Carolina alternative paper for the publication grid. Intervention Update: Dr. Lewis reported that Dr. Pulley and MaryAnn Littleton were working on an intervention analysis strategy with Dr. McCreath for the Alabama data. Dr. McCreath reported that the video data has been entered, however, Alabama will only have frequencies. Dr. McCreath will forward a frequency summary of the Alabama video evaluation data to Dr. Richter. Dr. Groff reported that Texas has completed the intervention and Dr. Linares is inputting data. Dr. Linares will extract a summary of frequencies from the Texas video evaluation data and forward to Dr. Richter. Dr. McKeown reported a part-time staff member's hours have been extended. so that she can work with one of the women's health advisors in Beaufort until the workshops can be completed. Dr. McKeown also reported that some workshops might possibly be done in the Columbia area. Conference presentation authorship: The steering committee made the following decisions regarding authorship for the conference presentations. Overview: Beth Lewis, Donna Richter, Jan Groff, Robert McKeown, and Carla Herman "The Role of Qualitative Data in the ENDOW Study": Carla Herman, Jan Groff, Beth Lewis, Robert McKeown, and Donna Richter "Preliminary Analysis of Mental and Physical Health Outcomes of Hysterectomy Experience: The South Carolina Data": Robert McKeown, Tom Hurley, Donna Richter, Beth Lewis, Jan Groff, and Carla Herman "Women's Preference's for Involvement in Medical Decisions": Jan Groff, LeaVonne Pulley, Carla Herman, Beth Lewis, Robert McKeown, and Heather McCreath "ENDOW Intervention": Donna Richter, Molly Greaney, Robert McKeown, Carol Cornell, MaryAnn Littleton, LeaVonne Pulley, Jan Groff, Theresa Byrd, and Carla Herman Dr. Lewis requested that Drs. McCreath and Pulley be added to the survey data presentations. Conference presentations: Dr. Lewis reported that preliminary slides have been mailed to the discussant, Dr. Susan Hendrix, and the wrap up speaker, Dr. Kumanyika. Dr. Lewis reported that no changes have been made to the overview since the September meeting. Dr. Herman reported that only format changes have been made for the conference presentation; however, pictures have been added to the WHI Advisory Board slides. Dr. Groff reported that format changes have been made along with the suggestions from the September meeting. WHI Advisory Board Meeting: Dr. Lewis reported that she and Dr. Herman would attend the WHI Advisory Board meeting. Dr. Lewis will give a 30-minute presentation on the study. Dr. Herman will be available to discuss the Navajo data. Dr. Williams suggested that Dr. Lewis include issues raised that need to be addressed with further research. Dr. Lewis reported that the overview will be short, more time will be devoted to intervention development and brief statements regarding the actual intervention results. Dr. Williams suggested that perhaps the study should be presented as a pilot study. Dr. Lewis stated that the decision-making theme will be discussed since it is represented in the qualitative and the survey data. Dr. Williams suggested that the group should watch what is in the news in the next few weeks and try to present something from this project that compliments the news. Dr. Groff stated that AHRQ just published in last month's newsletter findings that "To many hysterectomies are still being done". Dr. Groff will send these findings to Dr. Lewis immediately. Dr. Lewis stated that the USA Today story about "geographic differences in procedures". Call for abstracts: Dr. Folger distributed an email regarding a Public Health Reports Supplement. The agency wants to highlight research among academia, agencies, and the community to address health disparity across ethnicities with respect to various factors related to HRT and hysterectomy. The deadline for abstracts is December 1, 2000. Progress Reports: The CDC PRC office is requesting the following: Progress report is due on December 31, 2000 that summarizes progress for the last year. Final progress report will be due 60-90 days after the end of the extension period. Conference calls: Dr. Folger reported that monthly conference calls have been initiated between Dr. Loretta Finnegan, the SIP technical advisors and th e CDC PRC office. October 2, 2000. The October 2 call, however, had raised the question to Dr. Finnegan and CDC PRC here about mechanisms for continuing the dissemination of materials that are developed as a result of the SIP projects. There is interest across all the SIP projects concerning this matter. A variety of possibilities were discussed; however, no decisions were made. One decision that was made was that after the conference the technical advisors would be asking the PI's involved for their suggestions on how to disseminate the developed materials. Charges for disseminating developed materials: Dr. Folger stated that studies can charge for disseminating developed materials only to recoup immediate duplication costs including cost of coping, mail charges etc. Dr. Folger will check with David Elswick about the rules and regulations and paperwork involved regarding the cost for duplication of developed materials. Future conference Calls: The November 3, 2000 conference call has been cancelled due to the meeting on October 26, 27, 2000. Friday, December 8, 2000 conference call will be at 11:00 am CST. Future meetings: April 23-24, 2000, at the Hotel St. Francis, in Santa Fe, New Mexico with emphasis on publications and future directions. The meeting will be all day on Monday, April 23, 2000 and 1/2 a day on April 24, 2000. M001208 ENDOW Steering Committee Conference Call December 8, 2000 Attendees: Beth Lewis, Dale Williams, Heather McCreath, Carol Cornell, LeaVonne Pulley, and Trena Johnsey, University of Alabama at Birmingham; Jan Groff, and Adrianna Linares, University of Texas - Houston; Carla Herman, University of New Mexico; Suzanne Folger, CDC; Robert McKeown, and Donna Richter, University of South Carolina. The minutes from the October 6, 2000 steering committee conference call were approved with minor corrections. Data management and analysis: Dr. McCreath stated that she needed to clarify what is meant by the term final survey data. Final survey data is only final in the number of partici pants in the study. 3 versions of the dataset have been distributed thus far, some correcting problems and another adding all the open-ended questions. Version 4 will be distributed within the next week, correcting a problem that was found with the HRT status for the Texas participants. Evaluation data: The CC has received a New Mexico summary of the video postcard evaluation data. The CC has received the Alabama video postcard data. Dr. McKeown will send the South Carolina data when the postcard evaluation has been completed. Dr. McCreath reported this data would not be matched into one dataset, but would be available from the CC as a central repository. The CC will develop instructions on how to combine the data sets, should one decide to do combined analysis. Data archive: Dr. Williams stated that a discussion was held at the Charleston meeting about archiving the study data within the next year, however, no decision was made on how to do this. Dr. McCreath reported that the CC has received the Navajo data; however, it is not available in the regular dataset distribution because of the process of requiring Navajo IRB approval . Dr. Williams explained that archiving the data simply means having the dataset and enough appropriate documentation to support the dataset translation for years to come. Dr. McKeown stated that the codebook would help to some extent. Site-specific datasets: Dr. McCreath stated that the CC has core data from every site and a discussion was held about archiving the entire dataset from each site. Dr. McCreath reported that each site has forwarded their site specific survey data; however, she is not clear what version the CC has received. Dr. McCreath will check on the dataset version from each site within the next month and report back to each site what file the CC has, its date, and if sites have newer data, please forward to the CC. The committee decided that each site would keep the raw data, such as questionnaires and any hard copies. Dr. Herman reported that New Mexico would be scann ing all their raw data to CD ROM. Alabama reported that there are no paper forms from the survey; however, there are paper forms from all the focus groups and the evaluation data. Focus group: Dr. McCreath reported that the CC does not have any data from the focus groups. The committee decided that all the focus group data would be archived by each site. Dr. Williams stated that perhaps these should be available for review in the future. The site-specific transcripts are electronic. The decision needs to be made whether focus group transcripts should be centrally archived. Dr. McCreath and Trena will work on a plan for archiving these focus group transcripts. Publications: Manuscript possibilities: Dr. Lewis reported that at the WHI meeting the previous week Dr. Sue Hendrix, editor of the Clinical Journal of Women's Health, talked about funding from a company for a special issue. She was interested in the possibility of a special issue from the WHI CPS conference with a May deadline. Dr. Lewis reported that Dr. Lynda Doll from the CDC has been talking to an editor of a health education and behavior journal about papers pertaining to the WHI SIPs also. Dr. Folger will request that these journal requests be added to the December 13, 2000 conference call agenda for discussion with Dr. Loretta Finnegan, the SIP technical advisors, and the CDC PRC office. Dr. Richter reported that she received an email from Meredith Boxtin at JAMWA inquiring if she would contribute a manuscript based on ENDOW interventions presented at the WHI CPS conference. The deadline is February 15, 2001. The committee agreed that it would be good for Dr. Richter to proceed with this manuscript. American Psychological Association: Dr. Lewis reported that she submitted a proposal to the American Psychological Association for a 3-hour CME session in October, 2001. Dr. Herman reported that as an invited speaker travel, expenses would be covered. Dr. Lewis reported that she talked with Dr. Finnegan who was excited about this session and stated that perhaps ENDOW could prepare a 1-page description and submit it to the Office of Research on Women's Health and the CDC for funding. *****Dr. Richter reported that a manuscript has been drafted and is ready to be submitted based on the South Carolina qualitative data regarding alternatives. Dr. Richter will forward the paper to Dr. Lewis. *****Dr. Richter will forward the information on the South Carolina alternative paper for the publication grid. Intervention Update: Dr. McKeown reported a part-time staff member has been hired. She is working on continuing workshops and offering workshops with women's health advisors in Beaufort. Study Timeline: Progress reports: The CDC PRC office is requesting the following: Progress report is due on December 31, 2000 that summarizes progress for the last year. Final progress report will be due 60-90 days after the end of the extension period. Publications: Drs Herman and McCreath will have a conference call next week regarding the HRT paper. Texas will work on the decision-making paper. Dr. Lewis is working on the hysterectomy paper. Dissemination activities: Meetings/abstracts Drs. Groff and Richter are working on an abstract for SOPHE deadline regarding video development (all centers represented). Decided on at the September 18, 2000 meeting. Dr. Folger discussed the 4th International Symposium on Women's Health and Menopause, May 19-23, 2001. The deadline is January 31, 2001. The purpose of the meeting is to update physicians and other healthcare professionals on recent research in the field of women's health and menopause. Dr. Folger will distribute the flyer to each site for review. *****Dr. Groff stated that AHRQ just published in last month's newsletter findings that "Too many hysterectomies are still being done". Dr. Groff will send these findings to Dr. Lewis immediately. Awards: The ENDOW video entitled "Hysterectomy: the Decision is Yours" won another award entitled the International "Cindy" award. Future conference Calls: Friday, January 6, 2000 conference call will be at 11:00 am CST. Future meetings: April 23-24, 2000, at the Hotel St. Francis, in Santa Fe, New Mexico with emphasis on publications and future directions. The meeting will be all day on Monday, April 23, 2000 and 1/2 a day on April 24, 2000. April Agenda items: Prepare APA session Discuss publications - presentations of individuals regarding paper in progress or future proposals Discuss future directions Discussion of dataset archiving Discussion of focus group data transcript archiving. M010105 ENDOW Steering Committee Conference Call January 5, 2001 Attendees: Beth Lewis, Dale Williams, Heather McCreath, Carol Cornell, LeaVonne Pulley, and Trena Johnsey, University of Alabama at Birmingham; Carla Herman, University of New Mexico; Suzanne Folger, CDC The minutes from the December 8, 2000 steering committee conference call were approved with minor corrections. CDC up-date: Dr. Folger reported that she had received ENDOW abstracts from the Community Prevention Research on Women's Health Conference from Drs. Lewis, Herman and McKeown. Dr. Folger will contact Drs Groff and Richter this week for their abstracts. Dr. Folger reported that she received the overall ENDOW progress report from Dr. Lewis. Dr. Folger reported that Dr. Finnegan requested that the CDC technical advisors prepare a brief progress report of the WHI SIPS. Dr. Folger will email a draft copy to each site for comments. Dr. Folger reported that she joined a CDC working group of 4 WHI SIP technical advisors to look at the need for possible future funding for dissemination activities including research around dissemination and further research in effectiveness of the developed interventions. CDC working group members include Nell Brownstein, Dyann Matson-Koffman, Lynda Anderson, and Dr. Folger Data management and analysis: Version 4: Dr. McCreath will distribute version 4 of the data set which corrects the HRT use for Texas by the end of the call today. Site-specific datasets: Dr. McCreath will send to each PI the most current version of the survey dataset (site-specific data) that the CC has. If this is not the most recent version, please forward that version to the CC. Dr. McCreath reported that next week she and Trena are going to discuss how to archive the UAB focus group data. Publications: Manuscript possibilities: HRT paper: Dr. McCreath reported that she and Dr. Herman discussed the HRT paper analysis, which the CC will be working on the analysis plan within the next month. Alternative paper: Dr. McCreath reported that the CC has conducted additional analysis for the alternative paper that Dr. Cherrington presented at the October conference. Health Promotion Practice: Dr. Cornell reported that she received an email about an issue being develop for the next year on "Eliminating Racial and Ethnic Health Disparity Mapping a Course for Community Action and Research". Dr. Cornell suggested exploring the possibility for publication with a Deadline of May 1, 2001. Conference presentation publications: Clinical Journal of Women's Health: Dr. Folger reported that Dr. Antonia Spadaro will be in contact with Dr. Hendrix at the Clinical Journal of Women's Health about papers for the Community Prevention Research on Women Health Conference. Journal of Health Education and Behavior: Dr. Lynda Doll is going to follow-up with the Journal of Health Education and Behavior. Dr. Pulley stated that she is concerned that the ENDOW does not have enough results to go with the intervention materials, which is what the Journal of Health Education and Behavior would be primarily interested in. JAMWA: Dr. Richter reported that she received an email from Meredith Boxtin at JAMWA inquiring if she would contribute a manuscript based on ENDOW interventions presented at the WHI CPS conference. The deadline is February 15, 2001. The committee agreed Dr. Richter should proceed with this manuscript. Future ENDOW Presentations American Psychological Association: Dr. Lewis reported that a proposal was submitted to the American Psychological Association for a 3 -hour CME session workshop in October, 2001. Dr. Herman reported that she talked to Renae Royak-Schaler of the planning committee who wants ENDOW to do the 3-hour session as well as a 90-minute summary presentation during the conference, for those who could not attend the 3-hour pre-conference seminar. Dr. Herman will contact Ms Royak-Schaler to inform her that the committee agreed to do both. 4th International Symposium on Women's Health and Menopause, Washington, DC, May 19-23, 2001: Dr. Lewis reported that NHLBI, the Office of Research on Women's Health, the North American Menopause Society, Cornell University Medical College and Giovanni Lorenzini Medical Foundation are sponsoring this symposium. Dr. Lewis reported that Dr. Finnegan had contacted her. Dr. Finnegan was meeting with Dr. Pinn on January 3 to discuss a proposed special session at the symposium, and she wondered if ENDOW would be interested in presenting. The purpose of the meeting is to update physicians and other healthcare professionals on recent research in the field of women's health and menopause. The committee agreed to pursue this opportunity. Study Timeline: Progress reports: All study final progress reports are due to the CDC PRC office 60-90 days after the end of the extension period. Dissemination activities: SOPHE: Drs. Groff and Richter are working on an abstract for the SOPHE deadline regarding video development (all centers represented). Trena will contact Drs Groff and Richter to see whether this abstract was submitted. Trena will contact Dr. Groff and request a copy of the AHRQ published findings that "Too many hysterectomies are still being done". Awards: The ENDOW video has won another award entitled a "CINDY" award: "International Cinema in Industry Award". Out of 3400 from 28 country entries for the 42nd "Cindy" we were in the top 15%. Further details are posted on the website. Future conference Calls: Friday, February 2, 2000 conference call will be at 11:00 am CST. Future meetings: April 23-24, 2000, at the Hot el St. Francis, in Santa Fe, New Mexico with emphasis on publications and future directions. The meeting will be all day on Monday, April 23, 2000 and 1/2 a day on April 24, 2000. April Agenda items: Prepare APA session Discuss publications - presentations by individuals regarding paper in progress or future proposals Discuss future directions Discuss dataset archiving Discuss focus group data transcript archiving. M010202 ENDOW Steering Committee Conference Call February 2, 2001 Attendees: Beth Lewis, Dale Williams, Heather McCreath, Carol Cornell, LeaVonne Pulley, and Trena Johnsey, University of Alabama at Birmingham; Carla Herman, University of New Mexico; Suzanne Folger, CDC The minutes from the January 5, 2001 steering committee conference call were approved with minor corrections. CDC up-date: Dr. Folger reported that the PRC Office received all of the ENDOW abstracts from the Community Prevention Research on Women's Health Conference. Dr. Folger reported that the CDC dissemination group met, and Dr. Lynda Anderson is preparing a summary of each project on intervention materials that have been developed, the phase the products are in, and the purposes of the materials. Each of these summaries will be distributed to the project technical advisors for corrections. Dr. Folger also reported that Dr. Anderson is going to explore resource availability with Dr. Lynda Doll, and perhaps working through the PRC office for across the board dissemination plan for all the projects. Dr. Folger reported that she had requested that one of the ENDOW investigators present to the NCCDPHP director covering an overview of ENDOW focusing on intervention materials and future directions. Dr. Lewis volunteered to do this; however, the April 3rd date is not available. Another date will be found. Data management and analysis: Version 4: Dr. McCreath reported that version 4 of the data set correcting the HRT use for Texas was distributed. Archiving: Dr. McCreath reported that the CC has emailed each site regarding th e version of their original survey data located at the CC. If the version received does not contain a center's most recent version, please forward that version to the CC. Dr. Pulley stated that the CC has the most current version of the UAB data. Dr. McCreath reported that she and Trena worked on archiving the UAB focus group data. The UAB focus group data will be labeled and organized on a CD. Dr. Herman reported that New Mexico has already placed their focus group data on a CD for storage. Publications: Manuscript possibilities: Health Promotion Practice: Dr. Cornell reported that she received an email about an issue being develop for the next year on "Eliminating Racial and Ethnic Health Disparity: Mapping a Course for Community Action and Research". Dr. Cornell suggested exploring the possibility for publication with a deadline of May 1, 2001. Clinical Journal of Women's Health: Dr. Lewis reported that Dr. Hendrix emailed her yesterday. She received a message from Dr. Antonia Spadaro stating that during a WHI phone conference they decided that PI's should take the initiative for submitting papers to the Clinical Journal of Women's Health. Dr. Lewis stated that perhaps papers should be submitted however, she isn't sure if a whole special issue should be devoted to ENDOW. If we wished to do so, the papers would need to be finished at the same time. A possible list of proposed papers would be: The HRT paper The Alternatives paper The hysterectomy paper Dr. Herman reported that she has a student who submitted an abstract to APHA on New Mexico HRT. She is going to present a similar version at the APA meeting and might be a possibility for a paper in the Clinical Journal of Women's Health. News item: There will be a news item in the March issue of the Clinical Journal of Women's Health focusing on the ENDOW video. Booklets: Dr. Lewis stated that Dr. Hendrix is considering using some pages in the back of the Clinical Journal of Women's Health for patient education materials that people would be able to acc ess. Dr. Lewis will discuss in further detail with Dr. Hendrix how to publish the ENDOW booklets on these pages. Journal of Health Education and Behavior: Dr. Folger reported that the last time she talked to Dr. Doll, they were still planning to do something in the journal, but no other information is presently available JAMWA: Dr. Lewis stated that Dr. Richter was working on a paper but isn't sure if she will make the deadline of February 15, 2001. SOPHE: Trena reported that the abstract for the SOPHE deadline regarding video development (all centers represented) was not submitted. North American Primary Care Research Group: Dr. Groff stated that she is submitting the pilot evaluation data to the North American Primary Care Research Group. The deadline is April 25, 2001. The audience is made up of internists and primary care doctors who come and present original research in clinical and education, mainly clinical. Future ENDOW Presentations American Psychological Association: Dr. Lewis reported that the American Psychological Association proposal for a 3-hour CME workshop session in October, 2001 was accepted. However, Dr. Herman reported that Renae Royak-Schaler of the planning committee wants ENDOW to do the 3-hour session as well as a 90-minute summary presentation during the conference, for those who could not attend the 3-hour pre-conference seminar. Each 3-hour CME session requires objectives to be developed. Dr. Lewis reported that Trena circulated the CME objectives that were used for the "Community Prevention Research on Women's Health Conference" and would like for everyone to look these over and suggest revisions. Dr. Lewis reported that Renae Royak-Schaler requested CVs on everyone who might be presenting because of the CME credit. Trena reported that she emailed CVs for everyone listed on the original abstract submission form to Renae last week. Submitted tentative program: Overview and design -- C Lewis Summary of qualitative data -- L Pulley Dr. Pulley wasn't on the committee and doesn't feel comfortable presenting. Dr. Groff suggested asking Dr. Theresa Byrd to present if she has time. She will follow-up with Dr. Byrd. Summary of survey data Menopause -- H McCreath Hysterectomy -- R McKeown Hormone Replacement Therapy -- C Herman Decision-making -- J Groff Intervention approach, materials development, and demonstration -- D Richter Summary of intervention evaluation -- C Cornell Conclusions -- C Lewis Dr. Lewis stated that the presentations on the outline should be developed at the April meeting in Santa Fe, including objectives. 