1. Webber, Elaine DNP, PPCNP-BC, IBCLC

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Researchers involved with the Nurses' Health Study are looking for you! Recruitment efforts are underway to enroll a new generation of participants for the 3rd phase of this long-term health study. Why, you might ask, should this interest you? To answer this question, it is important to first look at the background that led to the initiation of the first Nurses' Health Study.

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Historically, women have been underrepresented in health-related research. Statistics tracking women's health over the past three decades indicate women had higher mortality rates than men for a number of health conditions including heart disease, stroke, influenza, diabetes, and pneumonia (US Department of Health and Human Services, 2002). In the late 1970s and early 1980s, few health studies focused on, or included women. To address this disparity, in 1983 the U.S. Public Health Service Task Force on Women's Health Issues was established. In 1990, the National Institutes of Health (NIH) issued guidelines requiring that women be included in all NIH-sponsored clinical research and this policy became law in 1993 (NIH, 2011). To evaluate the effectiveness of this new law, a 2004 review of literature was conducted to ascertain whether these guidelines were being followed. Researchers found that over 20% of the studies published from 1993 to 1998 failed to include women as research subjects (Vidaver et al., 2000). A follow-up review of the literature revealed there was "no statistically significant changes in inclusion or reporting of sex or race/ethnicity when compared with [the] 2004 study" (Geller et al., 2011, p. 315).


It was against this backdrop that the first Nurses' Health Study (NHS) was launched in 1976. The study, funded by the NIH, was initiated by Dr. Frank Speizer who was interested in the potential long-term risk factors of birth control pills on the health and well-being of women. Nurses were targeted as study participants because researchers felt they would have a strong commitment for continued participation in a long-term healthcare study. In addition, researchers believed nurses would be able to provide complete and accurate information about various health conditions due to their nursing education. Over 120,000 nurses responded to the initial NHS survey for a 72% response rate. Though the initial research focused on potential risks of birth control pills, the study expanded over time to include research on many other lifestyle factors and diseases processes, with cohort members receiving a new questionnaire every 2 years (NHS, n.d.a).


In 1989, the study was expanded into the NHS II. The focus of this new research was on diet and lifestyle factors in women who were younger than the original study participants. Over 116,000 women joined in this study, many of them the offspring or relatives of the original study participants. To date, over 90% of both the NHS & NHS II nurses continue to participate in the ongoing studies. Expanding the research further, in 1996 and 2004, the children of NHS II participants were invited to enroll their children into a similar long-term study-focusing on factors that influence weight change. This study, called the Growing Up Today Study (GUTS), is still ongoing (NHS, n.d.c).


The NHS, the NHS II, and GUTS have made significant contributions in the field of women's health as well as public health. Results have provided insight into the impact of diet on disease and have informed new national dietary guidelines. Collection of bio-specimens from many participants in all three studies have allowed researchers to investigate disease mechanics including how nutrients and inflammatory markers influence disease development. Key findings through the years have shown links between a variety of health-related behaviors and health conditions including breast cancer, coronary heart disease & stroke, cognitive function, and eye disease (NHS, n.d.b). The dedicated commitment from nursing participants and low attrition rates have contributed to the long term and ongoing results.


Much has been accomplished since the original NHS was launched in 1976; but there is more work to be done. Scientists involved with the NHS have launched a call for younger nurses to enroll in NHS 3. The new study plans to use technological and statistical advancements to expand on previous findings and link biological data with behavioral data. Researchers are looking for 100,000 new participants to form a diverse cohort for the next phase of this vital study. Unlike previous NHSs, participants do not have to wait for an invitation to join, and recruitment for the study will continue until the goal of 100,000 participants is met. The parameters for study participants are quite broad; you can enroll if you are:


* A nurse or nursing student (for the first time, male nurses and nursing students are invited to join)


* Age 19 and over, but born after January 1, 1965


* Living in the United States or Canada



If you are currently enrolled in another study (such as GUTS) you can still participate in NHS 3, and are even encouraged to do so. However, current participants in the original NHS, or NHS II cannot participate in NHS 3. Joining in the study is easy-simply complete an on-line registration, which can be found on the NHS Web site at:


Potential participants may ask themselves-why volunteer for this type of long-term study? The answers are simple and straightforward. First and foremost-the results from the original NHS and NHS II have made direct contributions to the health and well-being of women today. The opportunity to contribute to ongoing health research focusing on the needs of women is invaluable, with a possible impact on your own health, and certainly for the health of future generations. In addition, every time you read about medical breakthroughs originating from the NHSs, you can feel good about the role you have played in improving women's health throughout the world. I have been a participant in the NHS II since 1989, and my children have participated in the GUTS program as well. Please join me, along with thousands of other nurses from around the United States in making a difference in women's health.




Geller S. E., Koch A., Pellettieri B., Carnes M. (2011). Inclusion, analysis, and reporting of sex and race/ethnicity in clinical trials: Have we made progress? Journal of Women's Health, 20(3), 313-320. doi:10.1089/jwh.2010.2469 [Context Link]


National Institutes of Health, Office of Research on Women's Health. (2011). Report of the Advisory Committee on Research on Women's Health, Fiscal Years 2009-2010: Office of Research on Women's Health and NIH Support for Research on Women's Health. Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health. Retrieved from[Context Link]


Nurses' Health Study. (n.d.a). About the Nurses' Health Study. Retrieved from


Nurses' Health Study. (n.d.b). Key findings from the Nurses' Health Study. Retrieved from


Nurses' Health Study 3. (n.d.c). Nurses' Health Study 3: Our story. Retrieved from


US Department of Health and Human Services and Maternal and Child Health Bureau. (2002). Women's health USA 2002. Retrieved from[Context Link]


Vidaver R. M., Lafleur B., Tong C., Bradshaw R., Marts S. A. (2000). Women subjects in NIH-funded clinical research literature: Lack of progress in both representation and analysis by sex. Journal of Women's Health & Gender-Based Medicine, 9(5), 495-504. doi:10.1089/15246090050073576 [Context Link]