MOVING INTO THE FUTURE WITH NEW DIMENSIONS AND STRATEGIES: A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

OFFICE OF RESEARCH ON WOMEN’S HEALTH NATIONAL INSTITUTES OF HEALTH U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES STRATEGIC PLAN The Honorable Barbara Mikulski, U.S. Senator, Maryland August 16, 2010 “Fighting for women’s health has been one of my life-long priorities. For far too long, women’s health was ignored. When I first came to the Senate, women’s health wasn’t a national priority. Remember the famous study, take an aspirin a day to keep the heart attack away? That study was done on 10,000 men. Not one woman was included. In a study of the aging process, they told me women weren’t included because there wasn’t a ladies room available for study participants. Yet the results of these studies were being applied to men and women. I vowed to fix that. I helped establish the Office of Research on Women’s Health at the National Institutes of Health to make sure women were no longer being neglected. Through this office we have been able to increase women’s inclusion in clinical drug trials and to increase funding for breast cancer research by 700 percent since 1992. We now know that men and women have different symptoms before a heart attack. And there are many more biological differences that must still be studied and understood. I will continue to fight to make sure women’s health remains a priority in the federal checkbook and that women are not left behind when it comes to their health and survival.”

The Honorable John Lewis, Congressman, Fifth District, Georgia Regional Strategic Planning Meeting—Emory University • February 17, 2010 “Do something about the health needs of women. That is a must. That is our mission and it is our goal….In the area of health, we must do what we can to bring about a revolution of values, a revolution of ideas….We must have the capacity to stand up, to speak up and out, to organize and mobilize.”

The Honorable Connie Morella, Member, U.S. House of Representatives, 1987-2003 August 17, 2010 “The legislation that established the Office of Research on Women’s Health represented not only a victory for women, but an important contribution to science. By specifically studying women’s health issues the entire realm of scientific inquiry is enriched and expanded, and science is made more relevant. But, the challenge continues. The work is not finished. Our legacy for future generations, and to ensure that new and important advances continue, requires us to dedicate our continued energy, enthusiasm, and resources for women’s health research.” MOVING INTO THE FUTURE WITH NEW DIMENSIONS AND STRATEGIES: A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

OFFICE OF RESEARCH ON WOMEN’S HEALTH NATIONAL INSTITUTES OF HEALTH U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES STRATEGIC PLAN

A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

TABLE OF CONTENTS

5 Message from the Associate Director for Research on Women’s Health

9 Mission and Historical Overview

13 Vision, Goals and Objectives 16 GOAL 1 Increase sex differences research in basic science studies 17 GOAL 2 Incorporate findings of sex/gender differences in the design and application of new technologies, medical devices, and therapeutic drugs 18 GOAL 3 Actualize personalized prevention, diagnostics, and therapeutics for girls and women 19 GOAL 4 Create strategic alliances and partnerships to maximize the domestic and global impact of women’s health research 20 GOAL 5 Develop and implement new communication and social networking technologies to increase understanding and appreciation of women’s health and wellness research 21 GOAL 6 Employ innovative strategies to build a well-trained, diverse, and vigorous women’s health research workforce

23 Major ORWH Programs

27 Appendix A: Hosts and Working Group Cochairs of the Regional Scientific Meetings 34 Appendix B: Advisory Committee on Research on Women’s Health 35 Appendix C: Coordinating Committee on Research on Women’s Health 36 Appendix D: External Strategic Planning Review Group 39 Appendix E: Office of Research on Women’s Health Staff

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A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