4th International Symposium on Women's Health and Menopause, Washington, DC, May 19-23, 2001: Dr. Lewis reported that NHLBI, the Office of Research on Women's Health, the North American Menopause Society, Cornell University Medical College and Giovanni Lorenzini Medical Foundation are sponsoring this symposium. ORWH is sponsoring a session at the symposium and asked to include ENDOW. Dr. Lewis reported that an abstract was submitted to Dr. Finnegan for a 15-20 minute presentation. During this presentation a brief overview of the project will be given, so that more time can be spent on the intervention materials developed, since many of the attendees might be very interested in seeing these interventions. The purpose of the meeting is to update physicians and other healthcare professionals on recent research in the field of women's health and menopause. Dr. Lewis reported that a discussion would be held at the April meeting regarding presentation content. Study Timeline: Progress reports: All study final progress reports are due to the CDC PRC office 60-90 days after the end of the extension period. Intervention materials: The committee agreed that the ENDOW intervention materials are usable, the actual impact of there use is not known. There is not a formal evaluation; however, we do know that women really like them. Dr. Lewis stated that the "Wise Woman Guide to Decision Making" and "Talking to Your Doctor" developed by Texas are very good and have been used in all four sites. Dr. Groff reported that in Texas these booklets have been used with women reviewing them on their own Vs training facilitators to go through the booklets with them. Dr. Groff reported that 500 were originally printed. 50 booklets were distributed at the "Community Prevention Research in Women's Health Conference". 35-50 booklets were mailed to people who requested them at the "Community Prevention Research in Women's Health Conference". Persons calling from as far away as Alaska have requested booklets and Dr. Groff stated that she talks to these people informing them that she has no way of telling how effective they are. Dr. Groff also reported that the Susan J. Koman Foundation in Houston is looking at the booklets to see if they want to use them with breast cancer patients or if they want to ask us to modify them. Dr. Lewis reported that the CC is getting bids for having copies of these booklets printed, and more copies of the video made, so that we could then supply them and charge a nominal fee for those who request them. The CC will develop an order form to be passed out when investigators present ENDOW data, if someone wants to order our intervention materials. Awards: The ENDOW video has won another award entitled a "CINDY" award: "International Cinema in Industry Award". Out of 3400 entries from 28 country for the 42nd "Cindy," we were in the top 15%. Future conference Calls: Friday, March 9, 2001 conference call will be at 11:00 am CST. Future meetings: April 23-24, 2001, at the Hotel St. Francis, in Santa Fe, New Mexico with emphasis on publications and future directions. The meeting will be all day on Monday, April 23, 2000 and 1/2 a day on April 24, 2000. Agenda items: Prepare APA session Discuss publications - individual presentations regarding papers in progress or future proposals. Dr. Herman will present the HRT paper. Dr. McKeown will present the menopause paper. Dr. Lewis will present the hysterectomy paper. Dr. Groff will present the decision-making paper. Dr. Ri chter will present data submitted to the JAMWA. Discuss intervention evaluation data Discuss strategies to publish these data. Discuss the possibility of a paper in the development and evaluation of the video. Discuss future directions Miscellaneous: Trena reported that Dr. Groff emailed the AHRQ published findings article entitled "Too many hysterectomies are still being done". Dr. Herman will ask her student to attend the ENDOW meeting in April to present her APA presentation. M010309 ENDOW Steering Committee Conference Call March 9, 2001 Attendees: Beth Lewis, Dale Williams, Carol Cornell, and Trena Johnsey, University of Alabama at Birmingham; Carla Herman, University of New Mexico; Suzanne Folger, CDC, Jan Groff, University of Texas-Houston, Robert McKeown, University of South Carolina The minutes from the February 2, 2001 steering committee conference call were approved with minor corrections. CDC up-date: Dr. Folger reported Dr. Lewis had agreed to present on June 26, 2001 to the NCCDPHP director an overview of ENDOW focusing on intervention materials and future directions. Dr. Folger reported that the 2002 Chronic Disease Conferenc e is going to have a track on health disparities. Dr. Folger is also participating in a border health group which will have a panel discussion on border health. Dr Folger wondered if the El Paso Hispanic women were from the border and if Drs Groff and Byrd would be interested in this. Dr. Folger will contact Drs Groff and Byrd about the border results in Texas and see if they want to be involved with this discussion. 1% of extramural funding is set aside for evaluation activities through the CDC Office of Program Planning and Evaluation. Dr. Folger reported that she has called Kathy Cahill, the director, to see if this option is available to fund further research on the evaluation materials and is awaiting a reply. The request for applications will come out in late spring. Data management and analysis: Version 4: Dr. Williams reported Dr. McCreath had received no inquires concerning version 4 of the dataset. Archiving procedures: Dr. Williams reported that Dr. McCreath wants to have a discussion at the Santa Fe meeting regarding archiving to make sure that everyone is aware of the procedures and their status and is comfortable with the plan. Intervention activities: Dr. McKeown reported that a few workshops were done in Beaufort and they will try to schedule more; however they will not be able to use anyone who was previously trained. The person who worked on developing the SC materials will conduct the workshops in Columbia, and he hopes to finish by the end of April. Dr. McKeown also reported that the files in the Beaufort office have been lost so response rates will be more difficult to assess. Since the mailings had to be supplemented with other recruitment techniques, some of the people were volunteers, and some of them would have been part of the mailed samples. This has to be sorted out. Publications: Manuscript possibilities: The HRT paper - Dr. McCreath is presently working on analysis for Dr. Herman. The alternatives paper - Dr. Lewis reported that this paper has been forwarded to the co-autho rs for comments today. The hysterectomy paper - Dr. Lewis reported that a meeting was held with a CC analyst. The analysis is basically done, but the tables will have to be reformatted and perhaps a couple of models developed. Dr. Lewis questioned whether the HRT, Alternatives and Hysterectomy papers could be done as companion papers for the Clinical Journal of Women's Health? Dr. Lewis will contact Dr. Sue Hendrix to see if this is a possibility. Update: Dr. Hendrix would be delighted to consider these papers. News item: There will be a news item in the March issue of the Clinical Journal of Women's Health focusing on the ENDOW video. Booklets: Dr. Lewis stated that Dr. Hendrix is considering using some pages in the back of the Clinical Journal of Women's Health for patient education materials that people would be able to access. Dr. Lewis will discuss in further detail with Dr. Hendrix how to publish the ENDOW booklets on these pages. (Still a future possibility.) Journal of Health Education and Behavior: Dr. Folger reported that the last time she talked to Dr. Doll, they were still planning to do something in the journal, but no other information is presently available - No update. JAMWA: Trena reported that Dr. Richter will not make the February 15, 2001 deadline, however, the deadline has been extended. A draft paper is ready and will be circulated for review in the next week. North American Primary Care Research Group: Dr. Groff stated that she is submitting the intervention pilot evaluation data to the North American Primary Care Research Group. The deadline is April 25, 2001. The audience is made up of internists and primary care doctors who come and present original research in clinical and education, mainly clinical. Health Promotion Practice: Dr. Cornell reported that she received an email about an issue being develop for the next year on "Eliminating Racial and Ethnic Health Disparity: Mapping a Course for Community Action and Research". Dr. Cornell suggested exploring the possibility for publication with a deadline of May 1, 2001. - No further up-date available. Future ENDOW Presentations American Psychological Association: Dr. Lewis reported that she had received notice from the American Psychological Association that ENDOW will have a 90-minute session from 4:30 - 6:00 PM on Thursday, October 4, 2001. The 3-hour CME workshop session will be on Thursday, October 4, 2001 in the evening and will be a show and tell format. Dr. Herman reported that she has not received any further information, because they are in the process of naming the workshops now. Dr. Lewis will email the tentative agenda to the committee today. Objectives: Dr. Lewis reported that Trena circulated the CME objectives that were used for the "Community Prevention Research on Women's Health Conference" and would like for everyone to look these over and suggest revisions suitable for the APA session. These will be developed in Santa Fe. CV's: Trena reported that all the CV's have been forwarded to Renae Royak-Schaler for the APA presentation. Drs. Goetz and Byrd will have to send their CVs to Trena since they will be presenting. Submitted tentative program: The following highlighted changes were made to the APA 90 minute presentation tentative program: Overview and design -- C Lewis Summary of qualitative data -- Dr. Byrd to be substituted for Dr. Pulley Summary of survey data Menopause -- H McCreath Hysterectomy -- R McKeown - Dr. McKeown reported that the October presentation was a take off of Dr. Lewis hysterectomy paper, but before that a menopause presentation was done. Dr. McKeown reported that he had been looking at other issues such as the SF 12, and a Fatalism scale used by SC as it related to decision-making. The result was that not much related to decision-making as it did to the timing of a hysterectomy. Women who had ill-timed hysterectomies had more Fatalistic attitudes. Dr. McKeown stated that his presentation would be along these lines as related to menopause hysterectomy? across all sites usi ng the SF 12. Hormone Replacement Therapy -- Teresa Goetz PhD will present instead of Dr. Herman on "how well women are informed about HRT and Menopause' using the NM data. Decision-making -- J Groff Intervention approach, materials development, and demonstration -- D Richter Summary of intervention evaluation -- C Cornell Conclusions -- C Lewis 4th International Symposium on Women's Health and Menopause, Washington, DC, May 19-23, 2001: Dr. Lewis reported that NHLBI, the Office of Research on Women's Health, the North American Menopause Society, Cornell University Medical College and Giovanni Lorenzini Medical Foundation are sponsoring this symposium. ORWH is sponsoring a session at the symposium and asked to include ENDOW. Dr. Lewis reported that an abstract was submitted to Dr. Finnegan for a 15-20 minute presentation. During this presentation a brief overview of the project will be given, and more time will be spent on the intervention materials developed, since many of the attendees might be very interested in seeing these materials. The purpose of the meeting is to update physicians and other healthcare professionals on recent research in the field of women's health and menopause. Dr. Lewis reported that a discussion would be held at the April meeting regarding presentation content. Study Timeline: Progress reports: All study final progress reports are due to the CDC PRC office 60-90 days after the end of the extension period. Intervention materials: The committee agreed that the ENDOW intervention materials are usable, the actual impact of their use is not known. There is not a formal evaluation, however, we do know that women really like them. Dr. Lewis stated that the "Wise Woman Guide to Decision Making" and "Talking to Your Doctor" developed by Texas are very good and have been used in all four sites. Dr. Groff reported that in Texas these booklets have been used with women reviewing them on their own Vs training facilitators to go through the booklets with them. Dr. Gro ff reported that 500 were originally printed. 50 booklets were distributed at the "Community Prevention Research in Women's Health Conference". 35-50 booklets were mailed to people who requested them at the "Community Prevention Research in Women's Health Conference". Persons calling from as far away as Alaska have requested booklets and Dr. Groff stated that she talks to these people informing them that she has no way of telling how effective they are. Dr. Groff also reported that the Susan J. Koman Foundation in Houston is looking at the booklets to see if they want to use them with breast cancer patients or if they want to ask us to modify them. Dr. Lewis reported that the CC is getting bids for having copies of these booklets printed, and more copies of the video made, so that we could then supply them and charge a nominal fee for those who request them. The CC has developed an order form to be passed out when investigators present ENDOW data, if someone wants to order our intervention materials. The form will be distributed to the steering committee for review. The video will be $10.00. The booklets would cost $5.00 and Dr. Lewis recommended to Dr. Groff that the booklets should be copyrighted. Awards: The ENDOW video has won another award entitled a "CINDY" award: "International Cinema in Industry Award". Out of 3400 entries from 28 countries for the 42nd "Cindy," we were in the top 15%. Future conference Calls: Friday, June 1, 2001 conference call will be at 11:00 am CST. Future meetings: April 23-24, 2001, at the Hotel St. Francis, in Santa Fe, New Mexico with emphasis on publications and future directions. The meeting will be all day on Monday, April 23, 2000 and 1/2 a day on April 24, 2000. Agenda items: Monday - Data presentations Dr. Groff will present abstract data submitted to the North American Primary Care Research Group Others with writing projects should plan to present their data Data management issues Archiving issues Prepare APA sess ion (each presenter will present their topic) 90-minute symposium 3-hour workshop Tuesday - Intervention evaluation data discussion Discuss strategies to publish these data. Discuss the possibility of a paper in the development and evaluation of the video. Intervention materials dissemination Discuss future directions M990129 Study Group Conference Call Minutes January 29, 1999 @ 11:00 am CST Attendees: Dr. Robert McKeown, and Donna Richter, University of South Carolina; Dr. Carla Herman, Ina Bawaya, University of New Mexico; Dr. Jan Groff, University of Texas - Houston, Suzanne Folger, CDC, Dr. Beth Lewis, Dr. Dale Williams, Dr. Carol Cornell, Dr. Roma Williams, and Trena Johnsey, University of Alabama at Birmingham. I. Agenda: Publications Committee - Beth Lewis Approval of APHA abstract submissions -- Beth Lewis Hysterectomy in a multiethnic sample of women: The ENDOW Study - Lewis Ethnic and geographic variation in women’s use and attitudes toward hormone replacement therapy - Herman Decision making - Groff Menopause - McKeown The ENDOW Study: Ethnicity, Needs, Decisions of Women (Session Proposal)- Lewis Miscellaneous Up-date on February Prevention Center meeting - Trena Johnsey II. Abstract discussion: A. Hysterectomy in a multiethnic sample of women: The ENDOW study - Lewis The abstract was approved with suggested changes. Issues discussed: Dr. Groff asked if the Texas data was included in the denominator? Dr. Lewis stated Texas was not included because did not have hysterectomized participants. Dr. Groff said that it would be interesting to look at the prevalence of symptoms of women who had not had a hysterectomy in the presentation. Dr. Herman stated the Navajo data could be presented at the meeting as long as approval was granted even if it is not included in the abstract. B. Ethnic and geographic variation in women’s use and attitudes toward hormone replacement therapy - Herman Abstract was provisionally approved with suggested changes, pending Dr. McCr eath’s check of N’s. 3rd and 4th sentences the numbers don’t match, "2,413 completed the survey, 200 had never head of HRT and then you say of the remaining 1,943". Don’t use overall numbers. Dr. McCreath will check the numbers this afternoon and email Dr. Herman. Dr. McCreath also stated that not all the women between the ages of 40-64 completed the items regarding HRT and that may be why the numbers don’t match. C. Women’s Preferences for Involvement in Medial Care: The ENDOW Study - Groff Dr. Groff stated that the abstract is based on decision-making and information seeking scales used in Alabama and Texas. Would like to include the hysterectomy vignettes, but denominator becomes the issue since each site asked a different hysterectomy vignette. Abstract provisionally approved with suggested changes, pending resolution of analysis issue. Dr. Williams stated that there is no data for the vignette score, and since that is a mean instead of a p-value, it will be left out if not dealt with. Dr. Groff stated that she will leave it out if she and Dr. McCreath can not solve the analyses issue. Dr. Groff will add the standard deviations for these scores. D. A Cross-Cultural Study of Attitudes Toward Menopause: The ENDOW Study or Attitudes Toward Menopause in a Multi-ethnic Sample: The ENDOW Study - McKeown Abstract approved with suggested changes. E. The ENDOW Study: Ethnicity, Needs, Decisions of Women - Proposed Special Interest Session - Lewis, Folger In publication this abstract will be shorter since the schedule and titles of the presenters will be deleted. Abstract approved with suggested changes. III. Abstract discussion related to all abstracts: A. Explanation of abstract submission: Dr. McKeown explained the relationship between the session abstract proposal and the 4 individual abstracts and the talk itself. The overall proposal abstract tells the program planners that this is a group of presentations that belong together in the same session. Each abstract should be able to stand alone, in case the session proposal is not accepted the individual abstract can still be presented. B. Preliminary Data: Dr. McCreath stated that all of these abstracts have preliminary data, since the final South Carolina data have not been received, and the data have been completely cleaned. The committee decided to include the following statement "preliminary analyses of these results" in all abstracts. Dr. Groff stated that when Dr. McCreath did the analyses for the Texas abstract, she found Texas results were different. Dr. McCreath explained that she and Ms. Lange had already resolved a large problem with the coding and have agreed the overall mean for Texas, but still have slight differences on a standardized scale. Dr. McCreath stated that there are slight differences in the way that ethnicity was coded or that there are a few people whose scores did not get matched up exactly. IV. Miscellaneous: February 1, 1999 Intervention meeting 5:00 PM - Until Dr. Donna Richter’s suite, Georgia Terrace, Atlanta, GA February 2, 1999 Study Group meeting Sheraton Colony Square, Atlanta, GA, Marietta Room 8:00 am - 12:00 Noon Intervention Committee Meeting Georgia Terrace, Atlanta, Ga Attendees: Dr. Jan Groff, and Adriana Linares University of Texas - Houston, Dr. Carol Cornell, Dr. Beth Lewis and Trena Taylor Johnsey, University of Alabama at Birmingham, Dr. Donna Richter, University of South Carolina I. Agenda: Work on video grid developed in June of 1998 Discuss regional accents Intervention plans for other things other than video II. Video discussion: The committee decided that "Hysterectomy, The Decision is Yours" is still the best angle. Communicating with providers - this video should encourage women to develop a list of questions to ask their doctor regarding important issues in their lives. The provider/doctor should be made aware that patients are being encouraged to ask questions and make lists. The committee decided that a narrator would be used, either by voic e over or on screen. Ideally, the narrator should be someone that is representative and respected by all women. Suggestions for the English video are: Oprah Winfrey, Rosie O'Donnell, Felicia Rashad, and Whooppi Goldberg. For the Spanish video Christina, someone from the Spanish news station. Another approach would be the voices of many women. The committee decided that the video should explain how to approach their doctor, but not to bash the doctor. This video should be stand alone and also used in doctor's offices. A discussion guide should be developed to accompany the video. Women should feel free to take the video home for review. III. Time table from Nancy Hall: February 1- 8, 1999 Script discussions (Hall-Foushee/intervention committee) February 9-22, 1999 Writing content outlines and creative treatments (Hall-Foushee) February 22- March 1, 1999 Approve content and creative outlines (Committee) March 1-9, 1999 Shooting testimonials (Hall-Foushee with arrangements made by site staff) March 9-21, 1999 Transcriptions of testimonials - both sides (contracted out) (Nancy on vacation March 10-19, 1999) March 22-April 23 1999 Writing 1st draft of both scripts (Hall-Foushee) April 23 - May 3, 1999 Approve 1st drafts (Committee) May 3 - 14, 1999 Writing final drafts (Hall-Foushee) May 14- 24, 1999 Approval final drafts (Committee) May 24 - July 15, 1999 Shooting and narration (Hall-Foushee) July 15 - August 31, 1999 Editing (Hall-Foushee) September Testing (Committee/assistance by Hall-Foushee) September Changes for final copy IV. Regional Accents: The committee decided the regional accents are very important and should be shot on location at one or more of the sites. African-American women depicted should be from the South and Mexican-American women should be used for Spanish. V. Other interventions: •Brochures: should be staged and contain information can be up-dated periodically, but still tailored to decision making and how to interact with your doctor on a day-to-day basis. •Decision balance sheets are transitional and should be used in brochures as well as community workshop kits to explain the decision making process. First step is developing a list of the pro's and con's and then explaining how to use the information that is listed or to explain certain medical terms in lay words. •Physician education piece: The physician education piece should be developed to educate doctors that women may be approaching them with lists of questions regarding their decision on whether to have a hysterectomy. These classes would allow physicians to be aware that ENDOW has developed a video as well as other intervention materials which are being circulated in their communities. These classes could be presented as CMEs, as grand rounds presentations and perhaps as curriculum for residents. Flip charts can be developed by the intervention committee and used to educate others. •Malpractice angle: Is one of patient doctor communication. If a patient feels that they have a relationship with their doctor in which they can ask questions and the doctor will listen and answer their questions than they are satisfied and satisfied patients don't sue. •Partner information: Could be developed in brochures or flyers explaining what a women faces regarding the decision making process. •Provider Add: Providing information to medical students through grand rounds, CME's and seminars which would teach residents how to communicate with patients. Materials could be developed based on focus group data. •Community based workshops: These kits could be used by community health leaders to lead support groups after initial training by the invention committee . These kits would be developed by the