Fall 2010
Reflections on a 15-year study

synapse: University of Nevada, Reno School of Medicine

Staff of the School of Medicine's Women's Health Initiative

The remaining staff at the School of Medicine's Women's Health Initiative will wrap up the 15-year study this fall. They are from left to right, Jane Hammons, Robert Brunner, Ph.D., Betty Clark, LPN, and Mary Lopes, RN. Photo by Laura Levin

The Women’s Health Initiative (WHI), a suite of studies looking at major health issues of women after menopause, winds down its 15-year run at the University of Nevada School of Medicine this fall.

By Anne McMillin, APR

The School of Medicine was one of 40 sites across the country conducting these studies funded by the National Institutes of Health starting in 1994.

A diverse group of more than 161,000 women, including about 3,700 at the School of Medicine, were enrolled nationwide to help understand cardiovascular, cancer and fracture outcomes along with a number of other diseases and conditions.

Two of the randomized, blinded clinical trials in WHI, one that has studied combined estrogen and progesterone treatment (in women with a uterus) and a parallel trial of estrogen only (in women without a uterus) yielded highly publicized and controversial findings when released between 2002 and 2004. After these papers were published, the number of hormone prescriptions dropped sharply and the number has not fully recovered.

The public health impact of two other WHI randomized trials was not as dramatic. The eight-year test of a low-fat, plant-based diet showed small reductions in breast cancer and cardiovascular risk factors, but no changes in the risk of colorectal cancer or heart disease. The randomized trial of calcium and vitamin D supplementation did not show an overall significant reduction in hip fractures, although bone mineral density was increased.

As the program wraps up, participants reflect on their time involved with this study and the four remaining school staff members close a chapter of their careers.

Terry Journey decided to join the study in 1996 because “I was blessed with good health and had a body to use to help those who aren’t as healthy.”

“I felt good about participating because of what it might do to improve women’s health,” said the 86-year-old who wanted to be a surgeon.

She felt honored to take part in one of the hormone studies. “I wanted to give and will continue as long as I can even though the study is through,” she said.

Verlita Conner, 79, felt it was worth the time and effort required over a decade of testing and clinical visits for her involvement in five clinical studies.

“I thought it worthy to be involved in research with women because most research has been done on men,” said the avid golfer, gardener and bridge player. “I’m sorry it is going away but I will always be grateful I participated because life is about changes.”

Of the original staff members, four remain to close down the study at the School of Medicine.

“It has been a privilege to be part of the WHI and to have the rewarding experience of working with the dedicated women who contributed their time and effort to this landmark research,” said Robert Brunner, Ph.D., principal investigator for the WHI at the medical school. He will stay on as a consultant for a few years.

Betty Clark, a licensed practical nurse who has been with the study since its inception, recruited participants, conducted orientation meetings and processed medical records. She said the study has come a long way since 1995 when she joined.

“Back then we were in the Redfield Building without furniture and our files were in cardboard boxes,” she recalled. After expanding to six exam rooms, an office and a chart room, the study moved to the Pennington Medical Education Building when it opened in 2001, ultimately occupying half of the second floor.

Jane Hammons, an administrative assistant with WHI since 2001, conducted several cognitive tests with participants.

“I was inspired by the ladies who stuck with the study,” she said. “They are involved with life and still want to live and get out and about. There are no whiners or complainers; only the fighters are left at this point,” she said, making reference to the youngest women in the study who are now in their mid-60s. She added she is proud to have been a part of something that is bigger than herself and could help her kids and grandkids.

Mary Lopes, RN, assisted in the clinic taking measurements and giving breast exams. Since the clinics ended in 2005, Lopes has conducted follow-up phone interviews and has processed the medical or hospital records that confirm self-reported disorders and diseases, which are the “outcomes” of the studies.

“I used to think life was over at 50, but working with this study has given me a different perspective on our middle years and the aging process. It has expanded my outlook; I’m no longer going to run out and buy a rocker,” said the active nurse who still volunteers and travels.

Lopes gives credit to the WHI women saying through them, she gained perspective on the aging process and learned she can still contribute to society and family and be a valuable human being.

Even as the original study sites began to close their doors this summer, data collection for WHI will continue through 2015 largely by mail or phone through four regional centers at Stanford University, Ohio State University, the University of Buffalo and Wake Forest University.