MESSAGE FROM THE ASSOCIATE DIRECTOR FOR RESEARCH Vivian W. Pinn, M.D. ON WOMEN’S HEALTH

The Office of Research on Women’s Health addressing the health differences and needs (ORWH) was established in September 1990 of all populations of women; and increasing in response to congressional, scientific, and the diversity of the biomedical workforce. advocacy concerns that a lack of systemic and consistent inclusion of women in NIH- ACCOMPLISHMENTS supported clinical research could result in Twenty years after the establishment of clinical decisions being made about health ORWH, significant progress has been care for women based solely on findings achieved in four benchmark areas: (1) policies from studies of men—without any evidence have been developed and implemented that they were applicable to women. The to ensure the inclusion of women in NIH establishment of the Office heralded earnest clinical research; (2) women’s health and efforts by NIH to develop a research agenda sex differences research has increased; (3) addressing gaps in scientific knowledge new programs have been implemented to about women’s health across the lifespan and prepare researchers to conduct women’s to increase the number of scientists pursuing health research; and (4) there has been investigations with a scientific design that new focus on interdisciplinary career would reveal sex differences in outcomes. development and sex differences research These aims were articulated in the first across the research continuum. Consequently, ORWH agenda-setting report, Report of the reports on sex and gender-related factors National Institutes of Health: Opportunities in health and disease and analysis of for Research on Women’s Health (commonly clinical trials by sex of participants have referred to as the Hunt Valley report). In steadily increased in the scientific literature. 1997, ORWH undertook a second systematic Over the years, the biennial reports of program of collaborative planning and the Advisory Committee on Research on convened a series of public hearings and Women’s Health, in collaboration with the scientific workshops that culminated in NIH Coordinating Committee on Research the publication of the Agenda for Research on Women’s Health, attest to the attention on Women’s Health for the 21st Century. and greater appreciation that has developed That agenda expanded the vision for NIH, for women’s health and sex differences going “beyond Hunt Valley” to highlight the research in the design of studies and the importance of promoting interdisciplinary, translation of findings into clinical practice. collaborative research; studying and The growth of NIH-funded women’s health 5 research addressing the expanded concept of supports interdisciplinary research. In 2010, women’s health across the lifespan—including these three ORWH-initiated programs more than just the reproductive years while are flourishing and enjoy continuing continuing to explore understudied areas cosponsorship from many of the NIH of reproductive health and the menopausal institutes, centers, and offices. transition—has been impressive. Additionally, increasing numbers of investigator-initiated THE FUTURE women’s health research in areas such To build on past successes and determine as cardiovascular disease and stroke, future directions for the next generation of musculoskeletal and immune disorders, and women’s health and sex/gender research, mental health and substance abuse, among ORWH has once more updated the NIH many others, reflect enormous progress. women’s health research agenda in a third report, A Vision for 2020 for Women’s As a result of the increased attention to Health Research: Moving Into the Future women’s health research funded by the With New Dimensions and Strategies. The NIH institutes and centers, women’s health report is the culmination of a 2-year strategic scientists, providers, and advocates have planning process, involving more than gained a strong sense of their capacity to 1,500 leading scientists, women’s health effect change. Research on women’s health advocates, public policy experts, health care has become a tangible reality. Furthermore, providers, Federal, State, and local elected women’s health, sex differences, and officials, and the general public in 5 regional interdisciplinary women’s health research scientific meetings. This Strategic Plan not have become distinct research career only articulates new priorities, but also paths in multiple fields, a testament to the strongly reinforces existing areas, such as success of two ORWH signature programs: interdisciplinary and sex differences research. Building Interdisciplinary Research Careers Unlike earlier reports, the current Plan is not in Women’s Health (BIRCWH), established disease specific. It encompasses disease- in 1999, and the interdisciplinary Specialized specific research in a broader vision of Centers of Research (SCORs) on Sex women’s health that can benefit both women and Gender Factors Affecting Women’s and men by increasing our understanding of Health, established in 2002. As of 2010, the role of sex/gender factors in differential the BIRCWH program has supported the disease risk, vulnerability, progression, and career development of almost 400 early- outcome, as well as the effects of being stage research scientists at major research female on health. institutions throughout the United States. The SCORs on Sex and Gender Factors Affecting Over the past 20 years, research has Women’s Health support interdisciplinary revealed that from single cells to multiple research, from basic to translational to biological systems and mechanisms, sex clinical investigations, by accomplished differences exist—and these differences are scientists; while a third program, Advancing not just hormone based. Sex differences Novel Science in Women’s Health Research research is needed not only in fields such 6 (ANSWHR), established in 2007, further as endocrinology and immunology, but A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

also in rapidly evolving science areas Moving into the Future with New Dimensions such as epigenetics, systems biology, and and Strategies: A Vision for 2020 for neuroscience; and new technology- Women’s Health Research reflects ORWH’s enabled fields such as genomics, proteomics, commitment to fostering innovations and metabolomics. in women’s health research from bench to bedside, and from laboratories to The health of women has a direct bearing communities. Our strategy for the NIH on the health of their families and pledges us and our many partners to address communities, and ultimately, the health of opportunities, challenges, and health needs societies. In an increasingly interconnected of future generations of girls and women. world, the health of an individual or a We continue to look to our many partners community can, in some way, affect the among scientific groups, the public, advocacy health of all. Women’s health research groups, and policy leaders, who played such must encompass global considerations and a defining role in creating ORWH, to continue continue to seek ways to address the pressing to extol women’s health research and to help health needs of women worldwide. us realize our shared vision.

Vivian W. Pinn, M.D. Associate Director for Research on Women’s Health Director of the Office of Research on Women’s Health

Research on women’s health has become a tangible reality.

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A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

I MISSION AND HISTORICAL OVERVIEW

The Office of Research on Women’s Health 1 Advise the NIH Director and staff (ORWH) was the first Public Health Service on matters relating to research on office dedicated specifically to women’s women’s health. health. The office was established at the National Institutes of Health (NIH) 2 Strengthen and enhance research related on September 10, 1990. The office was to diseases, disorders, and conditions that reaffirmed by statute in congressional affect women. legislation by the NIH Revitalization Act of 1993 to serve as the focal point for women’s 3 Ensure that research conducted and health research at the NIH, reporting supported by NIH adequately addresses directly to the NIH Director, and working in a issues regarding women’s health. collaborative partnership with the institutes, centers, and offices. Congress assigned a 4 Ensure that women are appropriately far-reaching leadership role to the ORWH represented in biomedical and Director by mandating that the Director be biobehavioral research studies supported responsible for the following: by the NIH.

5 Develop opportunities and support for recruitment, retention, reentry, and advancement of women in biomedical careers.

6 Support research on women’s health issues.

9 Throughout its 20-year history, ORWH has Participating in this process were more worked in concert with the NIH institutes, than 1,500 individuals, representing the centers, and offices and the biomedical, full spectrum of academic institutions, behavioral, health care, and advocacy professional associations, advocacy communities to foster understanding in organizations, health care facilities, and support of a comprehensive approach to science policy analysts interested in research women’s health research. During this interval, on women’s health and sex/gender factors the office initiated two research agenda- in health and disease. Thirty-seven scientific setting initiatives in 1991 and again in 1997. and career development working groups Each of these efforts included public hearings were cochaired by leading external and and scientific workshops in formulating NIH scientists, representing 44 academic the research agenda. The first initiative institutions and 19 NIH institutes, centers, and led to the publication of the Report of the the Office of the Director. Participants in the National Institutes of Health: Opportunities meetings came from 33 states, Great Britain, for Research on Women’s Health, commonly and Australia. Nearly 400 recommendations known as the Hunt Valley report. The second emerged during the course of 5 regional report, Agenda for Research on Women’s meetings. Public and written testimony was Health for the 21st Century, was issued in 1998. received from 141 advocacy and academic organizations, as well as from individuals In October 2008, ORWH embarked on a presenting their personal health stories. 2-year process to plan the NIH women’s The concerns and issues highlighted by the health research agenda for the next decade. public testimony brought to the forefront The current Strategic Plan is the product of remaining gaps in knowledge and unmet a collaborative planning process informed needs in women’s health care, and served to by five regional scientific workshops and underscore the ultimate goal of the research public hearings anchored in leading academic agenda, to improve the health of women. and research institutions in St. Louis, San Francisco, Providence, Chicago, and Atlanta. In finalizing this document, the review Central to the approach of these meetings process involved three different levels: (1) was a decision to seek the opinions of a a review by the Advisory Committee on wide range of individuals from both within Research on Women’s Health; (2) a Strategic the NIH and from external scientific and lay Plan review group consisting of external communities regarding the research agenda scientists, some of whom also served as for the future of women’s health. As a result, cochairs of various working groups at the the format of each of the regional scientific regional meetings; and, finally, (3) an internal workshops was designed to promote an NIH review. The entire process is presented in interactive discussion involving leading three printed volumes and is also available scientists and researchers from across the to the public on the ORWH homepage nation, women’s health advocates, public http://orwh.od.nih.gov. policy experts, healthcare providers and the general public in a mutually informative and The benefit and purpose of the Strategic 10 collaborative strategic planning process. Plan are to identify a forward vision A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