intervention committee with reference materials such as decisional balance sheets, educational booklets, flip charts etc. These classes could be conducted as 1 day or multiple day workshops. VI. Conference calls: Friday, February 12, 1999 @ 10:00 CST Friday, February 26, 1999 @ 10:00 CST M99020~2 MINUTES: STUDY COMMITTEE MEETING Attendees: Dr. Robert McKeown, and Donna Richter, University of South Carolina; Ina Bawaya, and Dr. Clo Mingo, University of New Mexico; Dr. Jan Groff, Dr. Pat Dolan-Mullen, Dr. Guillermo Tortolero, Adriana Linares, University of Texas - Houston, Suzanne Folger, CDC, Dr. Beth Lewis, Dr. Dale Williams, Dr. LeaVonne Pulley, Dr. Carol Cornell, and Trena Johnsey, University of Alabama at Birmingham. I. Agenda: 1. Review and approve minutes from 1/8/99 conference call - Beth Lewis CDC up-date - Suzanne Folger Review project timelines - Beth Lewis Data Management and Analysis Subcommittee report - Dale Williams Intervention Committee report - Donna Richter Publications Committee - Beth Lewis Future planning, spin-off projects - Beth Lewis, Jan Groff Future meetings and conference call schedules - Beth Lewis II. The minutes from the January 8, 1999 conference call were approved without corrections. III. Review project timelines: Dr. Lewis reported that Alabama, New Mexico and Texas had completed the survey process and transferred all data to the coordinating center. Video development should be completed by Hall and Foushee by the end of year 4 and focus groups with regard to intervention development should have begun already or are being planned. IV. Up-date on data analysis/management: Dr. Williams reported Dr. McCreath should have a completed data set by March 15, 1999 excluding the open-ended questions and by mid - Summer a final data set would be available with all issues regarding the scales, and open-ended questions resolved. Dr. McKeown reported that South Carolina had completed 50 more surveys last week and after double entering and validating the data, these surveys would be transferred to the coordinating center by February 15, 1999. •Data transfers: Dr. Williams reported that the coordinating center would begin full editing of all the transferred data the week of February 1, 1999 in order to meet the above deadline. Final data set: Once the data set has been finalized (except for the remaining scale development and open-ended items), it will be distributed by the coordinating center to the sites for review. Action Item: Each site will then compare the final core data set for validity. Dr. McKeown explained that since the South Carolina survey was a stratified sample of randomly selected mailings which did not yield the African-American participants in Buford and Jasper Counties, advertising was developed (call in's and referrals by word of mouth) yielded well educated whites and the community contacts (such as prominent figures in the community) yielded the greatest number of low-income African-American women. •Medical history table/scale scoring: •Outcome expectancy scale: Is an algorithm scale going to be developed? Drs. Groff and Pulley reported that they were working on this scale and would contact Dr. McCreath for information as needed. Action Item: Dr. Folger will arrange for Dr. Sam Posner, a cognitive psychologist to consult with the ENDOW project on the best way to proceed with both individual site and cross site analysis of the outcome expectancy scales for HRT and Hysterectomy. •Social support scale: Dr. McKeown reported that he and Dr. McCreath were developing this scale at present, but since a different number of questions was asked at each site a decision needed to be made on how to approach the scale. Action Item: The committee decided to develop a Z-score based on site specific data. •Open-ended text: Last question of the survey, "What should a women know" Dr. McKeown reported that the coding for this question was not complete due to the truncated list of responses. At 1st pass, 20 codes were developed from the readable responses and returned to the coordinating center. Of the 1,500 responses "options and alternatives" appeared more than any other code, however, their meaning still needs to be determined. Dr. McKeown proposed the foll owing way of handling these responses. •The 1,500 responses should be sorted by the 20 codes and then distributed to each site for review. If the responses are handled this way who will distribute them? Dr. McKeown stated that South Carolina gathered exactly what the participant said during the interview, but when data entry took place made each comment a separate variable. Action Item: Dr. McKeown will send this spread sheet to coordinating center who will then send 20% to Texas for inter-rater reliability. After completion Texas will return their categories to the coordinating center who will then compare both sets. Remaining Open-ended questions: 1. What is the most important issue for the intervention committee, to have a raw list or to have a grouping prepared from the raw list for future data issues? 2. Review list and priority responses and have someone go through for inter-rater reliability. Action Item: The coordinating center will send all additional text responses as well as those that were truncated to the investigators assigned. Action Item: The investigator will then return their coded responses to the coordinating center. After all responses are coded, the coordinating center will send 20% of the responses to a site different from the one that originally processed the item. The second site will develop categories for the responses and return to the coordinating center. Action Item: The coordinating center will then compare the two category lists and determine if they are comparable. Once the category set for a given item has been finalized, Ms. Houser will code a random 20% of responses using the categories to determine inter-rater reliability. Analysis: The study group committee held a discussion concerning the expectation of publications for upcoming year. Action Item: Once the final data set is distributed to all sites, analyses should be done locally and then sent to the coordinating center for verification. Table of items: The coordinating center is compiling a table to show what qu estions were asked by all sites. This table will include differences in response formats, to allow investigators to easily determine which data is available for analysis at each site. Action Item: The coordinating center will distribute the table to the sites upon completion. V. Intervention committee up-date: Video production: Dr. Richter reported that video development had begun and that the intervention committee had received the following deadlines from Hall-Foushee after conducting the 1st conference call with Nancy Hall. February 1- 8, 1999 Script discussions (Hall-Foushee/intervention committee) February 9-22, 1999 Writing content outlines and creative treatments (Hall-Foushee) February 22- March 1, 1999 Approve content and creative outlines (Committee) March 1-9, 1999 Shooting testimonials (Hall-Foushee with arrangements made by site staff) March 9-21, 1999 Transcriptions of testimonials - both sides (contracted out) (Nancy on vacation March 10-19, 1999) March 22-April 23 1999 Writing 1st draft of both scripts (Hall-Foushee) April 23 - May 3, 1999 Approve 1st drafts (Committee) May 3 - 14, 1999 Writing final drafts (Hall-Foushee) May 14- 24, 1999 Approval final drafts (Committee) May 24 - July 15, 1999 Shooting and narration (Hall-Foushee) July 15 - August 31, 1999 Editing (Hall-Foushee) September Testing (Committee/assistance by Hall-Foushee) September Changes for final copy Dr. Richter gave a synopsis of the discussion with Nancy Hall: 2 videos, 15 minutes each would be developed (1 English and 1 Spanish) using the theme "Hysterectomy, The Decision is Yours". These videos could be similar in script and footage but featuring culturally appropriate characters, events, situations and settings. Ms. Hall proposed the question "Are regional accents important"? The decision was made by the intervention committee that southern African-American and Mexican-American accents for Spanish would be used. The intervention committee decided that a narrator would be used, either by voice over or on scree n and ideally should be someone that is representative and respected by all women. Examples: Oprah Winfey, Rosie O'Donnell, Felicia Rashad, or Whoopie Goldberg The intervention committee decided that the video should tell women how to approach their doctor, but not to bash the doctor. This video should be stand-alone and be used in doctor's offices as well as women being able to view on their own. Other Intervention materials: The intervention committee decided that the following types of interventions should be developed in addition to the video. a. Community based kits: These kits would be used by community health leaders in leading support groups after initial training by the invention committee . All information within these kits would be developed by the intervention committee with reference materials such as decisional balance sheets, educational booklets, flip charts etc. Educational classes for the use of these kits would be conducted as 1 day or multiple day workshops. b. Brochures: Brochures should be staged and contain information that is updated periodically, but still tailored to decision making and how to interact with your doctor on a day-to-day basis. A brochure could contain a decisional balance sheet which would allow one to list the pro's and con's of the decision making process and then explain how to use the information that is received. c. Physician education piece: This intervention should be developed to educate doctors on how to be receptive and respond to women who may be approaching them with a list of questions regarding their decision or whether to have a hysterectomy. These classes would allow the physicians to be aware that the ENDOW project has developed a video as well as other intervention materials which are being circulated in their communities. These classes could be presented as CMEs, as grand rounds presentations and perhaps as curriculum for residents. VI. Publications committee: Journal of Women's Health: Dr. Richter reported that all the individual site papers had b een received and miscellaneous corrections had been made. Drs. Richter and Galavotti are working on the introduction and summary piece for the journal and should be able to submit within the next couple of weeks. APHA submission: The deadline for APHA submissions is February 3, 1999. All four abstracts and 1 panel discussion abstract will be submitted for the November 1999 meeting in Chicago, Ill. Publication decisions regarding manuscripts: Action Item: The study committee decided that lead authors would determine whether an author is dropped from the manuscript or the authorship order is changed due to lack of contribution toward manuscript preparation. Action Item: The study committee decided that site specific papers would be analyzed locally and then sent to the coordinating center for validation. VII. Future planning, spin-off projects: The study committee discussed the prospect of submitting to AHCPR for additional funding for intervention implementation and decided that this process should be done as a group. The following options were discussed since AHCPR has a $500,000 rule. Submit a large grant to test all invention materials developed following completion of ENDOW funding Submit a smaller grant consisting of a provider piece and data gathering. This would consist of a medical education piece within the community and propose data collection with providers using the autonomy preference scale with GYN's and others. Submit a smaller grant evaluating the dissemination of the video and related materials such as brochures. Brochure development should be done by October 1, 1999 using reproductive health care choices of post-menopausal women (hysterectomy, HRT or menopause) concentrating on a vulnerable populations. Action Item: The study committee decided that the grant should be written regarding follow-up intervention as a group. It was determined that specific aims should be developed along with a budget and then submitted to AHCPR for permission using the ENDOW project as pilot data. Ideas for t his grants could be trying to access the consumer side with outcome expectation or just being satisfied with one's healthcare in general. Action Item: The study committee decided to submit this larger grant this time next year and do additional pieces as small segments at a later date. VIII. Future meetings and conference calls: Future meetings: Tuesday - Wednesday, May 11- 12, 1999 or Monday - Tuesday, May 24-25, 1999 Galveston, Texas Action Item: Trena will determine which are better days via email and then proceed to set up meeting. Future conference calls: Study Group Friday, Mach 5 1999 @ 11:00 CST Friday, April 4, 1999 @ 11:00 CST Intervention Committee Friday, February 12, 1999 @ 10:00 am CST Friday, February 26, 1999 @ 10:00 am CST Data management/data analysis committee Thursday, February 25, 1999 @ 3:30 PM CST M990305 ENDOW RESTRICTED AREA Study Group Conference Call Minutes March 5, 1999 at 11:00 am CDT Attendees: Dr. Robert McKeown, University of South Carolina; Dr. Carla Herman, Ina Bawaya, and Dr. Clo Mingo, University of New Mexico; Dr. Jan Groff, and Adriana Linares, University of Texas - Houston, Dr. Beth Lewis, Dr. Dale Williams, Dr. LeaVonne Pulley, Dr. Carol Cornell, Shannon Houser, Dr. Heather McCreath, and Trena Johnsey, University of Alabama at Birmingham. Agenda Review and approve minutes from February 2, 1999 meeting - Beth Lewis Up-date on survey progress - Robert McKeown Up-date on data analysis/management committee activities - Heather McCreath, Dale Williams Publications Committee - Beth Lewis Qualitative special issue papers - Donna Richter APHA abstract submissions - Beth Lewis Further discussion of future planning, spin-off projects - Beth Lewis Miscellaneous May meeting arrangements - Trena Johnsey May meeting agenda - Beth Lewis (Suggested items: Data Analysis/Management Committee, Intervention, Publications Committee reports, planning for Year 5 intervention and evaluation activities, scientific presentations) II. No additions were made to the agenda. III. The minutes fr om the February 2, 1999 Study Group Committee meeting in Atlanta, GA were approved without corrections. IV. Up-date on survey progress: Dr. McCreath reported that Dr. McKeown had sent the South Carolina data excluding 30 to 50 surveys that are still in the field; however, data collection is finished. VI. Up-date on data analysis/management activities: Survey data: Dr. McCreath reported that the coordinating center had received the final data from South Carolina and is compiling a final cleaned data set to be available for distribution on April 1, 1999. This, however, will not include the re-coded open-ended items and some scale scoring. The coordinating center will include as documentation a table that summarizes all the items asked at each site and will specify for some of the symptom items where those were asked. Open-ended coding: Dr. McKeown reported that he would be sending the truncated items sometime next week. Dr. McCreath stated the following plan would be used: each investigator who has agreed to code will code the entire set of responses. If the set of responses is large enough, the coordinating center will send out a subset; if it is small, the coordinating center will send the entire set again to another investigator to develop a list of categories. The coordinating center then will compare the two categories to see if there is good concordance. If there is, the coordinating center will then get Shannon Houser at UAB to do the 20% inter -rater reliability. Verification: Dr. McCreath is compiling a set of instructions for programmers and authors. These instructions will explain the verification process; however, Dr. McCreath asked for clarification on what the coordinating center 's role would be regarding verification of the core data. Dr. Lewis instructed Dr. McCreath to look at the publication guidelines for clarification. Action Item: Dr. McCreath will compile the verification instructions for programmers and authors based on the publication guidelines. Site-specific Table: Dr. McCreath is compiling a table showing all the different types of data collected. This table will specify which sites collected provider data, clinic data, partner data, as well as overall survey data. SF 12 Scoring: Thanks to Dr. Pulley the SF 12 scoring has been confirmed. Data management/data analysis role: Dr. McCreath would like for everyone to think about how the data committee can help with planning and evaluating the intervention and discuss this at the May meeting. V. Intervention Committee Report: Dr. Cornell reported that the intervention committee had a conference call with Nancy Hall to discuss the content outline for the upcoming video. Video taping began the week of March 1, 1999 in South Carolina with individual interviews. The committee discussed specific guidelines for whom she should interview while in South Carolina. Dr. Cornell explained how Ms. Hall is going to take the interview content from South Carolina and build the detailed script. After completing the detailed script, Ms. Hall will send to the intervention committee for review and from that Ms. Hall will work with New Mexico and Texas to develop the Spanish script. Presently other types of intervention activities are being conducted at each site. Alabama is trying to get focus groups up and running to find out what types of interventions women want. South Carolina has conducted several focus groups and will be meeting with their Community Advisory board in two weeks to get their input. VI. CDC/Office of Women's Health up-date: Dr. Lewis stated that she emailed the up-date this morning including abstracts, publications, center-specific and not and would like for everyone to review and make comments. VII. Publications committee: Dr. Lewis reported that it was her understanding that the special issue papers had been sent to the Journal of Women's Health. The APHA abstracts have been submitted and we are awaiting news. Dr. Lewis reported that Pat Riley forwarded an email from Dr. Loretta Finnegan calling for abstracts for the Society fo r Public Health Education meeting with deadline of March 17, 1999. Action Item: The committee decided that they were not ready to submit at the present time since this meeting deals with intervention. Dr. McCreath reported that all the APHA abstracts and papers in progress could use the April 1, 1999 core data set for analysis. Dr. McCreath also stated that since the APHA abstracts analysis would be done at each site, she would send her programs to anyone who requested them. VIII. AHCPR discussion: Dr. Lewis suggested that the committee continue the discussion from the February meeting regarding AHCPR submission. 1) Submit a large grant to test the intervention materials, 2) Submit a smaller grant with a provider piece and to collect some data and 3) Submit a smaller grant to disseminate the video. The deadlines for submission are the same as NIH, February 1, June 1 and October 1. Action Item: The committee decided that it would be best to submit this year due to the money allocation at AHCPR. Further discussion will occur. IX. May Meeting: May 11-12, 1999, Hotel Galvez in Galveston, Texas. Everyone can fly into Houston Hobby in the afternoon on Monday, May 10, 1999 and Dr. Groff will arrange transportation to Galveston. X. Agenda - May Meeting: General information regarding committee up-dates (intervention, publication, data analysis) Discuss intervention plans for next year Future planning for additional grant submission Data presentations - papers in progress and abstracts XI. Conference calls: Study Group committee, April 2, 1999 Return to ENDOW home page. All material on this server Copyright COPY; 1997-99 by the publishers involved. M990402 ENDOW RESTRICTED AREA Study Group Conference Call Minutes April 2, 1999 at 11:00 am CDT Attendees: Dr. Robert McKeown, University of South Carolina; Dr. Carla Herman, Ina Bawaya, and Dr. Clo Mingo, University of New Mexico; Dr. Adriana Linares, University of Texas - Houston, Dr. Beth Lewis, Dr. Dale Williams, Dr. LeaVonne Pulley, Dr. Carol Cornell, Dr. Roma W illiams, Shannon Houser, Dr. Heather McCreath, and Trena Johnsey, University of Alabama at Birmingham, Suzanne Folger, CDC Agenda Review and approve minutes from March 5, 1999 conference call - Beth Lewis Up-date on data analysis/management committee activities - Heather McCreath, Dale Williams Up-date on intervention committee activities - Donna Richter, Carol Cornell Publications Committee - Beth Lewis Qualitative special issue papers - Donna Richter APHA abstract submissions - Beth Lewis Dissertation Proposal - Robert McKeown Further spin-off projects - Beth Lewis Miscellaneous May meeting arrangements - Trena Johnsey May meeting agenda - Beth Lewis (Suggested items: Data Analysis/Management Committee, Intervention Committee, Publications Committee reports, planning for Year 5 intervention and evaluation activities, data presentations) II. No additions were made to the agenda. III. The minutes from the March 5, 1999 Study Group Committee conference call minutes were approved without corrections. IV. Up-date on data analysis/management committee progress: Dr. McCreath reported that data cleanup procedures are going well with no major problems, and the center data is corresponding appropriately with the correct variables. Sections 1-7 of the questionaire have been cleaned and a completed data set will be distributed in about a week via the Web. Navajo data: The committee decided that the Navajo data would not be distributed with the final data set, but the coordinating center would create a separate data set that corresponds in structure to the one that is distributed via the web that contains only Navajo data. Action Item: The committee will discuss guidelines and develop a plan to add disclaimers to all data including Navajo at the Galveston meeting. Open-ended coding: Dr. McCreath reported that the remaining open-ended responses without truncation along with individual response sets and a schedule for how coding should be done will be distributed to all investigators by April 5, 1999. Data management /data analysis role: Dr. McCreath reported that the data analysis/management committee has been discussing what role the committee needs to have with regard to the upcoming interventions and evaluating the interventions. Further input is needed. Data coordinating center : Dr. Lewis stated that the supplement from the Office of Women's Health at CDC for the data analysis/data management activities is due to run out in September, 1999. If there is any carryover, Dr. Lewis will discuss with Pat Riley and Enrique Nieves and she will and explore whether there is any funding available for the upcoming year, since data collection has only recently been complete and since resources maybe needed for Year 5 regarding intervention evaluation and further analyses of the survey data. Action Item: Site should plan for their needs for the data already collected and data needs for intervention evaluation VI. Up-date on intervention committee activities: Video discussion: Dr. Linares reported that Ms. Hall will visit Texas on April 21, 1999. Dr. Cornell reported that the intervention committee had a conference call with Nancy Hall to discuss the content outline for the upcoming video. Action Item: Trena will schedule a conference call for the intervention committee the week of April 5, 1999 to review the draft script. Video reproduction: Video reproduction will cost $2.00 per copy and the number of copies will be determined at completion of video process. ........ perhaps 20 original master giving each site 1 English and 1 Spanish. Other interventions: Dr. Cornell reported that Alabama will complete 4 to 8 focus groups using hysterectomized/non-hysterectomized African-American and white women. Recruitment for these focus groups has begun. Focus groups with African-American women will be conducted in the next couple of weeks. Dr. Cornell reported that Ms. Hall could help in the development of materials that would support the video. The committee as a whole has had discussions about what could or should go into a brochure a nd has had discussions about intervention evaluations, but no decisions have been made. Action Item: The committee will have discussions at the Galveston meeting in order to make plans for Year 5 intervention. Action Item: The intervention committee will schedule another conference call at the Galveston meeting. VII. Publications committee: Journal of Women's Health supplement: Dr. Lewis reported that it was her understanding that the special issue papers had been sent to the Journal of Women's Health. Numerous emails have been received checking titles and an email was sent today asking how many copies we will be requesting. APHA abstracts: Dr. McKeown reported that the APHA abstracts were accepted as a special session. Each abstract was criticized for different reasons for example, concerns about sampling, response rates, definition of terms, and the level of detail of results either too little or too much. The APHA website will reopen on April 15, 1999 and everyone should be able to determine the official status of your abstract. Special session time: Wednesday, November 10, 1999, 8:30-10:00 am. Action Item: The committee will begin working on presentations, and all presentations will exclude Navajo data . Action Item: Dr. Herman will bring Navajo analyses in table form to the Galveston Meeting and the committee will discuss for future analyses. VIII. Dissertation request: "Perceptions of well being: theorectical model of determinants among women who have had a hysterectomy" Dr. Lewis discussed the need to make sure that overlap does not occur. Dr. McKeown reported that all data would be used except for Texas, because she wants to use women who have had hysterectomy. Action Item: The committee decided to approve the proposal and if she wants to publish from the dissertation, then she will need approval again from the committee. IX. Future spin-off projects: Dr. Lewis stated that there was interest in submitting to AHCPR, a permission letter would be needed for over $500,000 in any year. Dr. McKeown re ported that AHCPR has been advertising that they have monies available to researchers and have identified that they are interested in vulnerable populations and shared decision making. Action Item: The committee will discuss at the Galveston Meeting developing a design, specific aims and budget in order to submit letter. X. May Meeting: Hotel Galvez in Galveston, Texas May 11, 1999: 8:00 AM - 5:00 PM May 12, 1999: 8:00 AM - 12:00 PM Continental breakfast arranged for both mornings. Lunch provided on May 11, 1999. Dr. Groff will arrange dinner on May 11, 1999 Dr. Linares has arranged van transportation for everyone to Galveston from the Hobby airport. Room reservations have to be made by April 20, 1999. Agenda - May Meeting: Data analysis - update on data set progress Data analysis strategy - Guidelines for data analyses after study completion - adding disclaimers for Navajo. Methodology discussions Data management/data analysis issues for intervention Intervention committee report - Planning for Year 5 intervention and evaluation activities Publication committee reports - Status of papers, analysis ideas Data presentations - Dr. McKeown will present preliminary analyses on menopause Dr. Herman will present Navajo analyses AHCPR submission Methodology discussions XI. Future Conference calls: Study Group committee, June 4, 1999 @ 11:00 CST. Return to ENDOW home page. All material on this server Copyright COPY; 1997-99 by the publishers involved. M99060~1 ENDOW Study Committee Conference Call June 4, 1999 Attendees: Dr. Beth Lewis, Dr. Dale Williams, Dr. Heather McCreath, Shannon Houser, Dr. Carol Cornell, and Trena Johnsey, University of Alabama at Birmingham, Dr. Adriana Linares, University of Texas - Houston, Dr. Carla Herman, Kathy Altobelli, and Ina Bawaya, University of New Mexico, Dr. Robert McKeown, University of South Carolina, Dr. Suzanne Folger, CDC Review and approve minutes from May 11-12, 1999 study group meeting: The minutes were approved without additions or modifications. ITEM 1: Action items from May meeting: Supplement funding: Dr. Lewis reported that supplement budget information regarding additional funding for other modalities such as brochures was e-mailed to the PI=s and the intervention committee members. Survey methodology documents: Dr. Lewis reported that the survey methodology documents were e-mailed to the PI=s. Study-wide paper #2 has been changed to proposed on the publication grids. Publications/presentations grid changes are changed as needed by the coordinating center.; sites should supply up-dates as needed to maintain. Draft scripts: The intervention committee will have a conference call next week to finalize the draft video scripts. Dr. Linares reported that Texas has found several materials on anatomy and will bring these items to the Intervention meeting in July. ITEM 2: CDC up-date: Renewal application=s: CDC deadline for SIP renewal applications is July 23, 1999. Dr. Folger reported that Pat Riley is no longer with the Prevention Research Centers, but that David Elswick is still the Project Officer . She will try to meet with him within the next week. Dr. Williams reported that Marshall Kreuter will be the new acting director of the Prevention Research Centers. ITEM 3: Data Management/analysis committee report: Final dataset: Dr. McCreath reported that the cleaning and editing of the dataset has been completed. Data questions were forwarded to the appropriate sites and clarifications have been returned to the coordinating center. The final dataset including the missing South Carolina data will be available on the web by Friday, June 11, 1999. Dataset documentation: Dr. McCreath reported that the dataset documentation has been scanned and will be available on the web with the final dataset on Friday, June 11, 1999. Open-ended coding: Dr. McCreath reported that she will be focusing on the open-ended response coding and will forward to the sites by the week of June 14. The next data management/analysis conference call will be Wednesday, June 23, 1999 @ 3:30 PM. The committee will begin to discuss issues of analysis as people prepare for the APHA presentations and accompanying manuscripts ACTION ITEM: Dr. McCreath will develop a table covering the number of surveys done at each site and will forward to the PI=s to be included with their renewal applications. ACTION ITEM: Dr. McCreath will develop an overall table for the sites including all ethnicities on the core data and will forward to the PI=s early next week. ACTION ITEM: Dr. McCreath will develop a demographic table for the core dataset and forward to the PI=s. ACTION ITEM: Dr. Lewis asked that all sites forward a copy of their renewal application to the coordinating center. ITEM 4: Intervention committee report: Dr. Cornell reported that Ms. Hall found two conceptual issues regarding video production: The English language video has too many married women. Dr. Cornell reported that Ms. hall placed a narrative from a single woman into the video. The Spanish language video was too pro-hysterectomy. Dr. Cornell reported that Ms. Hall is working on this issue. The intervention call for final script approval will be on Monday, June 7, 1999 @ 1:00 PM. ACTION ITEM: Dr. Lewis suggested that the intervention committee discuss with Ms. Hall other modilities such as brochures that will help support the video. A budget of $10,000 will be available for these other interventions. Dr. Cornell stated that Ms. Hall stated that other interventions would be needed to support the video and thought that they should overlap. ITEM 5: Publication committee report: Abstracts: The final dataset will be available on the web so that each site may do their own analysis for the APHA presentations. ACTION ITEM: Dr. McCreath will forward the SAS programs that were used to each site to help with the analysis for the abstracts. ACTION ITEM: Dr. Lewis requested that all investigators forward any changes or proposals of major papers to the coordinating center within the next month so that the publication grids will be current before the renewal deadline. ITEM 6: Intervention meeting discussion: The intervention meeting will be July 8-9, 1999 in Albuquerque, NM at the Rio Grande Best Western Old Town. ACTION ITEM: Each site will bring to the intervention meeting a written intervention protocol and evaluation plan, as well as recommendations for an evaluation instrument and examples of materials. ACTION ITEM: Attendees should e-mail Trena so that arrangements can be made. ITEM 7: Miscellaneous: Study group conference call: The next study group conference call will be July 2, 1999 @ 11:00 AM. Study group meeting: The next study group meeting will be tentatively scheduled for October 7-8, 1999 in Birmingham, Alabama. WEB site: Dr. Herman reported that she e-mailed to the PI's information about an Otawa website on decision making. This website contains information dealing with evaluation measures and has an excellent literature review on decision aides. The decision making instrument used was translated into French and Spanish, but was mostly used with a white population and would like to have experience in minority populations. Dr. Herman contacted them and they are interested in working with us, sharing any of their instruments in order to work with minorities. M99070~2 ENDOW Study Committee Conference Call July 2, 1999 Attendees: Dr. Beth Lewis, Dr. Heather McCreath, Shannon Houser, Dr. Carol Cornell, Dr. LeaVonne Pulley and Trena Johnsey, University of Alabama at Birmingham, Dr. Adriana Linares, University of Texas - Houston, Dr. Carla Herman, University of New Mexico, Dr. Suzanne Folger, CDC Review and approve minutes from June 4, 1999 study group conference call: The minutes were approved with minor modifications. ITEM 1: Action items from May meeting: Supplement funding: Dr. Lewis reported that supplement budget information regarding additional funding for other modalities (such as brochures) was distributed by e-mail to the PI=s and intervention committee members. Survey methodology documents: Dr. Lewis reported that the survey m ethodology documents were e-mailed to the PI=s. Publications/presentations grid are changed as needed by the coordinating center, sites should supply up-dates as needed to maintain. Scripts - draft: Dr. Linares reported that Ms. Hall has finalized the English script, but will distribute the Spanish script again due to last minutes changes regarding translation. The Spanish script will be reviewed at the July Intervention meeting in Albuquerque. Anatomy materials: Dr. Linares will bring anatomy materials to the Intervention meeting next week. Intervention meeting: The July 8-9, 1999 Intervention meeting plans have been finalized. Each site should bring their site-specific intervention protocol and evaluation plans to the meeting. Core dataset: Dr. McCreath distributed the 1st draft of the final dataset on June 30, 1999. ITEM 2: Publication committee activities up-date: Journal of Women's Health: Dr. Lewis reported that Dr. Richter had been in contact with the Journal of Women's Health regarding the ENDOW special issue. It should be in press a couple months after the referee's comments are distributed to the authors, reviewers' comments should be received sometime within the month of July. APHA abstracts: Dr. Folger reported that the APHA abstracts would not need CDC clearance unless a CDC employee is listed as a co-author. First authors should check their author lists. ITEM 3: Data Management/analysis committee report: Final dataset: Dr. McCreath reported that the1st draft of the final dataset was distributed to the sites on Wednesday, June 30, 1999. Dataset documentation: Dr. McCreath reported that 3 parts of the dataset documentation are available on the web: a) General usage notes, (naming conventions) b) Item by site table (summarizes all items asked on every survey, which site asked and if anything is unusual about the subpopulation or skip patterns), and c) the SAS program. The remaining items would be available on the web by July 6, 1999, including site specific surveys, core survey which will be a PDF file, and the methodology summaries from each site. Open-ended coding: Dr. McCreath reported that open-ended response coding was distributed to the appropriate investigators. The last question "what a woman should know about hysterectomy" will be forwarded to South Carolina on July 2, 1999. Investigators agreed to return open-ended responses to Dr. McCreath at the coordinating center by August 2, 1999. Quality Control: Dr. McCreath reported that she will discuss the procedure for quality control on open-ended response subsets with Dr. Williams and will distribute these files early next week The next data management/analysis conference call will be Monday, August 19, 1999 @ 3:30 PM unless otherwise determined by the committee. On this call the committee will begin to discuss issues of analysis as people prepare for the APHA presentations and accompanying manuscripts ITEM 4: Intervention committee report: Dr. Cornell stated that each site should bring their site-specific intervention protocols for next year including evaluation plans for intervention, any ideas for pre and post core questions, ideas of where to pilot materials and ideas for supplemental intervention materials in addition to the video. Please bring show and tell items that possibly could be adapted for ENDOW. The goal of the intervention meeting is to have a better understanding each sites intervention plans for next year and to know the commonalties across sites so that the data management committee will have a more concrete idea regarding data for next year. Supplemental funding: Dr. Lewis reported that of the additional $90,000 supplement to produce the video, approximately $11,000 remained to fund additional intervention activities roughly $2,500 to each site. Action Item: The intervention committee will develop a plan to spend the remaining $11,000 within this fiscal year. Logo: New Mexico, South Carolina, and Texas all have logos which represent their site-specific study. Action Item: Each site will bring their site-specific logos to the intervention meeting, at which time a definite logo will be developed for the study. Budgets: Dr. Lewis reported that Year 5 budgets are due on July 23, 1999 at the CDC; however, she will be forwarding to her Prevention Center by July 21, 1999 to be processed as part of the center application. Dr. Linares reported that the PHS 2590 continuation forms should be used. Action Item: Dr. Folger will explore what forms are requested for a continutation application at the CDC and will e-mail Trena, who will distribute to each site. ITEM 5: Miscellaneous: Intervention meeting discussion: The intervention meeting will be July 8-9, 1999 in Albuquerque, NM at the Rio Grande Best Western Old Town. The meeting will be Thursday, July 8, 1999 8AM-5:00PM, and Friday, July 9, 1999, 8AM-12:00 Noon. Action Item: Dr. Cornell will develop the agenda for the meeting and distribute to the attendees. Study group conference call: The next study group conference call will be August 6, 1999 @ 11:00 AM. Study group meeting: The next study group meeting will be October 7-8, 1999 in Birmingham, Alabama. Data management/analysis committee conference call: The next data management committee is scheduled for Monday, August 19, 1999 @ 3:30 PM unless otherwise needed. Action Item: Each PI should forward a copy of the continuation application to the coordinating center. M99078~1 ENDOW RESTRICTED AREA ENDOW Intervention Committee Meeting Thursday and Friday, July 8-9, 1999 Albuquerque, New Mexico July 8, 1999 Attendees: Dr. Carla Herman, and Ina Bawaya, University of New Mexico, Dr. Jan Groff, Dr. Theresa Byrd, and Dr. Adriana Linares University of Texas - Houston, Dr. Carol Cornell, and Dr. LeaVonne Pulley, University of Alabama at Birmingham, Dr. Donna Richter, and Molly Greaney, University of South Carolina I. Journal of Women’s Health Supplement: Dr. Richter reported that the special issue of the Journal of Women’s Health’s would be published within the next three months. Authors should receive referee's comments in th e next couple of weeks. II. Video: New Mexico found in their Hispanic population that a "thumbs up or down" was not recognized. Action Item: The committee agreed to change the "thumbs up, thumbs down" to a "check or an X" in both the English and Spanish videos. Translation: The intervention committee discussed the problems of translating the Spanish video in detail. Action Item: The committee decided that there would be a need to review the Spanish video prior to final approval. Action Item: Dr. Linares will ask Hall-Foushee to forward a copy of the Spanish video to Texas and New Mexico for translation review. Closed captioned: Dr. Groff proposed to the committee the possibility of including closed captioning on both the Spanish and English videos. Action Item: The committee decided that closed captioning should be included on both the English and Spanish videos. Action Item: Dr. Linares will asked Hall-Foushee to prepare a quote for closed captioning and send to the coordinating center to be processed. Video distribution: The intervention committee discussed ideas of how and when to distribute the videos. Action Item: The committee decided that the general interest of the video should be decision-making and an evaluation plan was developed. (See attached). III. Site-Specific Intervention Plans Each site presented their site-specific intervention plans for Year 5 to the committee. A. Alabama: Drs. Cornell and Pulley presented the following planed Alabama interventions for Year 5, pending resolution of budget issues. Participant intervention: Participant intervention will include peer-facilitated workshops led by trained African-American community health advisors, and will recruit African-American women from both urban and rural areas of Alabama. Prior to development, a series of focus groups will be conducted in these urban and rural areas to gather information to support intervention. A minimum of four workshops and as many as ten will be conducted and each participant will receive a $ 10.00 reimb ursement, a certificate of completion, refreshments and a T-shirt for participation. Mini-provider intervention: If the budget permits, the mini-provider intervention will allow medical professionals to obtain CME credits for participation either by FAX or web site. This intervention will focus on the skills women need to make decisions regarding healthcare and how doctors can facilitate these skills. The BCCPP has conducted a course similar to the mini-provider intervention using a video and fax. B. South Carolina: Dr. Richter and Ms. Greany presented the following intervention plans for Year 5 to the committee: Participant intervention: South Carolina has developed a similar participant intervention plan to that of Alabama. The focus groups conducted to support the intervention development found that women wanted general health and decision making information and preferred a health care provider. Based on the information from these focus groups, the decision was made to develop a co-facilitators (peer and medical professionals) intervention plan. They have already developed a draft facilitator’s guide (see attached). A total of four workshops (2 African-American and 2 white) will be conducted at a continuing education or community group center. The evaluation plan has not yet been developed. Provider plan: South Carolina will do a provider plan; details are still being developed. A paper comparing what women said about patient-provider interactions to what providers said is in preparation. Dr. Groff reported that she is collecting quantitative information from doctors using a re-worded version of the autonomy-preference index. The provider plan will be offered to providers through county medical societies in a face-to-face setting. The question is whether this type of intervention is more effective than a course using a fax return or the web. C. Texas Workbook intervention: Texas reported that they have decided to concentrate on what women are willing to do after an intervention, being generic using hys terectomy and HRT as examples, but coming up with general skills. A six step plan has been developed (see attached) to use with these naturally occurring groups of women and comparing with individual self-instruction. A budget for the participation of 300 women has been developed in pre and immediate post evaluation, and follow-up. Focus groups will be done to determine the needs and desires of women for intervention. A workbook will be developed to include a decisional balance sheet and resources which a peer would then deliver to women and encourage them to use. This intervention would focus on patient/physician discussions, how information is retrieved, and how to evaluate received information. Provider intervention: Texas has not yet planned to conduct any intervention with providers, but would be interested in a joint provider piece as discussed earlier. Possible provider topics: Decision-making and communication with the physician. D. New Mexico The New Mexico researchers reported that through participating in health fairs, women who sign up to receive information are not interested in learning about hysterectomy. They are still trying to evaluate the community reaction to their collaborative efforts of newsletter development (see attached) and radio talk show appearances. A site-specific brochure was developed for distribution and they are in the process of developing a web site that will include their information as well as links to other sources of information that women can request. Both pre and post hysterectomy focus groups are planned to pilot test the video within the Albuquerque community, but is still having problems with the HMO setting. An interactive CD on decision-making regarding HRT, herbs, etc is being developed and will be pre-tested on 40 women in the pre and post phase of their decision. At present, feedback is being gathered with women that come into the office regarding the CD evaluation. Dr. Herman received from the Ottawa Health Decision Center information regarding intervention development and encourages all sites to use it. Another web site was found on decision making: http://www.thelancet.com/newlancet/sub/issues/vol353no9168/body.book1980.html New Mexico has not planned a provider piece, but would be willing to participate in a group piece. IV. Web-based CME: The intervention committee discussed the possibility of a web based provider CME course offered through the ENDOW Coordinating Center. Dr. Groff brought a workbook from the MD Anderson Cancer Center at the University of Texas - Houston MD that could be helpful in developing materials and providing necessary information to work with HMOs, and decision-making, etc. The committee felt that a web based CME course may be the most cost -effective way to get providers involved, as well as developing interventions. The provider and participant intervention pieces would be separate, but could be developed simultaneously including information on shared decision making, communication with providers and a message board. The goal of the web based CME provider piece would be to get as many doctors involved as possible, but how to accomplish this could be difficult. Publicity could be done at each ENDOW site, through linking with other web sites and by mentioning in all published ENDOW articles. The costs of maintaining the CME provider course would be difficult. Charging providers would result in a need for the processing credit cards, or billing, etc. If a charge is requested getting providers to pay is another issue Decision: The intervention committee decided to develop the participant phase and explore in more detail the CME provider portion of the web site. Action item: Dr. Cornell will talk to coordinating center to determine the cost of providing a CME service. Action item: The committee will explore what if any cost a university would pay for provider CME course. V. Core Materials and Evaluation Instruments: The intervention committee discussed what would be the best ways to spend intervention supplement monies. The conclusio ns were that brochures, decisional balance worksheets, provider information sheets, resource directory, and web site evaluation would be the most important types of interventions. 1. Brochures (video elaboration). 2. Workbook (interactive). 3. Decisional balance sheet (with examples that were familiar). 4. Booklets to take to the practitioner visit (similar to the NERI diary) that can be filled out reminding them to ask questions and prepare for visit. 5. Skills for dealing with problems in interaction with physician. 6. Anatomy visuals (2 dimensional and 3 dimensional if possible). 7. Handouts on treatment options for various problems. 