I have recently completed a study with the specific aim to test the effectiveness of a multimodal treatment package (MMTP) of health promotion behaviors (high-fiber, low-fat diet; multivitamin and calcium supplements; moderate aerobic exercise; stress reducing breathing techniques) for management of symptoms associated with the menopause transition (day sweats, hot flashes, night sweats, vaginal dryness) in breast cancer survivors. In this study, 8 women (treatment group = 5; delayed treatment group = 3) utilized the MMTP for 60 days and experienced a 25- 30% reduction in symptom severity for days sweats, hot flashes, and night sweats compared to their baseline measures. As expected the MMTP did not reduce the severity of vaginal dryness. Women in the delayed treatment group experienced no significant differences in symptom severity between their first and second baseline measures. However, women in the treatment group compared to the delayed treatment group's second baseline measures indicated a 48% reduction in hot flash severity. A larger sample size is required to establish the effectiveness of the MMTP, and this will the purpose of an RO1 proposal to the National Cancer Institute. This research established that breast cancer survivors will utilize a MMTP of health promotion behaviors for symptom management, and this may be an effective way to encourage women to adopt positive health behaviors.

Notification of funding has been received from the National Institute of Nursing Research on a 3 year project titled "Nursing Interventions for Symptoms of Perimenopause," The project has the following specific aims:

1. To examine the immediate (1 month) and long-term (3 months) effectiveness of a MMTP compared to the control group at reducing symptom perception, severity, and distress for women experiencing severe symptoms and menstrual dysregulation associated the the perimenopausal transition.

2. To examine the immediate (1 month) and long-term (3 months) effectiveness of soy isoflavone capsules (SOY) compared to the control group at reducing symptom perception, severity, and distress for women experiencing severe symptoms and menstrual dysregulation associated with the perimenopausal transition.

3. To explore the relative effectiveness of the MMTP, SOY, and the self-monitoring by the control group at reducing symptom perception, severity, and distress for women experiencing severe symptoms and menstrual dysregulation associated with the perimenopausal transition.