that can further stimulate and continue scientific endeavor across and within all NIH institutes, centers, and offices and with an appreciation and understanding of the importance of conducting women’s health and sex differences research. Such research will ensure that science continues to be vigorous and dynamic and public health is well served. The Strategic Plan is also a tool for energizing partnerships across NIH, academia, the advocacy communities, and the world of public policy, leading to a better understanding of women’s health research and improving its benefits for human health worldwide.

11 Elizabeth H. Blackburn, Ph.D. 2009 Nobel Laureate A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

II VISION, GOALS, AND OBJECTIVES

A CHANGING VISION OF of research. Health outcomes are influenced WOMEN’S HEALTH by biological sex, gender identity, as well as The mission of NIH is to seek fundamental developmental, cultural, environmental, and knowledge about the nature and behavior of socioeconomic factors. The scope of women’s living systems and to apply that knowledge health research not only encompasses clinical to enhance health, lengthen life, and studies, but a full spectrum of scientific reduce the burdens of illness and disability. investigations, such as molecular and ORWH works in partnership with the NIH genetic, other basic and laboratory studies, institutes, centers, and offices to ensure healthy lifestyle and behavior, risk reduction that women’s health research is part of the and disease prevention. It also includes scientific framework. Since the establishment studies to design clinical interventions and of ORWH in September 1990, the field newly confirmed hypotheses to improve of women’s health research has greatly public health. There are striking sex/gender expanded in scope from a primary focus on differences in prevalence, progression, and reproductive health to a multifaceted area outcome of numerous conditions, including diabetes, obesity, cardiovascular diseases, substance abuse disorders, depression and brain disorders, infectious diseases, lupus and other autoimmune diseases, and cancer.

NIH has greatly expanded its portfolio of women’s health and sex/gender differences research. Because of the continuum of women’s lifespan transitions and roles, research on puberty, childbirth, and menopause are required considerations in the NIH women’s health research agenda. For the last decade, four overarching themes have guided NIH research on women’s health: 13 lifespan, sex/gender distinctions, health ADVANCING UNDERSTANDING disparities/differences and diversity, and OF BIOLOGICAL SEX DIFFERENCES interdisciplinary research. IN HEALTH AND DISEASE Over the next decade, the exploration of MAJOR CROSS-CUTTING THEMES, biological sex differences at multiple levels, GOALS, AND OBJECTIVES from genes to hormones to complex systems, The current Strategic Plan encompasses will be greatly accelerated. Research will fall disease-specific research in a broader vision far short of its promise to usher in an era of of women’s health, with the goal of increasing personalized medicine unless the contribution understanding of the major diseases and of biological sex to the diversity of health conditions that disproportionately affect outcomes is better understood and this women’s overall quality of life. It is important knowledge applied in the development of to note that the research priorities identified the next generation of interventions and in this Plan will benefit not only women, but medical technologies. men, by increasing our understanding of the role of sex/gender factors in disease risk, EMERGING NEW SCIENTIFIC vulnerability, progression and outcomes. FIELDS AND TECHNOLOGIES CAN The Plan envisions how women’s health PROVIDE UNIQUE OPPORTUNITIES research can enrich the biomedical TO MAXIMIZE RESEARCH landscape. The following key research The emergence of new fields of interdisci- themes provide additional context for the plinary science and the application of new goals and objectives in this plan. technologies and analytic methodologies (e.g., high-throughput screening, modeling, bioinformatics) to fundamental and transla- tional research can provide unprecedented future opportunities for understanding bio- logical sources of variance in human health and disease. Advances in science and technology hold the promise of identifying causative disease susceptibility genes and disease bio- markers, understanding the totality of physi- ological systems, and providing targeted and personalized sex appropriate therapeutics.

