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Women's Health Study Examples

Study Examples | Key Publications | Intro

Here are some projects of which Group Health Center for Health Studies (CHS) is particularly proud:

• Women and Bone Strength
• Breast and Bone Density: Impact of Colonic Environment
• Effect of HRT Cessation on the Recall Rates for Screening Mammography
• Translating Chlamydia Screening Guidelines into Practice (TRIP)

Women and Bone Strength

• Principal Investigator: Delia Scholes, PhD
• Co-investigators: Andrea Z. LaCroix, PhD; Susan M. Ott, MD, University of Washington (UW) Department of Medicine; William E. Barlow, PhD; Susan D. Reed, MD, MPH, UW Department of Obstetrics and Gynecology

The denser a woman's bones, the lower her risk of eventually developing osteoporosis; and adolescence is when women usually reach their peak bone density. This project is investigating several factors that are likely to be important in building and maintaining bone density: diet, physical activity, race or ethnicity, family and personal history of fractures, and use of hormones and other medications. The study is using periodic laboratory tests and bone-mineral density scans to follow 600 women, aged 14 to 30, for two to three years. Earlier, the same researchers found the bone density of teenagers and women under age 40 fell while using depot medroxyprogesterone acetate (DMPA, Depo-Provera), an injectable progesterone-based contraceptive method; stopping Depo-Provera reversed this process. The results of their new study, funded by a five-year, $3.1 million grant from the National Institute for Child Health and Human Development, may lead to new osteoporosis prevention services for young women.

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Breast and Bone Density: Impact of Colonic Environment

• Principal Investigator: Johanna W. Lampe, PhD, Fred Hutchinson Cancer Research Center
• Group Health Co-investigator: Katherine M. Newton, PhD

This project is designed to test the hypothesis that differences between individual women's intestinal bacteria may change the amounts, forms, or both of circulating estrogens, thus influencing the risk of breast cancer. The researchers are exploring women's ability to produce a chemical known as equol from the soy isoflavone called daidzein. Only a third of people have this ability, thanks to having the right bacterial species in their gut. The scientists will see whether there is any link between this ability, which may help prevent breast cancer, and the density of a woman's breasts and bones. These densities have been proposed as markers for cumulative exposure to estrogen. The National Cancer Institute (NCI) funds this four-year study, with more than $800,000 to CHS.

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Effect of HRT Cessation on the Recall Rates for Screening Mammography

• Principal Investigator: Diana S.M. Buist, PhD
• Co-Principal Investigators: Katherine M. Newton, PhD; Susan D. Reed, MD, MPH, UW Department of Obstetrics and Gynecology

Several factors affect the accuracy of mammograms to screen for breast cancer. For instance, as women age and their breasts become less dense and more fatty, accuracy increases. Conversely, for the women who take hormone replacement therapy (HRT) for menopause, this treatment tends make their breasts denser. This, in turn, makes their mammograms harder to read, thus lowering accuracy and leading to more false positives as well as cases missed until late-stage cancer. This randomized controlled trial is testing whether it is worthwhile for women to stop taking HRT for one or two months before screening mammography. If this short-term intervention is effective, it will significantly lower the number of women who are unnecessarily called back for additional mammograms. The U.S. Department of Defense is funding the study with a grant of $900,000 over three years.

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Translating Chlamydia Screening Guidelines into Practice (TRIP)

• Principal Investigator: Robert S. Thompson, MD
• Co-principal Investigator: Delia Scholes, PhD

This study, funded by a three-year, $1.4 million grant from the Agency for Healthcare Research and Quality (AHRQ), is evaluating the effectiveness of several strategies for implementing Chlamydia screening guidelines. For each strategy, researchers track the following four factors: the rate of screening of at-risk women ages 14–20; the rate of Chlamydia screening using a new Health Plan Employer Data and Information Set (HEDIS) measure; changes in provider knowledge, attitudes, and reported practices regarding Chlamydia screening; and costs per woman appropriately screened, as well as the marginal costs of the various intervention strategies.

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Study Examples | Key Publications | Intro