8. Website development for women and CME credits (see the NM website at: http://hsc.unm.edu/epiccpro/endfrm2.html for example of a website) VI. Brochures: The committee decided that the developed brochures would support the video, but stand-alone. The brochures would be available to "take home", re-stating the main points of the video and would need to be useful for both women who have or have not seen the video. The brochure design would be developed from images in the video. The intervention committee went through the video script and highlighted parts that would be beneficial in the brochure. They are as follows: Title stays the same. Intro about hysterectomy decisions (One big decision…) 1. Most not due to life-threatening conditions, there is time to consider. 2. This doesn’t tell you what to decide 3. What’s best for you (page three top) 4. The decision is yours but you’re not alone 5. Reasons for having a hysterectomy (list the most common) 6. Sharing the decision with the doctor (list from page 5) 7. Questions to ask doctor 8. Resources 9. Space for clinic stamps if there is one. Action Item: Dr. Linares will send copies of the relevant NERI materials to the intervention committee. Action Item: Ms. Bawaya will forward information on the "Health-Wise" book to Trena who will order one for each site. Action Item: The committee decided to concentrate on having a rough draft brochure, which could be tested at the same time as the video. Action Item: Dr. Cornell will contact Hall-Foushee regarding brochure development information and obtaining a diskette copy for future reference. The committee held an in depth discussion regarding how to get doctors interested in receiving the developed intervention information. Suggestions for doctor participation were awards or recognition. This could be a possibility for future grant. VII. Suggestions/concerns: Dr. Groff suggested that the intervention committee should look at Kate Lorig’s work on interventions for chronic disease. A concern was raised by the committee that the interventions should give women not only information on hysterectomy, but also other alternatives that are available. VIII. T-shirts logo: The intervention committee decided that the T-shirts would have the same logo for all sites. Example: "The Decision is Mine" with all of the three site logos above. ENDOW Meeting Continued on July 7, 1999 The intervention committee discussed the need to develop other intervention materials. Decisional balance sheet: The Texas group will draft a decisional balance sheet and will distribute to all other sites for remarks. Video evaluation tools: The committee decided that an evaluation instrument should be drafted to test the video. This instrument should include (standard) demographics including language of video, questions about comfort with the video for the participant and her family members. Questions like "Who did you watch it with?" "Do you have your own VCR? " "Where did you get the video?" "Was it for someone like you?" Action Item: Dr. Richter will develop this video evaluation tool and forward to the other sites for review. Dr. Cornell stated that the videos would be available for pilot testing by end of summer, but is unsure whether it will be a rough-cut or the final. The intervention committee decided that each site would conduct at least four focus groups to pilot test the video and the particip ants would be reimbursed from site-specific budgets. Action Item: Dr. Richter will develop a focus group guide to use with the video during pilot testing. Return to ENDOW home page. All material on this server is Copyright & Copied; 1999 by the publishers involved. M9908006 ENDOW Study Committee Conference Call Friday, August 6, 1999 Attendees: Dr. Beth Lewis, Dr. Heather McCreath, Dr. Dale Williams, Dr. Carol Cornell, Dr. LeaVonne Pulley and Trena Johnsey, University of Alabama at Birmingham, Dr. Adriana Linares, and Dr. Jan Groff, University of Texas - Houston, Dr. Carla Herman, University of New Mexico, Dr. Robert McKeown, and Dr. Donna Richter, University of South Carolina, Dr. Suzanne Folger, CDC Review and approve minutes from July 2, 1999 study group conference call: The minutes were approved without correction. ITEM 1: Up-date on publication committee activities - Beth Lewis: Plans for APHA presentation approval Dr. Lewis discussed the October meeting in Birmingham that will focus primarily on the APHA Special Session presentations. Each 1st author will present their presentation to the group for approval. Dr. Williams reported that he and Dr. McCreath have pre-tested placing the APHA presentations on the web. These presentations would be placed on the secured web site with a disclaimer and all the appropriate indexing as long as created in PowerPoint. Special Issue of the Journal of Women's Health Dr. Richter reported that she had asked the editor, as to why only 3 articles had been reviewed to date. Dr. Healy replied to Dr. Richter's email saying that she had resigned as editor, and the Editorial office is being transferred to Boston. A staff member will be going to Boston on Monday to personally review this situation and would have an answer very soon. Dr. Richter instructed each of the 1st authors to send all answers to referee's comments to her and she would forward to the editorial office, who will then process the acceptance letter. ITEM 2: Up-date on data management/analysis commi ttee activities: Survey data: Dr. Williams reported that the coordinating center has not received feedback on the distributed survey data to date. Dr. Williams asked that everyone try to access the dataset, so that if problems arose, the coordinating center could address prior to the push for the APHA presentations. Dr. Herman reported that Ms. Altobelli is working on the HRT data and has not reported any problems with the dataset. Open-ended coding: Dr. Williams asked people to please give a completion date for when the open-ended coding would be returned to the coordinating center from their sites. Dr. Herman reported that New Mexico had returned their open-ended questions. Dr. Linares reported that Dr. Tortolero is working on the open-ended responses from Texas and will be finished by August 27, 1999. APHA presentations: Dr. Williams reported that Eva Chirapongse is now working on the ENDOW project from the coordinating center and is very fluent in SAS programming. Action Item: Trena will add Ms. Chirapongse to the study-wide directory available on the web. The next data management/analysis conference call will be Monday, August 19, 1999 @ 3:30 PM and the committee will begin to discuss issues of analysis as people prepare for the APHA presentations and accompanying manuscripts ITEM 3: Up-date on intervention committee activities: Up-date from July meeting: Dr. Richter reported that the intervention committee meeting was very successful meeting and accomplished the goal of having a clear understanding of Year 5 study-wide and center-specific intervention evaluation plans. The committee decided that the Year 5 interventions that were planned would not be demanding of the study group. Each site reported on their center-specific intervention development plans and their ideas for study-wide interventions. The committee concluded that brochure development should be a study-wide intervention. Dr. Cornell reported that Hall-Foushee suggested the following intervention options: Brochure: A tri-fold, four colo r brochure (9 by 11 1/2), writing/design including working with research is about $ 2,000.00 and printing 3500 copies is about $1,200.00. Dr. Cornell reported that Hall-Foushee expressed the need to have a conference call with the intervention committee to clarify brochure questions before submitting a final brochure bid. Booklet: A 16-page, two-color workbook (3 7/8 by 7 1/8) which can be shrink wrapped to the video. Writing/design including working with research staff and printing would be about $3,500.00 and 500 copies would be $850.00. Tabloid: 4 page, two color (11 by 17), writing and design would be about $5,000.00 and printing of 5,000 copies would be $500.00 and additional groups of 1,000 would be only $50.00 per thousand. T-shirts: Dr. Richter reported that the intervention committee decided that T-shirts would be a good idea using two possible slogans "the decision is mine" or "got ovaries". Each T-shirt would have a study-wide logo. Ms. Bawaya received a quote of $3.87/shirt if order 500 and $3.67/shirt if order 1,000. The shirts will be Hanes 100% cotton 1-color printing and shipping will cost $.25/shirt. Closed caption: Dr. Linares received the following two options from Hall-Foushee for closed caption: Closed caption: The viewer has the choice of turning on/off the words and a statement is placed in the video saying that this option can be used. Open caption: Words are always shown with no option to turn off. The cost of video closed caption is about $841.00 for the Spanish video and $441.00 for the English video. Trena has issued a purchase order for these services. TV/VCR: Dr. McKeown asked if anyone had any ideas about what brand of portable TV/VCR would be better to purchase to use. Action Item: The coordinating center will explore what is the best brand option to purchase for screen size and money. Video progress: Dr. Richter reported that at the intervention meeting, the committee reviewed the text for the Spanish video in English and from that expressed the need to review the video i n Spanish before approval is granted. Dr. Linares reported that she would talk to Hall-Foushee on Monday to explain the translation problems from Texas in the Spanish video. Dr. Herman reported that the minor changes in translation from New Mexico had been emailed to Dr. Cornell who forwarded to Hall-Foushee. Healthwise books: The committee decided to order for each site a "Healthwise" book at a cost of $51.00 a book. Action Item: The coordinating center will order these books from Wendy Perkins at Wellness Promotion Inc. Focus groups: Each site will do four focus groups at each site in September to pilot test the video. Action Item: Dr. Richter will develop the focus group guide to use with video pilot testing. ITEM 4: Up-date on year 5 continuation budgets: Dr. Lewis reported center-specific budgets where sent to the CDC along with a budget from Dr. Lewis for continued support of the data supplement from the Office of Women's Health at the CDC. Dr. Lewis reported that the submitted budget included web development software. ITEM 5: Miscellaneous: Next general meeting: The next study group meeting will be in Birmingham on Thursday, October 7 and Friday, October 8, 1999. Action Item: The coordinating center is exploring possible hotels to hold the meeting close to the University. Conference calls: Study group conference call: The next study group conference call will be Friday, September 3, 1999 @ 11:00 AM. Data management/analysis committee conference call: The next data management committee conference call is scheduled for Monday, August 19, 1999 @ 3:30 PM CST. Intervention committee conference call: The next intervention committee conference call is scheduled for Tuesday, August 10, 1999 @ 2:30 PM CST. Action Item: Each PI will forward a copy of their center-specific continuation application to the coordinating center. Conference call with Dr. Loretta Finnegan: Contact with the STAMP/SWAN Project: Dr. Folger reported that she participated in a conference call with Dr. Finnegan and Antonia Spadaro he re at CDC Prevention Center Office to discuss the Women's Health Meeting and other issues. Dr. Folger reported that Dr. Finnegan again emphasized the need for ENDOW to talk with investigators from the STAMP (The Study on Traditional and Alternative Methods for Postmenopausal Women) and SWAN (The Study of Women Across Nations) projects. Individuals reported that the SWAN project is an epidemiological study of the peri-menopausal transition that is different than ENDOW. The STAMP project was looked into for a site visit and Dr. Groff reported that a decision analyst at Texas talked to someone in San Franciso (AHCPR funded STAMP site) who is accessing women preferences. They are not any further along than ENDOW. Additional contacts will be pursued. Women's Health Meeting: Dr. Folger reported that Ms. Riley said that this meeting is for studies done under the WHI-CPS and the purpose would be to show results of these studies and to talk about next steps of funding. Dr. Folger reported that Dr. Finnegan wants to see how the studies identified the types of intervention needed and how interventions were developed, disseminated and evaluated. According to Dr. Finnegan the meeting is not about future funding. M9909003 ENDOW Study Committee Conference Call Friday, September 3, 1999 Attendees: Dr. Beth Lewis, Dr. Heather McCreath, Dr. Carol Cornell, Shannon Houser and Trena Johnsey, University of Alabama at Birmingham, Dr. Carla Herman, University of New Mexico, Dr. Robert McKeown, and Dr. Donna Richter, University of South Carolina, Dr. Suzanne Folger, CDC Review and approve minutes from August 6, 1999 study group conference call: The minutes were approved with minor corrections. ITEM 1: Up-date on publication committee activities - Beth Lewis: Plans for APHA presentation approval: Dr. Lewis reported that she is waiting for Dr. McCreath to finish re-running the analyses needed for her APHA presentation with the most recent data. Dr. Herman reported that Ms. Altobelli found a glitch in the New Mexico data. Action It em: Dr. McCreath will contact Ms. Altobelli this week regarding this matter. Dr. Lewis reported that the October meeting in Birmingham will cover the APHA presentations. ITEM 2: Up-date on data management/analysis committee activities: Survey data: Dr. McCreath reported the following problems with the dataset: Ms. Altobelli found an error involving the calculation of the variable HRT user, which indicates the use status. Dr. McCreath reported that Texas asked the questions in a slightly different way from the other 3 sites and the variable was not picked up from their specific dataset, which would help clarify HRT use. Dr. McCreath reported that the variable was sent to Ms. Altobelli and the correction would be made in the next version of the dataset. Dr. McCreath reported that Dr. McKeown found a couple of problems with the dataset, however, she wanted to respond to Dr. McKeown before determining whether it is a real problem or just some confusion. Dr. McKeown reported that after receiving Dr. McCreath's email perhaps the 1st question is just confusion, however, he had not been able to look back at the data set as of yet. Dr. McCreath reported that these problems would be distributed via email to investigators so that the errors can be resolved in analysis for the APHA presentations, but will either be incorporated as changes in the data set or further explanation in documentation. Open-ended coding: Dr. McCreath reported Dr. McKeown raised a concern with the open-ended responses since so many women chose the other category on numerous questions. Dr. McKeown stated in the "reasons for hysterectomy" section, many women who had hysterectomies responded in the other category and named a symptom such as abnormal bleeding was the reason for hysterectomy instead of choosing a diagnosis from the categories given. Dr. McKeown stated that the study group needs to decide whether to examine the other category to see if any of the "other responses" match with the categories given. Dr. McCreath stated that this woul d help the data committee to determine whether women reported the "other diagnosis" reason, or if it turns out that not enough responses were listed in order for the decision to be made. Dr. McCreath stated that this would either tell the coordinating center whether women answered something that would actually fit into one of the categories or that it may be the alternative that not all the categories were listed and new categories are needed. Dr. McCreath reported that Alabama and New Mexico had returned their open-ended coding and that the coordinating center will be working with Dr. McKeown in South Carolina to complete the coding since his students are not available and the coordinating center caused some of the delay. Dr. McCreath reported that Ms. Houser will continue looking at all of the open-ended responses and checking the ones that appear to have truncated responses. The coordinating center will be sending a list of participants to see if there is something more on the questionnaire because some of the responses could not be coded due to the truncation. Quality control plan: Dr. McCreath reported that the coordinating center would proceed with the quality control process developed at the February meeting in Atlanta. Category quality control: Dr. McCreath reported that the coordinating center would contact different investigators to re-code 20% of the responses to a certain question and see it they give the same categories. Inter-coder reliability: The coordinating center will re-code 20% to see if they find the same codes. Dr. McCreath reported that after the quality control procedures have been done, a supplementary data set would be processed. The role of the data management committee in Year 5: Dr. McCreath would like for the committee to begin to think about the role of the data management committee for Year 5. The next data management conference call will be September 16, 1999 @ 3:30 PM. ITEM 3: Intervention committee activities: Dr. Cornell reported that the video should be available by the middle of September. Action Item: Each site will review the proposed credits and email comments to Trena. Action Item: Each site will determine the number of brochures and videos needed for their site and email Trena by Tuesday, September 7, 1999. Action Item: Trena will contact Hall & Foushee and determine length of time needed after credits are received for rough draft of the video to be distributed and email date to everyone. Brochure comments: Who is Alma and what nationality? Put many women on the cover to represent everyone. Action Item: Each site will make brochure comments and return to Trena by Tuesday, September 7, 1999 and she will forward to Hall & Foushee. T-shirts: The study group discussed the T-shirt design and decided to use the slogan "The Decision is Mine" and include all three-site logos. The study group decided on a natural 2-color Hanes beefy T-shirt with Turquoise logos. The group suggested XL and XXL sizes. Logos should be spaced either on the back or front and slogan on the reverse to be determined after PO is requested. Action Item: Each site will mail their camera-ready logo to Trena. ITEM 4: Public Committee: Journal of Women's Health: Dr. Richter reported that all the papers except for the Texas and New Mexico revisions have been received. ITEM 5: Up-date on year 5 continuation: Dr. Lewis reported she has to re-do the coordinating center budget, since the amount that the NIH sent to David Elswick was not all for the ENDOW study. $200,000 is for the WHI CPS meeting that Dr. Finnegan wants to have in Fall 2000. Dr. Lewis reported that she has to do a new core budget, a supplement budget and a meeting budget by September 15, 1999. ITEM 6: Miscellaneous: Next general meeting: The next study group meeting will be Thursday, October 7 and Friday, October 8, 1999 at the Pickwick Hotel in Birmingham. Prevention center meeting: February 1-4, 2000 in Atlanta, GA. m991007-8 ENDOW Steering Committee Meeting Pickwick Hotel, Birmingham, Alabama, October 7-8, 1999 Attende es: Dr. Suzanne Folger, CDC, Dr. Dale Williams, Dr. Beth Lewis, Dr. Heather McCreath, MaryAnn Littleton, Dr. Carol Cornell, Dr. LeaVonne Pulley, Shannon Houser, Trena Johnsey, Eva Chirapongse, University of Alabama at Birmingham, Dr. Pat Dolan-Mullen, Dr. Jan Groff, Dr. Guillermo Tortolero, and Dr. Adriana Linares, University of Texas - Houston, Dr. Carla Herman and Ina Bawaya, University of New Mexico, Dr. Donna Richter, and Dr. Robert McKeown, University of South Carolina Thursday, October 7, 1999 The minutes from the September 3, 1999 conference call were approved without corrections. CDC Report: Dr. Folger reported that two people from each Prevention Research Center (PRC) attended a CDC meeting to present future research ideas and their comments for future funding. The CDC concluded that the meeting with the PRCs was successful and all research ideas and comments would be considered for future CDC funding. Project timelines: Each site presented site-specific timelines. The steering committee concluded that finishing focus groups, continuing analyses and submitting publications would be the Year 5 study goals. The steering committee determined that all focus group intervention pilot testing should be completed after the holidays, and the final interventions would begin focus group testing in January. Dr. Folger will contact Mr. Elswick at the CDC to see if no cost extension could be requested if money exist at the end of September 2000. Data management report: Dr. McCreath reported that the following have been done within the last year (Year 4): Developed the structure for the core survey dataset Developed summary variables for the dataset Worked with each site to map site-specific data to the core dataset structure Distributed 4 versions of the interim dataset and 1 version of the final dataset Developed documentation for the final dataset Using study’s recommendation developed a plan for coding open-ended items. The October 21, 1999 data management committee conference call will work out si tuations raised at the meeting. For the rest of the year, conference calls will be quarterly, with the majority of contact by e-mail. E-mail should be a good mechanism regarding data questions because many questions will have to be pondered before answered. The major task for the data management committee is to finish the open-ended coding. All of the responses have been coded except for the last question "What should a women know before having a hysterectomy?" For that item, the SC site coded most of the last question and the CC will complete it. The timeline is as follows: Initial coding by November 1 Category QC by November 15 Rater QC coding by December 1, 1999. Responses for QC comparison categories were distributed to investigators. About 50% have been returned; the remainder will be returned by October 15, 1999. Once the categories for coding are approved, any changes will be made to the entire set and 20% of the responses will be evaluated for inter-rater reliability. For manuscript analyses, the Coordinating Center (CC) has budgeted for some support for all investigators. With an analysis request, please send the paper proposal, along with exclusion criteria, and table shells. The CC will develop a timeline for completion of the analyses. The timeline will be somewhat project dependent, but a 3-4 week turn-around should be expected for most manuscript requests. Instructions for submitting verifications will be sent to each first author when the paper proposal is approved. The instructions will also be distributed to the data committee members for review. Expect a 3-week turnaround for verifications. Another CC analyst will verify any analyses originally done by the CC personnel. Dr. Herman wanted to know how to run analyses on the data due to comparability issues. Dr. Williams proposed running models for each center separately to determine which predictors were significant at each center. Then, an overall model could be built using predictors significant at any one site. The group agreed to use this strategy. Dr. Herman requested that the dataset include information about whether the participant was recruited from the community or the clinic. Dr. McCreath will add this information to the next version of the dataset, along with a description in the documentation. Investigators reported difficulty locating the codebook on the website. Dr. McCreath will check the web for codebook accessibility and report to the committee. Dr. McCreath will forward all documentation and data on CD. In addition, Dr. Herman pointed out that each site has different age ranges included in their samples. The group agreed to use different age ranges depending on which sites are included in analyses to ensure comparability. Quality Control: The group reviewed the open-ended coding that had been completed to date. The decision was made that, if a response fits best a category already specified in the original survey, the response should be incorporated into the existing responses, rather than leaving in the "Other" category. The following are decisions for each item: (QC open-ended response tables, in Excel 97 format) Treatment options: "Can’t remember/not specified" and "Not applicable/none" can be combined. Remove pessiary from " Lifestyle modification (diet, exercise)". Medications and pessiary should be added to "Not specified or other medical treatment". "Watchful waiting" and "no other treatment" or "Doctors said don't do anything" can be combined. Ethnicity: Dr. McCreath stated that the committee should use the NM approach because it was thought through very carefully. NM did interview several Asians and some Pueblo Indians, but excluded them in the original data set. The committee decided that these surveys should be included if a valid survey was conducted. NM will include these 30 surveys as an "Other" ethnicity category so that they can be accessed. Surgical/medical treatment: Remove "Surgical treatment" from original and list procedures. Remove separate "Antidepressant" and "Pain medications" categories and create "Non-hormone or unspecified medications" category Why hysterectomy was not prompt: "Missed diagnosis" (original) and "Problem missed" (QC) judged to be the same category; combine in a category of "Diagnosis difficulties". Add "Doctor didn’t see need" and "Fears" to the overall list "Too young" (original) change to "Age" (QC) Reason hysterectomy not done: The following categories were decided upon: Fear Comorbidity Wanted kids Going to have one Advice of family and friends Unnecessary/not appropriate treatment/advice of doctor Insurance/financial Other treatment resolved problem Symptoms went away (fixed themselves) or woman decided Why HRT recommended: Create new category "Menopausal symptoms" to include "Incontinence", "Specific urogenital symptoms/diagnosis", "Hot flashes", "Mood or concentration". Add "NA" to "Misconception". Separate "Prevent CVD" and "Prevent cancer". Reason HRT not taken when recommended: "Doesn’t like to take pills, not natural, afraid of side effects" - check original coding. "Still deciding, not prescribed /received yet" should be separate code. Why you stopped taking HRT: Should be able to use existing codes. For all items, the CC will apply these category lists to the responses. The CC will then return the coding lists to the original coders for review. Upon approval, the 20% inter-rater reliability coding will be done and analyzed. Intervention: Video: The steering committee reviewed the video and each site presented site-specific focus group pilot testing video results. Alabama: 2 hysterectomy and 2 non-hysterectomy African-American focus groups in 2 rural and 2 urban communities were conducted. 