Findings from Nurses' Health Study Benefit Women's Health

By Krisberg, Kim | The Nation's Health, November-December 2013 | Go to article overview
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Findings from Nurses' Health Study Benefit Women's Health


Krisberg, Kim, The Nation's Health


FOR MORE THAN 30 YEARS, Ingrid Fetkoeter has been committed to what has become the world's largest, longest-running study of women's health. In fact, Fetkoeter is so committed to the Nurses' Health Study that she has authorized her doctors to send all of her medical records to study researchers after she dies.

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"I even started clipping out and saving articles about (the study)," said Fetkoeter, NP, RN, who retired from nursing in 2011 after 50 years in the field. "Over the years, it got to be that you couldn't open a health magazine without finding a result from the Nurses' Health Study. I'm just so proud to be a part of it."

Fetkoeter, now 72 years old, enrolled in the Nurses' Health Study in 1976 after hearing about it via a local nursing licensing agency. The study, which ended up recruiting 122,000 female nurses to participate, was launched to examine the long-term risk factors for cardiovascular disease and cancer in women. Today, 90 percent of those nurses--including Fetkoeter--are still participating via surveys they receive by mail. The study does not focus on nursing practices, instead using female nurses as subjects for study of women's health.

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The study that Fetkoeter enrolled in is now known as Nurses' Health Study 1 and was just the first iteration of the decades-long endeavor. Nurses' Health Study 2 began in 1989 to examine diet and lifestyle risk factors and successfully recruited more than 116,680 nurses, of which 90 percent are still participating, and the Nurses' Health Study 3 began in 2010 with a goal of recruiting 100,000 new female nurses and nursing students. Oftentimes, previous study participants are integral to recruiting new nurses to enroll and Fetkoeter is no exception. The retired nurse is using her Facebook page to encourage the next generation of nurses to contribute their knowledge and experiences to keeping the massive women's health study going strong.

"The study really does speak for itself," she told The Nation's Health.

Indeed, findings from the studies have led to real changes in how health professionals care for women. For example, according to APHA member Walter Willett, MD, MPH, who helped launch the second and third rounds of the study and serves as principal investigator, findings on oral contraceptives and their relationship to cardiovascular disease led to changes in prescribing practices and a reformulation of contraceptive pills. Findings on vitamin A consumption and the risk of hip fractures led to the reformulation of vitamin supplements and contributed to practices such as fortifying breakfast cereals. And findings on the timing of postmenopausal hormone use and the risk of heart disease and breast cancer offered new guidance to doctors caring for women.

"The Nurses' Health Study has been a milestone because it is providing the most detailed information anywhere in the world on diet and many other factors, operating across the lifespan, in relation to almost all major diseases in women," said Willett, a professor of epidemiology and nutrition at the Harvard School of Public Health.

Focusing on nurses, who were initially recruited for their ability to accurately report on health issues, has been key to the studies' success. Willett said nurses offer a "fairly good cross-section of American women, excluding the most poor and rich," and are able to provide high-quality data about their health and medication use. Participants are also overwhelmingly committed to the research.

For the most recent study, Nurses' Health Study 3, researchers are examining health issues related to lifestyle, pregnancy and fertility, and environment. The study is also collecting data on the occupational health risks specific to nursing, partnering with the National Institute for Occupational Safety and Health to develop a thorough assessment of workplace exposures to which nurses are particularly susceptible.

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