Waning Moon: A Whole Person Health Intervention Designed by and for Urban Menopausal American Indian/Alaska Native Women - PROJECT SUMMARY/ABSTRACT Menopause is the cessation of menses that occurs with aging. Hormone fluctuations during the menopausal transition, a period of several years leading up to menopause, are associated with a range of symptoms including vasomotor symptoms (VMS), ranging from hot flashes, night sweats, increased heart rate, to feelings of anxiety or palpitations. Social determinants of health such as education, socio-economic status, health conditions, and cultural background impact VMS symptoms, particularly in American Indian/Alaska Native (AI/AN) women who are overlooked in menopause research. One of the few studies to include AI/AN women reported they were the most likely to report severe VMS of any ethnic group. A growing body of evidence demonstrates that VMS may be a predictor for cardiovascular disease (CVD). AI/AN women have a shorter life span and higher mortality rates from CVD than White women and may benefit from culturally tailored intervention. One method for culturally congruent health promotion is health education delivered by a Community Health Worker (CHW) in a group format with social support. Our team has developed Waning Moon, a novel intervention that provides education (conventional and complementary integrative health menopause and CVD information), experientials (mindfulness, self-acupressure), and facilitated discussion (sharing experiences, asking questions). A group format delivers this greatly needed information to more urban AI/AN women simultaneously and thus increases efficiency. The curriculum is based on Social Cognitive and Biopsychosocial Theories to improve cognitive outcomes (VMS knowledge, CVD knowledge, menopause self- efficacy, perceived social support), behavioral outcomes (self-management behaviors, CVD screening rates), and health outcomes (menopause related quality of life, VMS). The unmet needs of urban AI/AN women have been largely neglected in research. We propose to address these gaps by evaluating the feasibility and acceptability of Waning Moon in preparation for future fully powered clinical trials. Leveraging the resources of our close and longstanding collaboration with the Urban Indian Center of Salt Lake and our interdisciplinary team’s successful research experience, we will conduct a feasibility study to systematically assess Waning Moon. We will convene community and leadership advisory boards to jointly finalize the feasibility study and enroll 3 CHWs and train them in Waning Moon delivery. We will enroll 30 menopausal women to receive Waning Moon. This project will be the first to assess the integrated delivery of conventional and complementary health education designed to provide education and CVD screenings delivered in a socially supportive environment and to increase self-management behaviors of menopausal women. The long-term goals of this project are to conduct future multi-site, fully powered feasibility, efficacy and then implementation trials of Waning Moon to increase self-management, quality of life, and rates of CVD screenings for urban AI/AN women during menopause.
