ProudWoman: enhancing the health of menopausal women in lower economic positions

The transition to midlife and older age is a critical stage in a woman’s health and working life. Around 1.6 million female workers are above the age of 45 and can be expected to face menopause in the (near) future. Menopause is associated with a wide range of health problems impacting women’s quality of life, their risk of cardiovascular diseases and their functioning at the workplace. In particular, women in low socioeconomic positions (SEP) are more vulnerable for these health problems and harder to reach by preventive programs. The work-life program developed by ProudWoman offers guidance to working women in the transition to midlife and older age. The program encompasses education about menopause and a healthy lifestyle, a health check, coaching to improve the work-life balance, and physical training (personal training or walking training). The program has been successfully implemented in a large healthcare institution with many female workers in lower socio-economic positions. More recently, implementation of this program in a cleaning company with many workers with a migrant background, engaging women required adaption of recruitment strategies in relation to their cultural context. This project aims to I) tailor the intervention, enrollment procedure and implementation strategy of the work-life program (ProudWoman) to the needs of women in lower SEP across diverse backgrounds, II) to study its implementation success, and III) to gain insight in the cardiovascular risk profiles of participants. These aime will be addressed in six subsequent steps. The project starts with a context analysis in a female-typed work organizations employing women in lower SEP (healthcare organization) in which the work-life program was already introduced (STEP 1). Next, the work-life program is implemented in a new work organization with a large proportion of female workers in lower socioeconomic positions (VUmc, facility department and nutrition assistants). Step 2 is a context analysis in the new organization. The objective is to identify barriers and facilitators for the implementation of the program in the structure and culture of the work organization, including the vision, communication and existing facilities and resources. In the third and fourth step the work-life program, its enrollment procedure and the implementation plan are tailored to the needs of workers in lower socioeconomic positions across diverse backgrounds and the needs of the work organization. The fifth step concerns the actual implementation of the work-life program accompanied by a process analysis based on the RE-AIM model. The process analysis will assess the reach, effect, adoption, implementation, and maintenance of the intervention. The sixth step includes drawing up an advice on the tailoring of the work-life program and its implementation in other work organizations. A life-course perspective is adopted during the implementation of the intervention and the study of its effects, focusing on important transitions in the (working) lives of women. In investigating the needs of our target population, we will take on an intersectional approach. This means that we study needs in relation to intersections between sex (the biological aspects of being a man or a woman), gender (the social cultural aspects), and other dimensions of diversity such as age, socioeconomic position, cultural background, and profession. This proposal is relevant to the call because we i) focus on workers with low socioeconomic positions; ii) aspire to reduce life expectancy disparities by targeting women’s and cardiovascular health; iii) aspire to reduce disparities in perceived health by guidance during the transition to midlife and older age; iv) tailor the enrollment and implementation strategy of an intervention to the needs of women in lower socioeconomic positions across diverse backgrounds; v) implement the intervention while improving and consolidating ongoing implementation efforts. Our project will contribute to health promotion by yielding valuable knowledge on how to reach and engage women in lower socioeconomic positions across diverse backgrounds via the workplace. It will fill a gap in knowledge about menopause and women’s work and impact the employability of women during their transition to midlife and older age. Moreover, it will inform the search for improved cardiovascular risk characterization in women.