In an age emphasizing analytic strategies (e.g., mapping, data mining, meta-analysis), new enabling technologies will be able to take full advantage of information in data re- positories, population datasets, observational studies, and clinical trials.

14 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

FOSTERING PARTNERSHIPS TO IMPROVE THE TRANSLATION AND DISSEMINATION OF HEALTH INFORMATION Biomedical research ultimately serves human health by contributing to improved health care, reduction of morbidity and mortality, and enhanced health-related quality of life. In the next decade, NIH and ORWH will continue to provide leadership in forging links to further research along the translational spectrum toward community health and health services. By including academic partners from fields such as economics and ethnography as well as public and private partners, interdisciplinary research can also have significant impact on community health, health care delivery, and public policy.

The Plan identifies six major goals to advance women’s health research and represents a synthesis of almost 400 recommendations that emerged from five regional planning meetings.

15 GOAL 1 INCREASE SEX DIFFERENCES RESEARCH IN BASIC SCIENCE STUDIES

Over the past two decades that ORWH has promoted women’s health research, most studies of sex differences have been in clinical research. Looking forward, and ensuring that scientific knowledge continues to advance, an expanded conceptual framework is needed that explores variations due to sex as an integral part of the search for knowledge across the entire research spectrum, beginning at the most basic laboratory level. This should encompass research in diverse fields, including genetics, immunology, endocrinology, developmental biology, cell biology, epidemiology, microbiology, biochemistry, and toxicology, as well as in behavioral and social sciences. Advances in these fields will be further strengthened by emerging technologies such as high-throughput sequencing, data acquisition, bioengineering, and bioinformatics, and on new modeling and data analytic techniques. This convergence of information presents an opportune time to expand what is known about the effects of biological sex on normal development and the structure and function of cells, tissues, and organs. Therefore, the identification of sex of origin of cells, tissues, and animal model systems, as appropriate, can lead to improved clinical diagnosis and health care based on accurate, sex-specific data.

OBJECTIVES

1.1 Encourage genetic and epigenetic studies to 1.6 Increase basic and translational research on sex/ identify sex differences in gene expression. gender differences in the pathobiology, prevention, and treatment of diseases including HIV/AIDS, urinary tract 1.2 Explore sex differences in the structure and and sexually transmitted infections. function of male and female cells (including stem cells), tissues, organs, and physiological systems. 1.7 Investigate the actions of steroid hormones and hormone-mimicking environmental agents on 1.3 Study sex differences using a systems biology- gene expression, cells, tissues, and organs. Apply this based approach. This will include research based on new knowledge to sex differences in disease prevalence, technology platforms such as microbiomics, genomics, symptoms, management and outcomes, in conditions phenomics, proteomics, and metabolomics. such as lupus and cardiovascular diseases and to predominantly sex-specific diseases such as breast 1.4 Include sex parameters in the design of cancer and uterine fibroids. experiments using animal models. 1.8 Further understanding of sex/gender differences in 1.5 Promote neuroscience research to study sex/ fundamental mechanisms and patterns of behavioral and gender differences in vulnerability to and clinical course of social functioning relevant to health and well-being. neurological, psychiatric, and substance abuse disorders. 16 1.9 Incorporate sex/gender considerations into discussions in scientific conferences and meetings. A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

INCORPORATE FINDINGS OF SEX/GENDER DIFFERENCES GOAL 2 IN THE DESIGN AND APPLICATION OF NEW TECHNOLOGIES, MEDICAL DEVICES, AND THERAPEUTIC DRUGS

Improvements in research methodology, instrumentation, and technology have dramatically accelerated progress in the biomedical sciences. As a result of new technologies in the last decade, human DNA can now be sequenced in a matter of hours versus years, therapeutic small molecules can be accurately synthesized by robots under highly controlled conditions, and brain functions can be noninvasively imaged. In clinical medicine, the availability of new medical devices as well as advances in bioimaging, genetics, and biochemistry have revolutionized models of disease diagnosis and management.

In developing and utilizing new research technologies and clinical applications, it is important that sex/gender differences be part of their design and utilization. Some currently used technologies are not as applicable to women as to men because their development and standardization have been based primarily on study of males. Sex differences in biological response to drugs remain an underexplored area.

