Ethnically Diverse Midlife Women’s Menopausal Transition Symptom Experience and Access to Medical and Integrative Health Care: Informing the Development of an Integrative Medicine Group Visit for the Menopausal Transition

Objective Individuals in the menopausal transition often seek healthcare in the United States. However, many individuals who seek healthcare do not receive treatments for their symptoms. And, some lack access to providers of both medical care and evidence-based integrative health interventions such as acupuncture, acupressure, or massage. A potential solution to this problem is medical group visits. Medical group visits are when multiple patients are seen by one provider. The present study gathered the opinions of diverse midlife women about interest in and desired design elements of medical group visits for menopause-related symptoms and concerns. Methods We conducted one focus group with ethnically diverse midlife women to learn about their experiences in the menopausal transition, specifically their symptom experience, barriers, and facilitators to accessing medical and integrative health providers, and their interest in and suggestions for the design of an integrative medical group visit. Qualitative research methods were used to summarize session results. Results Nine women participated and were diverse in terms of race/ethnicity and religious affiliation, and were highly educated. Themes included: an interest in participating in this conversation; that medical terms were mostly unfamiliar, and that terminology was less important than having a conversation; many symptoms were experienced; social factors affected participants, stressing the need for communication on this topic; receiving both unhelpful and helpful healthcare, a desire for whole person care; a need for information about what conditions Integrative Health interventions can treat, barriers to accessing both conventional and integrative care providers and facilitators include knowledge about insurance coverage and word of mouth. The group expressed great interest in the proposed integrative medical group visit (IMGV) model but expressed barriers such as a lack of time available, and needing childcare. Women indicated that an online format may help to overcome barriers. Conclusions These findings highlight the importance of engagement with stakeholders before the design and implementation of IMGV and the great need among midlife women for education about the menopausal transition and relevant interventions and self-care. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by funding from the Undergraduate Research Opportunities Program at the University of Utah awarded to Kari Stoddard. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the University of Utah Institutional Review Board and each participant provided informed consent before the start of the session. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors