WHIM (Women's Health in Menopause): Promoting healthy aging in menopausal women

Abstract Menopause is a significant part of the aging process experienced by women during midlife. In the U.S., the mean age of menopause is 51 years. The menopausal transition leads up to menopause and may last a decade. Over 85% of women experience multiple symptoms over an average of 7 years, both physically and emotionally. These symptoms interfere with their quality of life and daily activities both at home and in the workplace, costing the healthcare system an estimated $24.8B and the workforce $1.8B annually. There is a gap in accessing menopause care: 73% of women do not receive any treatment during a medical visit, partially because only 1/3 of OB/GYN medical residents are being trained in menopause care. Maximizing efficient care delivered by providers experienced in the provision of menopause care has the potential to increase access to treatments. Medical group visits (MGV) can deliver 300-400% efficiency compared to usual care, and are reimbursable, which also increases access for menopausal women. Group medical care, especially when conducted online, improves access in locations experiencing provider shortage. The proposed product, WHIM (Women's Health in Menopause), is envisioned to be a digital health product designed to improve the menopause-related experience for midlife women. It is built upon an existing digital behavioral intervention platform, GEMINI (Haas/Gardiner), that facilitates the development and delivery of behavioral intervention curricula in both MGV-based or self-guided settings with built-in support for didactic content, multimedia experiential practices, local/online resources, forums, and engagement features. In this Phase I study, we will build WHIM by extending GEMINI with three main additions: (1) MENOGAP (Taylor-Swanson/Moreno), an MGV-based patient education program, will serve as the primary source of menopause content. (2) We will enhance the potential psychological and physical health benefits of WHIM by incorporating positive emotion regulation skills, which have shown efficacy for helping people cope with various types of health-related and other life stress (Moskowitz/Addington/Yang). (3) Regular exercise and healthy diet are strongly recommended for managing menopausal symptoms, often referred to as “food and movement as medicine.” We will integrate WHIM with popular health wearables and apps and incorporate their use in home practices and engagement features to improve the adherence to recommended exercise and/or diet regimens. Phase I aims are: 1) Collect stakeholder feedback from perimenopause/menopause patients and menopause care providers via focus groups and interviews; 2) Develop the WHIM prototype using user-centered design and integrating with health wearables and mobile apps, as well as adapting the MENOGAP content to incorporate positive emotions skills; 3) Evaluate WHIM’s Participant Portal and Provider Portal via usability and acceptability testing, which will be used as the success criteria.