OBJECTIVES

2.1 Encourage the development of technologies that 2.6 Exploit high-resolution bioimaging technologies will address sex-based differences at all scales of detail, to provide structural and functional imaging of sex from the nanometer to the whole person. differences in a variety of areas such as pain, brain activity, metabolism, infectious diseases, inflammation, 2.2 Develop novel animal, in vitro, and computational and drug delivery. (virtual) models to study sex differences in diseases and conditions. 2.7 Design drugs, biologics, and devices to diagnose, prevent, and treat diseases and conditions affecting 2.3 Develop the information systems needed for women and girls. collecting, sharing, and comparing clinical data for diseases and conditions of women and girls. 2.8 Consider the sex and age of the patient in the development of engineered medical products, cell-based 2.4 Develop computational models that will utilize therapeutics, and regenerative procedures. multiple levels of analyses to address both qualitative and quantitative outcomes of clinical research related 2.9 Encourage collaborative interactions among to women. clinicians, bioethicists, and technologists regarding accessibility of new technologies, drugs, and other 2.5 Work toward devising minimally invasive technolo- interventions relevant to women’s health. gies for rapid and accurate screening, diagnosis, and 17 treatment of diseases and conditions of women and girls. ACTUALIZE PERSONALIZED PREVENTION, GOAL 3 DIAGNOSTICS, AND THERAPEUTICS FOR GIRLS AND WOMEN

A major goal of biomedical research is to create knowledge that will lead to more accurate strategies for diagnosis, and preventive and therapeutic interventions, thereby ushering in a new era of personalized medicine. Personalized medicine considers individual differences in genetics, morphology, behavior, and health history. A comprehensive approach to personalized medicine must take into account biological sex, age, and factors such as social and cultural influences.

NIH research has provided a wealth of biomedical scientific knowledge about women’s health across the lifespan, placing strong emphasis in recent years on the importance of speeding the translation of basic research into clinical applications. But efforts to translate clinical knowledge into interventions, services, and policies with measurable public health impact have had mixed success. To truly affect women’s health, translational research must go beyond “bench to bedside” by pursuing opportunities for dissemination and community uptake and involvement, including advocacy and policy development. Achieving Sex differences research can increasingly make this goal will require interdisciplinary collaboration and major contributions to the goals of individualized communication between basic science researchers, medicine and improved public health. clinical researchers, behavioral scientists, public health researchers, clinicians, the community, and policymakers.

OBJECTIVES

3.1 Conduct developmental and developmentally 3.6 Study sex/gender differences in the aging process. � framed research to understand the role of hormones, hormonal changes, and reproductive transitions on cond- 3.7 Explore differences in response to therapeutic itions affecting women and girls throughout the life span. interventions among samples of elderly women, including those with comorbid conditions. 3.2 Study sex/gender differences in embryonic development, including epigenetic changes. � 3.8 Conduct research on aging women with emphasis on prevention of frailty, promotion of healthy lifestyles, 3.3 Encourage research on safe and effective maintenance of independent living, self-management interventions for conditions affecting pregnant women. � of symptoms, preservation of cognitive functions, and health-related quality of life. 3.4 Expand research on pregnancy related conditions, such as preeclampsia, diabetes, and hypertension on the 3.9 Examine health disparities among women subsequent health of women and their offspring. stemming from differences in such factors as race and ethnicity, socioeconomic status, gender identity, 3.5 Identify and validate sex-specific biomarkers for and urban-rural living, as they influence health, disease risk and prognosis across the lifespan. health behaviors, and access to screening and 18 therapeutic interventions. A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

CREATE STRATEGIC ALLIANCES AND PARTNERSHIPS GOAL 4 TO MAXIMIZE THE DOMESTIC AND GLOBAL IMPACT OF WOMEN’S HEALTH RESEARCH

Strategic alliances and partnerships with women’s health stakeholders, including NIH institutes, centers, and offices; other Federal agencies; academia; advocacy groups; foundations; and industry are imperative to furthering women’s health research. Collaborations resulting from these alliances can help advance improvements in women’s health, leverage resources among public and private entities, help advance public health, and enhance public knowledge. Effective partnerships will also promote increased attention to women’s health research issues and ORWH’s role as a national and global leader in this arena.