6 women were present in each group in Wilcox County and 8 women were present in each of the 2 focus groups in Riley/West Jefferson County. In general, women liked the video and felt that the video gave them a lot of information. The video did inspire each of the women to tell their stories/experiences with doctors, whether good or bad. The women really like t he doctor skit and felt that it was a real situation. Focus group suggestions were that perhaps the doctor needed to interact more with the woman or possibly talk more about the after effects of surgery. Participants felt that when the men spoke, what they said was not reality. They felt that perhaps younger women should be used in the video, and that perhaps a x should not be used directly on the face. Texas: 3 (..hysterectomy and ..non-hysterectomy) focus groups with a total of 16 women, including 4 Hispanics, were conducted. One of the focus groups conducted at the university were women who participated in an original focus group. These women generally liked the video, but would have preferred that the doctor be a woman. These women felt that the video was lying because doctors don’t have time to talk to women at all. They didn’t like the X on the woman's face, and said that children were talked about but not included. They felt that the video should show women doing something more than working and felt that younger women should be used. The women felt that the message regarding having choices and the fact that other options were suggested was good. The women felt that the video was lying since husbands are generally not supportive. They thought that seeing the video at the doctor's office was a good idea, but felt that the video should be available to be taken home. All the women who had a hysterectomy wanted to talk about their stories. No focus groups were conducted with low-income women during this phase of pilot testing. South Carolina: 2 focus groups in Columbia were conducted. Many of the women like that the video talked about alternative treatments, and pre and post hysterectomy. The women felt that the men in the video were not realistic. Dr. Richter reported that one woman stated that "the Bird was so interesting that she lost the video message." No women objected to the X on the woman's face. Dr. Richter stated that a checkmark doesn’t appear at the end when something was done right. The women re ally like the humor of the video, and believed that using it in a doctor's office would be good, but thought that the opportunity to take the video home would be good. Most of the women wouldn’t pass the video on to someone else, because it talked about decision making. One lesbian non-hysterectomy focus group was conducted. The second group was with hysterectomized women of various ages and talked a lot about outcomes such as depression. New Mexico: 2 focus groups were conducted and the message was conveyed. Some got the message that one can delay a hysterectomy, but not avoid it. The women suggested that more alternative therapies should be used in the video. The focus groups didn't like the video at all, didn't like the humor, or the men, didn’t like the hats, or the wedding vail and didn’t like the husband issue. They thought that the X on the woman's face was wrong and felt that a high socio-economic status was used and they didn't see any low-income women, and no Hispanics. The group suggested that the video could possibly be shown in churches. The group did not see any distinction between hysterectomy and non-hysterectomy or hysterectomy without oopherectomy. The group liked Syndi but did see some confusion regarding Rose since she was talking about the uterine lining being removed. The group felt that younger women should be used, since most women in the video were past childbearing years. The groups did not like the fact that no terrain from New Mexico was used. They did not like the fact that women were not shown talking to other women. The steering committee decided to make the following changes to the video: Delete the beginning glow on "the decision is yours". Delete the hat segment - Add the introduction statement written by Dr. Pulley explaining what hysterectomy is about. The committee decided that it takes too long to state the purpose of the video. Remove Liz watering flowers and perhaps add young Hispanic women talking to each other (possibly Cassandra and her mother from the Spanish vide o). Change the wording "emphasis" to "some" Remove the wording "Florida vacation" in Liz’s introduction. Remove shots of Rose’s husband. Remove the X from the woman's face and use only the background sound and freeze the frame. Use wording "before you go" instead of beforehand. Be consistent: The first two women have introduction and the third woman does not. Be consistent: with names and don't use last names of anyone. Everybody’s face that is shown in the video should be listed on credits Add the conclusion that Dr. Pulley wrote. T-shirts: The steering committee decided to use a Roswald fond for the T-shirt and the font color should be the same as the brochure. The wording should be in quotes on the front of the shirt over the pocket. Read as follows: one in English "The decision is mine" and one in Spanish" La Decision es Mia (accent over the o)". Logos will be centered on the back of the shirt. Brochures: A tri-fold brochure will be used. Colors will match the video. New Mexico will provide a Native American photo for the cover of the brochure. The steering committee decided to change the photos on the brochure cover, so that the minorities would be mixed up. Replace Alma with Dannette, and delete the glow on "yours". Panel 1:about "1/3" paragraph should be the 1st paragraph. Remove the Roswald "body image" picture and replace with a decorative box including treatment options: watchful waiting, medications, hysterectomy, other surgeries. Panel 2: Switch Rose and Liz. Leave other 2 photographs the same. Year 5 Intervention site plans: Alabama: Site-specific intervention plans are: No CME credits will be offered. Conduct focus groups in one urban community. Use only African American participants. South Carolina: Will use both African American and White and will focus on St Helen’s island. Texas: Site-specific intervention plans will concentrate on treatment option decision-making skills. Will use clinic and Community setting alone and in a group on about 300 women from a predominantly Afr ican American and a predominently Hispanic community Pilot Testing will be done in a take home packet including the video and brochure. Then someone will call the participant to find out results. One session in a clinic setting, stopping the video and asking for comments will be done to compare. New Mexico: Site-specific intervention will be conducted with a lay health advisory group on decision making. Decisional balance sheets will be developed and used with Navajo participants. A Spanish decision-making CD has been completed. Dr. Herman will forward a copy of the Spanish CD to every investigator. Publications: Trena will make necessary changes to the publication grids regarding the APHA presentations. Prevention Center Research Meeting: The abstract deadline for the Prevention Center Research Meeting is October 15, 1999. The steering committee agreed to submit the following study-wide ENDOW abstracts: "The use of Qualitative data in the Development of an Intervention tool: the ENDOW Project", written by Drs. Richter and Groff. " Hysterectomy in a multiethnic sample of women: the ENDOW Study" written by Dr. Lewis. APHA presentations: Dr. Lewis presented the APHA presentation overview. The following changes were suggested by the steering committee: Overview: Change the word "implement" to "pilot testing". Use wording of "quantitative data" instead of "survey data collection". Add a bullet "focus groups were used to inform survey" On map slide: Change Navajo Reservation to Navajo Nation, Take Grants off under New Mexico sites. Mention Navajo data, but state not available, until the Navajo Nation grants approval. Sample selection strategy: New Mexico: The surveys were conducted either on site or in the home. Use wording of "sampling methodology" instead of "targeted approach". Texas: Use wording "Targeting methodology approach" instead of "targeted approach". Under Clinic based sample: Community health and public hospital serving the same geographic area. Don’t say low income; didn't screen for low income just survey low income areas. South Carolina: Add the word "community" to "advisory board". Use wording of "snowballing technique" instead of "volunteer sample. Alabama: Add 1/3 from clinic sample. Take out response rates completely, not shown on any other site methodology Presentations: Change wording to "HRT use and attitudes" instead of "HRT attitudes" Conclusions: Change wording to "strengths" instead of "conclusions and strengths". "Hysterectomy in a multiethnic sample of women: The ENDOW Study" - Beth Lewis: Remove "surgical menopause" in the header. Change wording to "rates may differ ". Demographic characteristics - look at numbers and re-run data to only include ages 35-64, possibly use a bar graph. Change title on Pre-op overhead to "Pre-op Conditions Reported by Women with Hysterectomy (%)". Change wording to "pregnancy complications" instead of "pregnancy". Dr. Lewis will add a footnote: Funding: Centers for Disease Control and Prevention and National Institutes of Health Women's Health Initiative Community Prevention Studies. "Attitudes toward Menopause in a Multi-ethnic Sample: The ENDOW Study" - Robert McKeown: Dr. McKeown questioned the steering committee on how to consistently report African-American and Hispanic populations. Use the state names instead of university names. Done by self-definition: Define pre, post menopausal and menopausal. Break out ethnicity across sites regarding menopause. List 3 levels of responses instead of five. View of menopause as unpleasant - women were less likely to answer don’t know. Menopausal attitude scale score by center Remove the wording "by center". Remove the wording "are reversed". In a bi-variate model change the wording from "marginally" to "Statistically significant difference in attitude scores by menopausal status". Use a graph with p-values for slides before and menopausal attitude scale score by ethnicity. Educational Slide: Define education as having less than a high school education, high school education or high school educatio n or more. Differences in attitude by age, education, research center, marital status slide: Make bullet phrases instead of complete sentences. Change wording to "relationship" instead of "relation". Presentation - Jan Groff: Background slide: Change the word "missing" to "less". Say that the hysterectomy vignette was only asked of women who had not had a hysterectomy. Methods: Hysterectomy vignette: Change wording to specific "outcome variables". Demographics: Use a bar graph by site. Scores on outcome variables by site: add a footnote that the vignette score was only asked of.... Delete the total column. Bi-variate analysis: Footnote the p-values. Uni-variate analysis: Show before the bi-variate analysis "Ethnic & Geographic Variation in Women’s Use and Attitudes Toward Hormone Replacement Therapy" - Carla Herman: Purpose: Remove the word "cultural". Methods: Add wording "without a hysterectomy". Demographic: Move the missing category to the unmarried couple category. Change wording to hormone replacement use for women without hysterectomy by ethnic group. Dr. Herman will remove all women who say "they have never heard of HRT" from the analysis and rerun. Dr. Herman will place the Texas don't knows in the neither category and then re-evaluate the education category. Change wording to "had a very likely". Dr. Herman will limit the analyses age to 50-59. Closing remarks - Suzanne Folger: Dr. Folger will address the limitations and overall conclusions of the presentations. Friday, October 27,1999 Video changes: Ms. Hall of Hall & Foushee faxed the following video suggestions based on the October 7, 1999 conference call with the intervention committee: Number 1: Instead of showing video of Hispanic women, while the narrator speaks in a voice-over, I would like to have the words of the narrator shown on the screen. The steering committee decided to leave this decision up to Ms. Hall. Number 2: To get more Hispanic women, in the video, I suggested that we use Gloria in the opening, instead of Dannette. The steering committee agreed with Ms. Hall. Number 3: The goal of the opening is to keep women speaking of decisions - Keep Alma. The steering committee agreed with Ms. Hall. The revised video will be mailed to the intervention committee in late October, 1999. Brochure changes: Dr. Cornell reported that Ms. Hall felt the requested brochure changes were minor and a revised brochure would be returned to the intervention committee by the middle of October, 1999. Miscellaneous: February meeting: The ENDOW steering committee will meet on Tuesday, February 1, 2000 in Atlanta, GA during the Prevention Center Research Meeting. Dr. Folger will request meeting space. Action Items: Dr. Folger will contact Mr. Elswick at the CDC to see if no cost extension could be requested if money exist at the end of September 2000. Dr. McCreath will add this information to the next version of the dataset, along with a description in the documentation. Dr. McCreath will check the web for codebook accessibility and report to the committee. Dr. McCreath will forward all documentation and data on CD. New Mexico will provide a Native American photo for the cover of the brochure. Dr. Herman will forward a copy of the Spanish CD to every investigator. Dr. Herman will remove all women who say "they have never heard of HRT" from the analysis and rerun. Dr. Herman will place the Texas don't knows in the neither category and then re-evaluate the education category. Dr. Folger will address the limitations and overall conclusions of the presentations. Dr. Folger will request meeting space. m991105 ENDOW Steering Committee Conference call, November 5, 1999 Attendees: Dr. Suzanne Folger, CDC, Dr. Beth Lewis, Dr. Heather McCreath, Dr. Carol Cornell, Dr. LeaVonne Pulley, Shannon Houser, Trena Johnsey, University of Alabama at Birmingham, Dr. Adriana Linares, University of Texas - Houston, Dr. Carla Herman and Ina Bawaya, University of New Mexico, Dr. Donna Richter, and Dr. Robert McKeown, University of South Carolina The minu tes from the October 7-8, 1999 steering committee meeting were approved without corrections. CDC Report: Dr. Folger reported that the CDC will fund the Journal of Women's Health supplement. They are waiting for cost information from Dr. Richter to process the paperwork. Dr. Folger reported that she contacted Mr. Elswick and that no-cost extensions will be granted as long as submitted a couple of months in advance. Publication activities: Journal of Women's Health issue: Dr. Lewis reported that all of the papers have been submitted to the Journal of Women's Health. Dr. Folger reported that it would take at least 3 months to publish once the process begins with the publisher and it would take at least 3-6 weeks to get the CDC paperwork completed to issue payment. Dr. Richter reported that the cost for the Journal of Women's Health supplement is $12,000.00 including printing for the entire issue. An additional 400 copies are being requested by the ENDOW group @ a cost of $4.00 a piece including shipping. Each site will cover the cost of individual article reprints. APHA slide presentations: Dr. Lewis reported that all the APHA slide presentations have been launched on the web. PRC meeting: Dr. Lewis reported that 2 ENDOW abstracts were submitted to the February 2000 PRC meeting in Atlanta, GA. The ENDOW steering committee meeting will be Tuesday, February 1, 2000, 8:00 am -12: 00 PM. Data management: Open-ended coding: Dr. McCreath reported that the CC is continuing to work through the open-ended coding as a result of the October meeting. The CC will re-distribute the coding within the next week or so for investigators to review the current coding responses using the categories that were agreed upon at the October meeting. After review, they should be returned to the CC. APHA analyses: Dr. McCreath reported that through APHA analyses a few other problems were found with the dataset and all the changes have been distributed to the data management group. Dr. McCreath reported that she is working with a stu dent of Dr. McKeown who thinks that a problem may exist with the dataset. The data management committee decided to have quarterly conference calls and to do most corresponding through e-mail. The data management group decided that it would be a good idea to post all problems with the dataset on the web for review. Interventions: Video: Dr. Richter reported that all the changes were made in the English version. The steering committee approved the video. The Spanish video was sent to Texas and New Mexico and comments should be returned to Hall & Foushee. Dr. Linares reported that the same scene was used three times in the video. Brochures: Dr. Richter reported that all the changes were made in the English brochure. Dr. Richter reported that she found numerous grammar mistakes in the Spanish brochure. Dr. Linares will contact Hall & Foushee regarding errors in the Spanish brochure. Ms. Bawaya will contact Ms. Weaver and have her send all the brochure comments to Dr. Linares this week. Closed caption: The steering committee decided that the closed caption of both the Spanish and English videos should be approved prior to printing. T-shirts: Trena reviewed the decisions made at the October meeting: the English saying would be on the top, the Spanish saying on the bottom and ENDOW in the middle on the front, over the pocket in a circular fashion, with all three logos on the back of the shirt. The steering committee decided that the wording should be in the middle of the shirt and that ENDOW should not be on the shirt at all. Intervention action items: All comments regarding the Spanish brochure should be sent to the coordinating center. Trena will contact Hall & Foushee regarding video closed captioning. Each site should send exact numbers of how many English and Spanish videos and brochures will be needed for their site. Each site will send how many XL and XXL T-shirts will be needed. Each site will forward on disk a copy of their camera-ready logo to Trena. Future conference calls and meeting s: The next steering committee conference call will be Friday, December 3, 1999 @ 11:00 CST. The steering committee will decide on the next conference call when and where the face-to-face meeting following the PRC meeting will be and what the agenda will consist of. The next steering committee face-to-face meeting will be Tuesday, February 1, 2000 in Atlanta, GA, 8:00 am - 12:00. The WHI community prevention study meeting will be October 26-27, 2000 in Washington DC. M991203 ENDOW Steering Committee Conference call, December 3, 1999 Attendees: Suzanne Folger, PhD, CDC, Beth Lewis, MD, Heather McCreath, PhD, Dale Williams, PhD, Carol Cornell, PhD, LeaVonne Pulley, PhD, Rex Bomhold, Shannon Houser, Trena Johnsey, University of Alabama at Birmingham, Adriana Linares, MD, University of Texas - Houston, Carla Herman, MD and Ina Bawaya, University of New Mexico, Donna Richter, DrPH, and Robert McKeown, PhD, University of South Carolina The minutes from the November 5, 1999 steering conference call minutes were approved without corrections. CDC Report: Dr. Folger reported that the requisition payment for the Journal of Women's Health supplement has been done. The CDC will also cover the mailing charges for each center to receive 100 copies of the journal supplement. Publication activities: Journal of Women's Health issue: Should be published in early 2000. Dr. Richter reported that the cost for the Journal of Women's Health supplement is $12,000.00 including printing for the entire issue. An additional 400 copies are being requested by the ENDOW group @ a cost of $4.00 a piece including shipping. Each site will cover the cost of individual article reprints. APHA slide presentations: Dr. Lewis reported that all the APHA slide presentations have been launched on the public side of the web. PRC meeting: Dr. Lewis reported that two ENDOW abstracts were submitted to the February 2000 PRC meeting in Atlanta, GA. Dr. Lewis reported that the abstract entitled "Hysterectomy in a multiethnic sample of women: the ENDOW Study" was accepted as an oral presentation on Wednesday, February 2, 1999. Dr. Richter submitted an abstract entitled "The Use of Qualitative Data in the Development of an Intervention Tool: the ENDOW Project" and has not received acceptance as of yet. The ENDOW steering committee meeting will be Tuesday, February 1, 2000, 8:00 am -12: 00 PM. Data management activities: Dr. McCreath reported that the CC has been successful in resolving questions from one of Dr. McKeown's students for now, but she will require more data eventually that is not in the core dataset. Open-ended coding: Dr. McCreath reported that the CC has been able to complete the following: At the October meeting a few open-ended coding lists were decided where original and the QC categories were reviewed and a final set of categories decided. For those items, the responses have been re-coded by the CC to correspond to the new set of categories. Dr. McCreath stated that at the October meeting the committee decided that once the CC was through with the category correction, the entire list of responses with codes would be sent back to the original coder and they would double check the CC work. Dr. McCreath reported that Dr. McKeown has forwarded more QC categories for the last question to the CC and the comparison will be done next week. After the CC has re-coded what needs to be re-coded, it will then be sent to the original coder for review. Dr. McCreath reported that the QC changes would be completed by the end of the month. Dr. McCreath reported that the steering committee decided to have a two step process for all open-ended questions. First, the CC