Understanding the factors that influence women's decisions to use hormone replacement therapy during menopause using the Theory of Planned Behavior
The purpose of this study was to determine the factors that influence women's decisions to use hormone replacement therapy (HRT) during menopause. Using the Theory of Planned Behavior and constructs of risk perception, this study was able to explore the beliefs and attitudes of women about HRT use during menopause. The study was also able to explore how risk perception of HRT and the conditions that affect women during midlife impact their decision to use HRT during that time. Focus groups were conducted to develop the questionnaire used in the larger study. A community-based sample of women from Houston area churches participated in the study. The major theme that emerged from the focus groups was the weighing of cancer risks and the protection benefits of HRT. The most interesting factor that emerged as a barrier to HRT use was "negative publicity" and myths toward taking HRT. Results from the larger study demonstrated that the construct of attitude was the predominate predictor of intention when direct measures were used in a model to predict intention. Meaning that women's attitudes towards HRT use during menopause (whether they are safe, wise to use, good or bad, beneficial, risky, pleasant, or valuable) played a significant role in their intention. In contrast when the belief-based measures were used in the model, subjective norm and perceived behavioral control were significant predictors of intention. Meaning that the intention to use HRT was based more on the influence of their husbands, physicians, and families. This also meant that the dosage form, cost, negative publicity, family history of cancer, personal fear of developing cancer, and education about HRT would affect their intention to use HRT during menopause more than the advantages and disadvantages of using HRT (advantages such as protection from osteoporosis, relief from hot flashes; or, disadvantages such as risk of breast cancer). Finally, women's perception of risk with regards to HRT was highest for breast cancer followed by heart disease, endometrial cancer, and osteoporosis. This study found that there are many factors that may affect the decision to use HRT during menopause and that overall these factors affect women’s attitudes towards HRT and their intention to use it.