In an increasingly interconnected world, the health of an individual or a community can, in some way, affect the health of all. Women’s health research must encompass global considerations and continue to seek ways to address the pressing health needs of women worldwide.

OBJECTIVES

4.1 Convene futuristic thinkers from many fields of 4.4 Create solid partnerships by engaging in scientific science, engineering, business, and the humanities to briefings and ad hoc meetings with policymakers, elected assist in devising implementation strategies for women’s officials, and advocacy groups. health research. 4.5 Partner with professional societies to include 4.2 Establish new ventures and initiatives with women’s health research issues in national scientific a wide cross-section of partners, including NIH meetings and conferences, including issues involving institutes, centers, and offices; academia; other Federal career training and development. agencies; international organizations; private foundations; and industry. 4.6 Expand global strategic alliances and partnerships aimed at improving the health of women and girls 4.3 Promote an environment which uses multiple throughout the world, particularly in developing countries. avenues and technologies to facilitate continuing input from partners committed to improving women’s health and promoting research.

19 DEVELOP AND IMPLEMENT NEW COMMUNICATION AND SOCIAL GOAL 5 NETWORKING TECHNOLOGIES TO INCREASE UNDERSTANDING AND APPRECIATION OF WOMEN’S HEALTH AND WELLNESS RESEARCH

Advances in all areas of science must be shared with diverse audiences. Effective communication can improve health outcomes for women and girls, both for their own sake and because women throughout the world play a central role in the health of their families and communities. Communications, policy development, and implementation science must be linked effectively to achieve these outcomes. Moreover, because of cultural and racial/ethnic diversity in national and international societies and communities, information about women’s health research and related issues must be disseminated in culturally appropriate ways. Multiple media strategies, along with the latest communication technologies, should be considered in communications research to determine how to best reach diverse audiences.

The NLM-ORWH Web portal, Women’s Health Resources (http://womenshealthresources.nlm.nih.gov), provides information about the latest NIH-funded research in a centralized location for consumers, health providers, and researchers. The portal provides research literature, videocasts of NIH presentations, podcasts, videos, fact sheets, and other formats with health information. The portal also uses social media to connect with the public for awarness campaigns.

OBJECTIVES

5.1 Serve as a key informational resource for Federal 5.5 Support research to explore and evaluate the and State agencies, elected representatives, the media, ability of women and men of different ages to access, health and advocacy organizations, and the public on process, and act on health-related information. women’s health research issues. 5.6 Build a central portal of information for women’s 5.2 Expand collaboration with other NIH institutes and health research findings suitable for the specific needs centers and Federal agencies in outreach activities on of researchers, health care practitioners, patients, and issues related to women’s health. their families.

5.3 Expand strategic alliances and partnerships with key national and international organizations to maximize the communication and impact of women’s health research.

5.4 Convene leaders in communication sciences to explore and identify optimum messages and messaging to benefit women’s health research.

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EMPLOY INNOVATIVE STRATEGIES TO BUILD GOAL 6 A WELL-TRAINED, DIVERSE, AND VIGOROUS WOMEN’S HEALTH RESEARCH WORKFORCE

The research workforce serves as the foundation for scientific progress and must reflect the brightest talent equipped with essential scientific knowledge and exceptional training. Although women are well represented in early career phases of the life sciences, there is a well-recognized underrepresentation or absence of women in senior research leadership positions. It is therefore essential to learn from and expand upon successful efforts and develop and implement innovative programs and policies that will attract, retain, and advance women throughout their scientific careers. ORWH assumes a large-scale view of these challenges and extends career outreach efforts to include a focus on girls in secondary education settings, particularly among underserved populations. To advance women’s health research, it is also critical to prepare researchers with the interdisciplinary training and knowledge to evaluate and improve all aspects of women’s health.