would look through the responses and reassign codes based on the final list developed at the October meeting and then send the response list to the original coder for review. After the original coder has reviewed the responses, they will return it to the CC who will then distribute to a third reviewer who will code 20% of the responses for agreement statistics. Dr. McCreath asked if it is sti ll necessary for a third person to review 20% for agreement statistics? The committee decided it would still be necessary to have the last question "If a woman is thinking about hysterectomy, what kinds of things do you think she should know" reviewed by a third reviewer for agreement statistics. Dr. McCreath reported that all original coders should expect to receive spreadsheets from the CC sometime next week with turnaround by the middle of January 2000. Intervention activities: Video: Dr. Richter reported that the English version is final and will be sent for closed captioning sometime before the end of the year. The Spanish video comments have been return to Hall & Foushee and they are working on the revisions. Hall & Foushee will distribute a final version of the Spanish video sometime this week. All comments should be forwarded to Trena as soon as possible. Brochures: There was a final draft of the English brochure distributed with the Spanish video. Please forward comments to Trena by Monday, December 6, 1999. Hall & Foushee would like to have final approval on the English brochure before the end of the year, because they feel that the Spanish video will take more time to develop because of the translation. The committee decided that it would be acceptable for Sema to be in the Spanish brochure even though she is not in the video. Closed caption: Hall & Foushee will distribute the English and Spanish videos for closed caption approval. T-shirts: The English saying would be on the top, the Spanish saying on the bottom in the center of the shirt in a circular fashion, with all three logos on the back of the shirt. Each site will let Trena know how many XXL shirts they would like to purchase in addition to the 1,000 shirts purchased by the CC. Evaluation tools: Dr. McKeown reported that South Carolina would like to develop an evaluation based on two or three different levels of interventions. Each woman would be interviewed after their doctor visit and then compared to other groups. Dr . Cornell reported that Alabama would conduct pre and post self-report interviews on attitudes and intentions. Dr. Lewis stated that the committee agreed to use the same evaluation tools for the video. Dr. Cornell reported that Alabama and South Carolina will use the evaluation tool that Texas is developing and the article circulated previously will be very useful. Dr. Linares reported that Texas has been working on intervention development for the last month, and Dr. Groff is developing this evaluation tool presently. Texas has decided to evaluate the intervention video in a joint effort with the other 3 sites, and will site-specifically evaluate other intervention components. Dr. Cornell reported that the intervention committee agreed to use a postcard to evaluate the video. Dr. Linares reported that Texas will also use 3 brochures from the AHSC, entitled "Options for hysterectomy", "Anatomy and physiology of reproductive system" and another one listing resources available in Texas. Texas, Alabama and South Carolina plan to begin training in February. Dr. Cornell reported that Alabama is going to use the intervention materials in training that will be used with the women in order to do pilot testing. Each site should bring drafts of intervention evaluation materials to the February meeting for review. Future conference calls and meetings: The next steering committee conference call will be Friday, January 7, 2000 @ 11:00 CST. The next intervention conference call will be in the second week in February. Date to be confirmed on the January steering committee call. The steering committee will decide on January conference call the dates and location of the next face-to-face steering committee meeting following the PRC meeting and will plan agenda. The next steering committee face-to-face meeting will be Tuesday, February 1, 2000 in Atlanta, GA, 8:00am - 12:00 noon. The agenda will focus on intervention materials and evaluation tools with updates on data. Agenda comments should be sent to Dr. Lewis. The next ENDOW presentation will be in the Tuesday, February 1, 2000 12:00 noon - 5:00 PM session with Dr. Finnegan. Dr. Lewis will present an ENDOW abstract in the Wednesday, February 2, 2000, 10:30 am - 12:00 noon scientific session. The community prevention research in women's health conference is October 26-27, 2000 in Washington DC at the NIH Mazur Auditorium. Dr. Lewis reported that a block of hotel rooms are be reserved. The conference budget has travel for two people per SIP per project. Each SIP will be expected to present study results. A preliminary program is being developed by the conference committee to cover topic areas. For instance the three physical activity projects will have one session. Each physical activity project will present an overview and what their accomplishments are, then Dr. Andrea Kriska will summarize what has been done and what direction future projects need to go. Dr. Lewis asked the steering committee for suggestions on a discussant for the ENDOW project. Invited speakers following ENDOW will be: Dr. Sherry Sherman, The SWAN project officer, Dr. Sarah Marks from CAMP, and Dr. Marci Gross from AHCPR will speak on their 3 hysterectomy Vs medical therapy trials. Dr. Lewis reported that Dr. Finnegan would like to have an exhibition poster type session where projects display their materials. Perhaps an abstract competition will be held. NIH and CDC personnel will give opening remarks. Dr. Shiriki Kumanyika will give closing remarks. main Ethnicity, Needs, Decisions of Women (ENDOW) Participating Institutions and Principal Investigators: University of Alabama at Birmingham, Field Center and Coordinating Center Cora E. Lewis, MD, MSPH, Principal Investigator University of New Mexico, Field Center Carla J. Herman, MD, MPH, Principal Investigator University of South Carolina, Field Center Robert E. McKeown, PhD, Principal Investigator University of Texas at Houston, Field Center Janet Y. Groff, MD, PhD, Principal Investigator mstc981204 ENDOW RESTRICTED AREA Study Group Conference C all Minutes December 4, 1998 at 11:00 am CDT Attendees: Dr. Robert McKeown, University of South Carolina; Dr. Carla Herman, Ina Bawaya, and Dr. Clo Mingo, University of New Mexico; Dr. Jan Groff, University of Texas - Houston, Chris Galavotti, CDC, Dr. Beth Lewis, Dr. LeaVonne Pulley, Dr. Carol Cornell, Shannon Houser, Dr. Heather McCreath, and Trena Johnsey, University of Alabama at Birmingham. I. Agenda: 1. Review agenda - Beth Lewis 2. Review and approve minutes from November 6, 1998 conference call - Beth Lewis 3. Up-date on survey progress - LeaVonne Pulley, Jan Groff, Carla Herman, Robert McKeown 4. Up-date on data analysis/management committee activities - Dale Williams, Heather McCreath 5. Up-date on intervention committee activities - Donna Richter 6. Publications Committee - Beth Lewis Qualitative special issue papers - Donna Richter APHA submission - Jan Groff 7. Miscellaneous II. The minutes from the November 6, 1998 conference call were approved without corrections. III. Survey up-date: New Mexico: Community survey has been completed; trying to decide whether to continue with the hospital survey. Alabama: 1103 completed surveys; 805 community surveys completed with a 67% response rate and 238 clinic surveys completed with a 96% response rate. Texas: community survey completed and ready to start analysis. South carolina: 562 surveys completed with 139 African-American women and 96 men. IV. Up-date on data analysis/management: Dr. McCreath stated that the data management group had a conference call on December 3, 1998 and reported the following: 1. Data transfers: The coordinating center has received final data sets from New Mexico and Texas and will begin to process these. The Alabama data and another large part of the South Carolina data will be sent next week. The final data transfer will be in mid-January, 1999 with a clean and coded data set available by mid-February, 1999. The coordinating center has started doing range and skip patterns checks on the data that has been received, so that only minimal, cleaning will be required on the final data set. 2. Medical history table: Dr. McCreath reported that the coordinating center has been putting together a medical history table by center to make sure that the skip pattern are coded correctly. Action Item: Dr. McCreath will distribute the medical history table to the sites next week. 3. Open-ended text: These responses have been distributed to investigators and should be returned to the coordinating center by December 15, 1998. If problems arise or if you need more information than was provided, please let Dr. McCreath know. 4. Scale scoring: Dr. McCreath stated that she will send information to Drs. Groff and Pulley regarding outcome expectancies and autonomy preferences, but decided to wait until the missing data is transferred next week. 5. Analysis: Dr. McCreath stated that the coordinating center will be able to do analysis in December and January if anyone has requests. V. Up-date on intervention committee activities: Dr. Cornell reported that 3 of the 4 videographers sent the RFP responded (Dan Curry, Hall-Foushee Communications and Write Eye Productions). Dr. Cornell suggested that everyone look at the bids, CV’s and budgets and then a conference call will be arranged to select. Action Item: Trena will send a packet to the PI’s and invention committee members consisting of CV’s and proposals for the 3 bids to be reviewed prior to the conference call on Friday, December 11, 1998 @ 11:00 am CST. Dr. Cornell stated that the intervention committee will need to prepare before talking to the videographer in January. VI. Publication committee: Action Item: Dr. Lewis stated that the publication grids were circulated with the minutes. They are still being refined, everyone should provide updates or corrections. 1. Journal of Women’s Health’s special issue: Dr. Galavotti stated that she and Dr. Richter talked this morning regarding the supplement journal. Dr. Galavotti will contact Dr. Lewis and Dr. Groff to discuss revisions. Dr. Richter has already contacted Dr. Williams and will be contacting Dr. Mingo regarding revisions. Dr. Galavotti stated that Dr. Richter is working on the beginning paper describing the qualitative methods and Dr. Galavotti will be working on the discussion piece at the end to compare and contrast the 4 different papers. The deadline for completion is December 14, 1998. Dr. Mingo reported that it has been 6 weeks with no objections from the Navajo nation, so therefore approval is granted based on the understanding that lack of comment was assumed to mean acceptance. Dr. Lewis reported that Dr. Galavotti was submitting her background paper to the CDC for approval. 2. APHA submission: Dr. Groff stated that the committee previously decided to submit to the APHA this year. The abstract deadline is February 3, 1999. The APHA meeting is November 7-11, 1999 in Chicago, Illinois. Dr. McKeown reported that he is on the program committee this year, and that he can create invited sessions. These have a deadline in May, 1999 if the February deadline is to soon. The disadvantage to the May deadline is that they don’t receive the same amount of advance publicity since they are not in the preliminary program. Dr. Groff also reported that the Latino caucus has expressed interest in sponsoring the group. The theme for the APHA meeting this year is "A Century of Progress in Public Health". The EPI section is celebrating their 70t anniversary and is leading up to 2001 when the North American Epidemiology Congress will meet which includes all the Epidemiology societies. Dr Groff stated that committee had decided p reviously to do something like SWAN did, a panel discussion with presentations of different types of results from the whole study. Dr. Herman suggested that it be based on the papers already in progress such as hysterectomy, HRT, social support and decision making scales. Action Item: Requests for analyses for APHA abstracts should be received by early January. Trena will schedule an additional conference call in January to handle abstract approvals. Dr. McCreath stated that the coordinating center would have some time at the end of December, beginning of January to work on analyses. If everyone would sketch out some tables and send them to Dr. McCreath, she will perform the analyses and complete the tables. Action Item: Dr. Herman will inform the group of details regarding the February 99 PRC meeting as she learns of them. VII. Miscellaneous: Dr. Lewis discussed the possibility of developing a Web site for all upcoming communications regarding minutes, agendas and other miscellaneous information. The group agreed and work will start. Return to ENDOW home page. All material on this server Copyright© 1997 by the publishers involved. mstc981204 ENDOW RESTRICTED AREA Study Group Conference Call Minutes January 8, 1999 at 11:00 am CDT MINUTES: STUDY GROUP CONFERENCE CALL Attendees: Dr. Robert McKeown, and Donna Richter, University of South Carolina; Dr. Carla Herman, Ina Bawaya, and Dr. Clo Mingo, University of New Mexico; Dr. Jan Groff, University of Texas - Houston, Chris Galavotti, and Suzanne Folger, CDC, Dr. Beth Lewis, Dr. Dale Williams, Dr. LeaVonne Pulley, Dr. Carol Cornell, Shannon Houser, Dr. Heather McCreath, Dr. Roma Williams and Trena Johnsey, University of Alabama at Birmingham. I. Agenda: 1. Review agenda - Beth Lewis 2. Review and approve minutes from December 4, 1998 conference call - Beth Lewis 3. Up-date on survey progress - LeaVonne Pulley, Jan Groff, Carla Herman, Robert McKeown 4. Up-date on data analysis/management committee activities - Dale Williams, Heather McCreath 5. Up-date on intervention committee activities - Donna Richter 6. Publications Committee - Beth Lewis APHA submission - Jan Groff 7. Miscellaneous February meeting (Prevention Center meeting) Atlanta II. The minutes from the December 4, 1998 conference call were approved without correction. III. Survey up-date: New Mexico: Lovelace Hospital has been given until 1/15/99 to cooperate or the hospital survey will not continue. 20 pre and post hysterectomy interviews completed before the hospital staff lost interest and will share these results with the intervention committee for the video. Dr. Herman stated that re-budgeting was going on now to submit a new proposal to the Prevention Center to focus all efforts in Gallop. Alabama: Dr. Pulley stated that the survey is complete and data has been transferred.. Texas: Dr. Groff stated that community survey is complete, and are trying to get a community task force involved for the development phase. IV. Up-date on data analysis/management: Dr. McCreath stated that the coordinating center received the last of the data transfers excluding South Carolina on December 23, 1998. 1. Data transfers: The coordinating center spent the week between Christmas and New Years pulling the data set together and cleaning it up. Dr. McCreath stated that the data compiled will be used to complete the preliminary analysis for the upcoming abstracts. Final data transfer: Depends on when South Carolina is finished with their survey. 1. Medical history table/scale scoring: Dr. McCreath reported that the coordinating center has not distributed the medical history table or any of the scale scoring because the data set has just been compiled. Action Item: Dr. McCreath will distribute the medical history table and the scale scoring within the next couple of weeks. 2. Open-ended text: Dr. McCreath reported that the open-ended text coding has been processed for everyone except Drs. Pulley and McKeown.. Dr. Pulley reported that she needed some additional information regarding clarity to complete. Action Item: Dr. Pulley will put an asterisk by the responses that need more information and email back to Dr. McCreath. Action Item: Dr. McKeown will work on this the week of January 18, 1999 and return to Dr. McCreath. 4. Analysis: Dr. McCreath stated that the coordinating center has begun working on the data analyses for the hysterectomy abstract that Dr. Lewis and Kate Wheeler requested. V. Up-date on intervention committee activities: Dr. Richter reported that the committee had been focusing on the video selection process and is now ready to start working on the other interventions such as South Carolina who will begin working with focus groups of a targeted audience in late January/early February to see what kinds of interventions would work best with their populations. Dr. Cornell stated that Hall and Foushee Communications, Inc. were chosen as the videographer and the day of the award Ms. Hall called and requested information about the project. Dr. Herman stated that New Mexico has a group of women who have been interviewed pre and post hysterectomy and have signed consent forms and have stated that they would be willing to participate in anything. Action Item: The committee suggested that the videographer sign a confidentiality agreement as part of the record. Action Item: The intervention committee will have a conference call on Tuesday, January 19, 1999 @ 1:00 P.M. CST. Action Item: The invention committee decided to have Ms. Hall join the conference call on Tuesday, January 19, 1999 to begin the communication process. Action Item: The intervention committee will meet on Monday, February 1, 1999 @ 5:00 P.M. VI. ENDOW Study Group Meeting Tuesday, February 2, 1999 @ 8:00 am - 12:00 P.M. Sheraton Colony Square, Atlanta, GA Agenda: Intervention discussion, with some publications and analyses issues. VII. Publications: 1. Journal of Women’s Health: Dr. Richter reported that all the individual site papers had been received and miscellaneous corrections had been made. Drs. Richter and Galavotti will write the introduction and the summary in order to complete the supplement. 2. APHA submission: The abstract deadline is February 3, 1999. The APHA meeting is November 7-11, 1999 in Chicago, Illinois. The abstract submission form is on the web site. The committee decided to submit several abstracts based on the discussion at the October New Mexico meeting. Dr. McKeown explained the two types of APHA sponsorship: Co-sponsor: Look at all other sections’ programs and list what might be interesting to their section as being sponsored by their section, but don’t really have anything to do with the planning. Jointly sponsored: Really is co-sponsored and both of the sections have to review the abstracts. Dr. McKeown stated that co-sponsor is easier, because each abstract will be submitted to a specific section and then the section would contact other caucuses such as the Women’s and Hispanic caucuses and ask them to be a sponsor of the section. Dr. McKeown stated that the EPI section will blind review the abstracts. Each abstract will be submitted separately, and then an overall abstract will be submitted to link the abstracts together for a panel session.. Action Item: The committee decided to submit abstracts to Epi section and link them as a panel discussion. Action Item: Dr. Lewis will write the overall abstract for the Epi section.. Action Item: The conference call will be on Friday, January 29, 1999 @ 11:00 CST to approve these abstracts. Action It em: The committee will submit abstracts to the coordinating center by Thursday, January 28, 1999 for distribution to the committee prior to the conference call. Action Item: Individual site abstracts should be submitted to the coordinating center for documentation only, do not need approval for submission VII. Miscellaneous: Dr. Suzanne Folger introduced herself to the committee and stated that she is willing to help in any way that she is needed. Dr. Folger came to CDC in 1986 starting working in Infectious Diseases, then moved to Environmental Epidemiology and came to the Division of Reproductive Health about 3 Return to ENDOW home page. All material on this server Copyright COPY; 1997-99 by the publishers involved. mstc981204 ENDOW RESTRICTED AREA ENDOW Study Committee and Subcommittee Meeting Tuesday and Wednesday, May 11-12, 1999 Galveston, Texas Attendees: Dr. Robert McKeown, Dr. Donna Richter, University of South Carolina; Dr. Carla Herman, Dr. Clo Mingo, Ina Bawaya, University of New Mexico; Dr. Jan Groff, Dr. Teresa Byrd, Emily Lees, Dr. Adriana Linares, Dr. Guillermo Tortolero, Dr. Pat Mullen, Kimberly Phillips, Andrea Shelton, University of Texas; Dr. Beth Lewis, Dr. Carol Cornell, Dr. Heather McCreath, Dr. LeaVonne Pulley, Dr. Dale Williams, University of Alabama at Birmingham; Dr. Suzanne Folger, CDC Review and approve minutes from 4/2/99 conference call The minutes were accepted without additions or modifications. ITEM 1: CDC report Dr. Folger reported that fifth year funding is to be awarded in the fall; carry over will be approved. Continuation applications will be due 7/23. There has been some delay in previous approvals of carry over; sites are asked to notify Dr. Folger if this is a problem in the future so she can assist with the process. A meeting of the WHI is being planned for Fall, 2001 by Dr. Finnegan in Washington, DC. One of the objectives of the meeting is to identify next steps for funding. A monograph is to be pub lished from the meeting, most likely summaries and accomplishments of the projects. ITEM 2: Review project timelines and current activity report The project is in the final quarter of Year 4; Year 5 will be evaluation of the interventions. Hall-Foushee is on schedule: much of the footage has been shot and the script for the English version was faxed to the meeting. Additional intervention materials such as brochures will be discussed. Hall-Foushee is experienced in developing companion materials to videos and this option will be explored. Funding may not be available in the intervention supplement so sites may have to fund these activities themselves. UAB is planning focus groups and finalizing questions. Companion materials to accompany the video are desired. Plans are underway to develop brochures as well as materials for peer-led groups that will include a brief introduction to the biologic systems and role playing exercises. USC has begun conducting focus groups for the intervention. On the basis of their community advisory committee's suggestions, they will also conduct focus groups with Hispanics who have been moving into the area. In addition, access to a clinic population has been gained. They will use this to validate the self-report of medical conditions provided in the survey. They have also done some provider interviews. UNM is working on their data to answer relevant questions. The Women's Exchange office in Gallup has opened and is taking off. Women are coming to look for resource material that Ina has been developing. Interest has been high and they have compiled a report of outreach activities to date, including TV and radio call-in shows done by project staff. The community is more interested in menopause than hysterectomy. Also, the Northern Navajo Medical Center has a video center and is interested in working with project staff to develop a video on menopause informed from the survey and using decision-making techniques. UT is working through their data, looking at effect of acculturation on m any issues. This will be important to intervention development. Further focus groups will wait until specific intervention components are complete. As the intervention will focus on African Americans, they are exploring access to the community, with a pilot intervention scheduled for Acre Homes, an area with a large African American community. Also, the clinics there serve a Mexican-American catchment area. UT has also developed a partnership with another community to expand delivery and the ENDOW project will be a test case for these activities. They are planning both community and practice-based activities. In addition, the ENDOW project team is working on revising the autonomy preference instrument to explore the opinions of providers on patient autonomy and preferences. They will also develop a provider intervention. They will survey lesbian women at a conference and perhaps the Gay Pride parade in Dallas. Dr. Williams reported some modifications to the PRC program. Dr. Darwin LaBarthe has been elected to the Directors Committee chair. He will be interested in any information relevant