Attitudes and knowledge associated with being undecided about hormone replacement therapy: Results from a community sample

HRT has important potential public health benefits because it can delay the age of onset and reduce the risk of many chronic diseases. However, the inherent complexity of HRT risk and benefit analyses necessary for a woman to make an informed decision about whether to use HRT presents a significant challenge. To date, decision-aid interventions have primarily been evaluated with clinic-based samples of women who may or may not represent the needs of women in the community. This paper reports data from the baseline assessment of participants in a randomized controlled trial designed to evaluate the efficacy of a tailored decision-aid intervention on HRT decision making. Of the community sample of 581 women ages 45-54 who were interviewed by telephone, 318 were determined to be menopausal and were included in this report. Fully one-third (n = 104) of these menopausal women were undecided about using HRT; 55% (n = 176) had decided to use HRT and 12% (n = 38) had decided against using HRT. Women who were undecided about HRT use were significantly different from the other two groups in their income, stage of menopause, prior use of HRT, hysterectomy rates, attitudes about menopause, and knowledge about HRT. This paper describes directions and strengths of these differences. Findings suggest that future decision-aid interventions with potential for dissemination outside of clinical settings would benefit this undecided group.