A commentary on this article appears in this issue on page 1095.

No abstract

Purpose: Bladder symptoms are common in women and result in use of healthcare resources and poor quality of life. Bladder symptoms have been linked to age and menopause, but debate exists in the literature. This article examines factors associated with bladder symptoms and compares women in late reproductive stage with those in menopausal transition. Materials and Methods: We analyzed cross-sectional data from a prospective cohort study of midlife women (mean age, 48; range, 44-54 years) in northern California. The sample consisted of 158 women in late reproductive stage or menopause transition. Assessments included anthropometrics, menstrual cycle lengths and symptoms, urine samples for follicle-stimulating hormone level, and self-reported health perception and depressive symptoms. Analyses included descriptive bivariate statistics, group comparisons, and regression models. Results: The most common bladder symptoms were nocturia (72%) at least once per night and urinary incontinence (50%) at least once per week. Incontinence was less prevalent in African American women compared to European Americans and Latinas ( p = 0.001) and more prevalent in late reproductive stage than in menopause transition ( p = 0.024). Controlling for age, women in late reproductive stage were more likely to report nocturia compared to those in menopause transition. Reproductive stage ( p = 0.016), higher body mass index ( p = 0.007), and race ( p = 0.017) contributed to the variance in weekly nighttime urinary frequency. Conclusion: Bladder symptoms were associated with reproductive stage. Women in late reproductive stage were more likely to experience nocturia and incontinence than those in menopause transition. The higher rates of nocturia and incontinence in late reproductive stage are intriguing. Future studies should include analysis of pelvic organ prolapse degree and other structural differences.

Midlife Black women suffer disproportionately from heart disease and stroke in comparison to White women of similar age and demographic. Risk for cardiovascular disease (CVD) and stroke is largely considered to be modifiable yet CVD prevention and awareness campaigns have been less effective among Black women. Decreased awareness of personal CVD risk is associated with delays in the presentation of women to the emergency room or health care providers for symptoms of myocardial infarction. The Midlife Black Women’s Stress and Wellness (B-SWELL) program was designed to increase awareness about CVD risk factors, stress, and healthy lifestyle behaviors among midlife Black women. In partnership with an existing Community Research Advisory Board (C-RAB), materials were developed and culturally adapted for the B-SWELL program. Following successful development of the B-SWELL materials, a trial of the B-SWELL program was conducted with a sample of midlife Black women recruited from the community. The program was co-facilitated by members of the C-RAB. We outline the strategies used to successfully co-create and trial the B-SWELL program materials and reflect on the strengths and challenges associated with the development of a culturally tailored heart disease prevention program using community participatory methods.

Chronic stress is a social health determinant associated with many persistent health conditions and health disparities for midlife Black women. Midlife Black women in the United States are exposed to multiple, competing stressors, increasing their risk for adverse health outcomes. The objective of the current study was to illicit information about the key life stressors experienced by midlife Black women. Focus groups were conducted using a convenience sample of midlife Black women ( N = 11, age range = 41 to 54 years). Coding and thematic analysis identified four primary sources of stress: workplace, parenting, finances, and social media. Gendered racism and discrimination and life imbalance emerged as underlying stressors linked to the Strong Black Woman persona. This persona prioritizes resilience and self-reliance while suppressing self-care. The stressors identified will inform the development of an intervention and should be considered when providing care for midlife Black women. [ Journal of Psychosocial Nursing and Mental Health Services, 57 (3), 32–38.]