to the programs' accomplishments, particularly in the context of materials the Legislative Committee can use and Dr. Williams encouraged investigators to communicate such information to Dr. LaBarthe. ACTION ITEM: Dr. Lewis will check the supplement budget to see if there is additional funding for other modalities such as brochures. ITEM 3: Data Management and Analysis Subcommittee report A. Status of final data set Dr. McCreath reported that the dataset is in the final stages of cleaning. Details of translation, coding, and skip patterns are being worked through and documentation is being prepared. The Subcommittee has been working through this process, especially the differences between the sites. Hopefully, the first version of the core data will be available next week. A copy of the core survey, each site's survey, and a summary table will accompany the dataset. Both the documentation and the data are planned for distributio n through the website. USC has located another 30 surveys; these will be incorporated into the final data set distributed later this year. The Navajo data will not be distributed with the final data, nor will the Texas convenience sample of lesbians and their pilot data. These data will, however, be available at the Coordinating Center. Dr. Herman asked about a summary of each site's survey methodology. This was sent to Trena. Dr. Lewis will locate the documents and will send them to the sites. B. Discussion of open-ended response coding All nontruncated data are now in Dr. McCreath's possession. These will be sent out for coding and due back to Dr. McCreath July 1. Then, the reproducibility of the categorization schemes will be evaluated by another site developing a category list for a subset of responses. If there is congruence, the Coordinating Center will recode a subset of the responses and calculate inter-rater reliability. We hope to finalize this process by the end of the summer so that the data are available for APHA presentations. Most of the data should be ready by Sept. 1. More than one response was included in some sites and these data will need to be captured. C. Data analysis strategies and methodologies for survey data Dr. Williams presented tables of the survey data. Comparing the non-Hispanic whites across centers and comparing ethnic groups within center will be straightforward. Comparing across ethnic group and site will require adjusting for center. For example, Hispanics in New Mexico are a bit older than Hispanics in Texas, African Americans are generally younger than non-Hispanic whites across all centers, and incomes are quite high in South Carolina non-Hispanic whites and generally low in Texas. Dr. McCreath presented representative descriptive data tables so the group could begin to get a feel for the dataset. There are a large number of women who replied "Don't know" to several items for some of the scores (such as the menopause attitudes); it will need to be determined if some women repeatedly replied "Don't know" for many items or if many women had that reply for a few items. Because of how Texas asked questions on number of children, the number of live births should be used across centers as a surrogate for pregancy history. Menopausal status is also an area of confusion; there are a number of missing responses for these items, in part due to women's confusion and in part based on how sites asked the questions. New Mexico and South Carolina have more questions in this area. Because of skip patterns, we do not know the number of ovaries women have if they had a tubal ligation (except in Texas). It may be that menopausal status will not be classifiable for all women. Texas did not ask about current use of HRT, but the data can be obtained from the questions asked (ever taken and still taking). Use of herbal hormone preparations will need to be characterized in New Mexico. Dr. McKeown began a discussion of how to determine menopausal status, and the scoring of the menopausal attitudes for women who replied that they did not know for specific items. For menopausal status, sites differed in questions asked and order. For women who reported they have gone through menopause, we do not know the basis for this response. It could have been due to hysterectomy, or due to cessation of menses, or to some other factor. It would be possible to categorize women two ways, one would be women's self-report and one would be medically, based on age, surgery, etc. It may be problematic to summarize all the information we have into one variable. Dr. Williams stated that cross-site comparisons may best be made using different dimensions for different site comparisons, in other words using a set of definitions. This would maximize the information used. Dr. Groff stated that one interesting report would be the correlation between self-report and status based on a series of variables on periods, surgery etc. Dr. McCreath stated that the site-specific data would be useful for some of these analyses, but would not be distributed with the core data. Dr. Herman stated that the HRT paper will also need to consider this issue. Dr. Pulley pointed out that all 3 sites that asked the menopause attitudes questions all asked the single question, "Have you gone through menopause?" This single item could be used for that analysis. Scoring of the menopausal attitudes questions - there are some women who refused one specific item (there are few), there are women who reported that they did not know, and some women who neither agreed nor disagreed. Should we impute for women with missing responses? How should we treat women with don't know responses? Dr. Pulley stated that women who were given the option to neither agree nor disagree but who replied they did not know, should not be classified as neither agree nor disagree. She also stated that it was her experience that women who had not experienced a condition or procedure were reluctant to state an opinion, and would state that they didn't know; this is more common in African Americans. Dr. Groff stated that not equating don't know with neither agree nor disagree would mean that a scale could not be calculated and nonparametric techniques would need to be used for analysis of each item. Another very informative paper would be to look at the characteristics of women and items that would garner large numbers of "Don't know" responses. Dr. McKeown stated he would avoid imputing for this scale, since it has relatively few items. Dr. Williams stated that a sensitivity analysis could be done to explore different strategies of imputing. Dr. McCreath stated that the only other items this would apply to are the outcome expectancies. The conclusion was that the study needs to continue to develop strategies for handling classifications during analyses, sensitivity analyses for different scoring approaches, and consistent discussions of the analysis challenges for inclusion in manuscripts. ACTION ITEM: Dr. Lewis will locate the survey methodology documents from the sites and will send them to the s ites. DONE except for Texas document. ACTION ITEM: The CC will distribute the final dataset next week. ACTION ITEM: Dr. McCreath will send the open-ended data to specific investigators for coding. Coding should be completed and returned by July 1. She will also check on the coding of marital status for Texas. ITEM 4: Publication Subcommittee report A. Up-date on proposed paper progress Dr. Lewis distributed copies of the publications grids from the web site. Each site should be sure that the list and status of publications and presentations, both center-specific and study-wide, are current. Please send any changes to Trena. The major analyses from the survey previously discussed, those topics for which abstracts were written for APHA, need to be pursued now that the dataset is almost complete. Only Dr. Lewis' paper has been proposed; others need to submit their paper proposals. Dr. Richter reported that the qualitative special issue papers have been submitted to the Journal of Women's Health. There are seven papers included: an overview paper of qualitative research, an overview of ENDOW, four site specific papers and a wrap up paper. We will receive feedback from the journal in June (presumably the peer reviewers' comments), publication will occur 3 months after final acceptance in a special supplement. B. Up-date on APHA presentations All the abstracts have been informally accepted as a Special Session. Official word of acceptance has not been sent as yet. No laptop projectors will be available unless provided by the speakers. Dr. Groff stated that it would be helpful to have a meeting and go over these presentations prior to the APHA meeting. C. New analysis ideas Investigators should consider additional data analyses from the survey data, as well as the qualitative data. The group also needs to plan ahead for reports of the intervention activities, to occur in Year 5. From the survey, Dr. Cornell mentioned that analyses of proxies for SES (e.g., income, health insurance access) and decision making will be ti mely. Analyses of information channels and attitudes may also be of interest. Dr. Herman mentioned the analyses of the many things women have reported they have not heard of or don't have information about will be an important analysis, especially for intervention development. Dr. Groff stated that the group will need to decide how to approach issues of ethnicity and SES in analyses. Dr. Herman stated that reports of symptoms, comparing women with hysterectomy and those without, is important and may be a paper itself. Further, looking at women who didn't have a hysterectomy but may have considered it or had it recommended to them, would also be an interesting analysis. How are they different from women who received the procedure? This will require combining across sites due to small numbers. Dr. Groff stated that development and psychometric properties of the hysterectomy and HRT outcome expectancy scales will also be reported as well as the relationships between these scales and other factors, totaling 4 papers. Acculturation factors and the qualitative report of the African American and lesbian focus groups will be reported by Texas. Dr. Cornell stated that for interventions, a report could be generated on the development and piloting of the video and accompanying materials. Dr. Groff stated that a report of how the interventions were developed, such as use of qualitative data, would also be of interest. SOPHE has a new journal, Health Education Practice, that may be interested in papers of this type. ACTION ITEM: Dr. Lewis will ask Trena to change the status of study-wide paper #2 to "Proposed". ACTION ITEM: Each site should be sure that publications and presentations, both center-specific and study-wide, are updated. Send updates to Trena. ACTION ITEM: Paper proposals for the major survey data papers (eg, menopause and HRT) should be submitted for approval. ITEM 4: Intervention Committee report A. Intervention planning - progress on video tape production, other intervention material development Dr. Richter r eported that Nancy Hall is almost done with shooting. A draft of the script was reviewed. Critical points will be stressed both visually and verbally. Humorous aspects are modeled in a constructive way so as not to negatively reflect on providers; these will model what should happen as well as humorously showing what often does happen. These aspects are drawn from the focus groups. All sites should review the draft script and get comments to the intervention committee before their next conference call. Dr. Herman asked for information on the contract timeline and deliverables. Will the sites receive multiple copies of the video? Are additional items, such as brochures, budgeted? Dr. Lewis will clarify. The video will be provided, both Spanish and English, by the end of September. The Hall-Foushee subcontract covers only the video. Nancy Hall wanted information on acknowledgements. The committee members will be acknowledged as contributing to the development of the video. Nancy Hall should check the contract language regarding these issues. Texas and New Mexico staff will review the Spanish version; some issues will be added to address unique cultural aspects for that community. It will vary somewhat from the English version. Dr. Linares reported that bilingual speaking women who were interviewed did their own translations. Otherwise, Dr. Linares did the translations. The importance of the family was mentioned often and will be incorporated into the video. Hispanics who prefer to speak English may be different, and may relate differently to the different videos. It remains to be determined how women will select which they want to view. Dr. Groff stated that the supplementary brochures will assist with this. Dr. Cornell reviewed needs for other materials besides the video. Brochures, handouts reviewing anatomy, decision skills work sheets, decisional balance sheets, and discussion guide for community- based peer-led support groups were discussed. These could be developed for both hysterectomy and HRT use. Dr. Grof f stated that the AHCPR brochure on "10 Questions to Ask Before Surgery "would be helpful. The committee will explore how to access these. The video does not cover what a hysterectomy is; this would need to be in supplementary materials. Texas will explore materials for instruction on anatomy and will report back on availability. These would be useful for peer-led groups. Materials for use by other providers (e.g., nurse practitioners) would be helpful. Dr. Mingo stated that a postcard with a few evaluation questions would be helpful and could be disseminated with the video. This would give us counts on how many videos were disseminated and give some evaluation information. This could be developed this year and used for intervention evaluation next year. A more detailed pre- and post- intervention evaluation would also be needed; it could be completed in the peer-led groups. Dr. Richter stated that we need to consider how and where these materials would be used during the development phase. Dr. Groff stated that materials to take home for use by family members are needed. Also, a list of where to find other materials and good information would be useful. Dr. Herman stated that advice on how to evaluate and use health information would be very helpful for women; they are gathering lists of Internet resources and will share with the other sites and Ms Bayana is developing a brochure. Dr. Groff stated that NERI has produced a kit and workbook on partnering with your doctor for elderly women. Dr. Linares is expecting this material from NERI and will report on progress. This may be useful if the age group is appropriate and if it is generic enough. The Committee will further explore these issues, and will plan another meeting for this purpose. B. Up-date on Intervention planning activities in each site These activities were discussed under review of project timelines. C. Intervention planning data needs and intervention/ evaluation plans (Year 5) Large amounts of data are now available from the survey and focus group s, and more groups will be completed in certain sites for planning the intervention. Dr. Groff stated that women expressed the desire for information and for involvement so the intervention plans are consistent with their wishes. Dr. Lewis stated that plans for evaluation activities in Year 5 are needed. It would be useful to have more consistency between sites than we had for the survey. Dr. Pulley stated that pre- and post-test instruments for individual women who go through the intervention could be developed. One approach would be to have a bank of questions that could be used, and might be somewhat generic for different interventions. Some items from the survey could be used. Dr. Williams asked if different interventions will be piloted. Dr. Groff stated that the interventions will be the same generally, but dissemination may be different. Dr. Pulley asked what constructs will be measured and how would they be operationalized. She stated that one level will be process measures: how many women attended a session, how many videos were sent out, etc. Another level would be individual-level measures of pre- and post-intervention change, such as self-efficacy, knowledge, and attitudes. It would be too expensive to plan a formal trial of women who received the intervention vs. those who didn't. The strategy will be to assess the feasability of different aspects of intervention, such as peer-led support groups. Dr. Williams asked the Committee to state what the interventions are and to carefully consider the design of the pilot study. The next Intervention Committee meeting will focus on the development of evaluation tools. The content of the intervention materials will drive some of the evaluation items. The evaluation instrument will be short (1-2 pages), although different intervention formats may allow more information to be collected. ACTION ITEM: Dr. Lewis will review and circulate the subcontract and budget for the intervention supplement so that the sites are clear on what is budgeted for centrally, and wh at will require funding by the individual sites. ACTION ITEM: All sites should review the draft script and get comments to the Intervention Committee before their next conference call. ACTION ITEM: Texas will explore materials for instruction on anatomy and will report back on availability. ACTION ITEM: The Intervention Committee will select dates for a meeting to discuss intervention evaluation materials and strategies. Dr. Lewis will check the travel budget. DONE The Intervention Committee held a breakout session to further explore issues from the general meeting, and reported back to the group. They discussed plans for a meeting July 8 and 9 in Albuquerque and Dr. Herman will begin to make arrangements for the meeting. Sites will come with their written intervention protocol and evaluation plan site as well as recommendations for core questions for an evaluation instrument to be used at each site. They will bring examples of materials. They will decide what materials will need to be produced by the group (such as supplementary materials to accompany the video) and items to be developed by each site. They will plan for data needs for the evaluation to assist the Coordinating Center in planning. They would like the Coordinating Center to provide a template of information needed for continuation funding, if needed. ACTION ITEM: Dr Herman will begin meeting planning for July and will work with the Coordinating Center to finalize plans. ACTION ITEM: Sites will bring written intervention protocol and evaluation plans as well as recommendations for core questions for an evaluation instrument and examples of materials. ITEM 5: Further discussion of potential grant submission to AHCPR for future funding Dr. Lewis began the discussion by summarizing previous discussion of the group's interest in this. Dr. Herman had materials from the AHCPR website, which include interest in projects looking at effective models of informed, shared decision-making for women (98-049). Marci Gross, the Senior Advisor on Women's Health, wo uld be the contact person. The group discussed designs and goals of such a submission. A trial to test the interventions developed in ENDOW was discussed. The goal would test the hysterectomy interventions with the primary outcome of quality of life, and secondary outcomes of cost-effectiveness. Without a provider piece, the intervention would be on the consumer and not shared decision-making. Therefore, a provider intervention would be desirable and a 2X2 design would accommodate these questions nicely. Such a decision-making trial could be seen as a complement to the on-going 3 trials on medicine vs. surgery funded by AHCPR which have had recruitment problems. The issues our trial would address occur before the decision of management strategy is made. Dr. McKeown stated that the bioethics community believes there is interest among providers in promoting shared decision-making, but they don't feel they have time to do it. Developing tools for providers could thus be very appealing. An interactive CD-ROM could be done by the woman that would educate the woman, document her preferences and then her consent for treatment. This could then be reviewed by the provider and treatment started. This would be similar to a formalized decisional balance sheet that would address literacy issues, and would be the provider piece to be tested. An issue will be the relatively small numbers of women expected to be poised to make the decision regarding hysterectomy. The numbers of women may be low. Also, the emphasis would be on a clinical, not community-based intervention. A more generalized approach to decision-making, not focused on hysterectomy, might be less appealing to AHCPR. However, the announcement from AHCPR indicates that such a generalized project, not disease specific, might be of interest to them. In addition, use of prescription drugs is also of interest to the agency, so the project could be centered around HRT. Since the focus of our intervention is on decision-making skills with hysterectomy as an example, our i ntervention experience is still relevant. Cost-effectiveness would be a minor issue for such a trial on HRT. Outcomes could be adherence, initiation, and cessation, but would be difficult to measure. Further, the knowledge base is changing fairly rapidly and it would be a challenge to make the intervention flexible enough to accommodate these changes. The group decided that hysterectomy would be the most appropriate outcome to address. As the intervention pilot plans and the components become more firmly outlined, AHCPR could be approached with the idea of a project to pilot the provider piece and then pursue a trial as outlined above. Other funding ideas would be Robert Wood Johnson Foundation that likes to partner with other funding agencies, such as health plans or health foundations. Sample size estimates will be helped by information from the pilot testing of the intervention. Recruiting women with the conditions for which hysterectomy is often performed, such as endometriosis and fibroids, would expand the pool of women from which to recruit. The group should continue to think through these issues. ITEM 6: Scientific presentations and discussion: A. Attitudes to Menopause Dr. McKeown presented data from his APHA abstract including women from Alabama, New Mexico, and South Carolina (Texas did not administer the scale). There are many women excluded due to missing data; one strategy will be to exclude women with a hysterectomy to avoid some of the missing data problems. New Mexico reversed the order of questions to determine menopausal status, and that could explain some of the difference in their distribution of pre-, post-, and perimenopause. There are 200 women missing from the UAB sample, women who stated they had not gone through menopause but then volunteered that they had a hysterectomy and who then skipped the perimenopause question. Strategies to approach this problem were discussed. B. Navajo data analyses Dr. Herman discussed data from the survey in New Mexico. There are large differences in educa tional and income distributions between the non-Hispanic whites and the other groups. Acculturation will also be an issue. Hysterectomy rates are relatively low in New Mexico, especially in the Navajo, as expected due to the Indian Health Service's management of care. A large number of Navajo women did not know their menopausal status and had never heard of HRT and "Don't know" responses are a challenge for analysis of several items. This may be due, in part, to the fact that the concept of menopause is not really relevant in the Navajo culture. Thus, age and traditionality of the individual women affect the expressed attitudes and beliefs among the Navajo. Translation may be an issue for some of the items as well. C. Future meetings and conference call schedules The Intervention Committee is planning a meeting July 8 and 9 in Albuquerque. The next scheduled conference call for the entire group is June 4, 1999 at 11 am CDT. The next face-to-face meeting of the entire group will be scheduled so that the APHA presentations can be reviewed, probably in September. The exact dates and location will be determined on the next conference call. The next data management call is May 20 at 3:30 pm CDT. ACTION ITEM: Dates for the next face-to-face meeting of the entire group will be finalized on the June call. Summary List of Action Items: ACTION ITEM: Dr. Lewis will check the supplement budget to see if there is