OBJECTIVES

6.1 Connect and empower scientists across career 6.4 Evaluate the challenges and successes of part-time stages by developing a central career advice/ research careers and explore strategies to allow part- development resource that includes contact with time faculty to remain involved in their fields of science. knowledge-rich people at the NIH. 6.5 Promote recognition and understanding of 6.2 Lead the way in encouraging institutions to women’s health among future health professionals and recognize mentoring as an essential component of scientists by informing the design of curricula with up- building career success in their training programs; to-date research findings for use in educational materials encourage evaluation of mentoring practices. for medical, dental, nursing, and other professional training.

6.3 Address the organizational, institutional, and systemic factors that impede recruitment, retention, and advancement of women in science, and modify practices that impede the careers of biomedical scientists.

21 Jeffrey Henderson, M.D., Ph.D. Instructor of Medicine, Washington University School of Medicine “This program [BIRCWH] has helped me tremendously as I begin the transition from mentored research toward an independent research career. Through this, I have obtained protected time to establish a research track record and have established a helpful mentoring relationship with several successful and established researchers. It has also helped me to better understand women’s health and the outstanding Valerie Flaherman, M.D., M.P.H. questions in this area.” UCSF “My relationship with my BIRCWH mentors and advisors has allowed me to move forward much more rapidly on the path to independent Clay Semenkovich, M.D. clinical research.” Professor, Washington University “….the [BIRCWH] program provides salary support for the Scholars that enables each Scholar to devote a majority of their efforts to developing their own independent research program. This support comes at a pivotal time in the development of the Scholar and is essential for fostering their careers as biomedical researchers in the Joan Riley, Ph.D. area of women’s health.” Instructor, Washington University “I hope that one day I can help shape the career of young scientists the way that….the members of my BIRCWH advisory committee have shaped mine.” A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH III MAJOR ORWH PROGRAMS

INTERDISCIPLINARY PROGRAMS and the Food and Drug Administration Because many factors influence women’s (FDA) developed the following programs, health, a comprehensive and interdisciplinary beginning in 1999, to enhance collaboration approach to conducting research in this area and encourage interdisciplinary research. It is fundamental. Interdisciplinary research was a prescient undertaking. The concept facilitates the integration and synergy has not only been critical to the development of basic science, clinical, translational, of women’s health research at the NIH, but population, behavioral, social, and outcomes it also served as a template for what could research. Women’s health research is best be accomplished through interdisciplinary served by integrating this extensive variety approaches throughout the NIH. of disciplines and fields. With increasing understanding of the interrelatedness and BUILDING INTERDISCIPLINARY complexity of disease, the nature of scientific RESEARCH CAREERS IN investigations has increasingly shifted to WOMEN’S HEALTH an interdisciplinary, collaborative approach. The Building Interdisciplinary Research Interdisciplinary research provides an Careers in Women’s Health (BIRCWH) opportunity not just for medical specialists program is a novel, NIH-mentored research but also for researchers in dentistry, career development program (K12) for men pharmacy, nursing, biotechnology, social and women junior faculty that is based upon sciences, anthropology, genetics, and other three components: (1) career development, disciplines representing different perspectives (2) strong mentoring, and (3) interdisciplinary and areas of expertise to work together in a research. BIRCWH supports the training of mutually beneficial collaboration. Broadening junior faculty in an interdisciplinary mentored this approach to encourage collaboration environment by pairing junior researchers among research scientists in academia, with senior investigators in women’s health. private industry, and Federal settings Mentors are established researchers in provides expanded access to the latest their respective fields. Each scholar has an scientific tools and technologies. interdisciplinary mentoring team comprising of at least two mentors from different ORWH, with the support of 23 NIH institutes, disciplines. The BIRCWH program is a bridge centers, and offices, the Agency for to research independence as scholars learn Healthcare Research and Quality (AHRQ), not only research techniques, but also the 23 skills to become independent investigators The success of the program is impressive. and mentors. A key goal of BIRCWH is to Since its inception in 1999, 63 BIRCWH promote sustained independent research career development programs have been careers. Scholar research areas cover a established at 41 institutions, with 27 variety of topics including mental health, programs currently active. To date almost diabetes, cardiovascular health, neurological 400 individuals have participated in the disorders, trauma, health disparities, program as BIRCWH scholars, of which 80% reproductive health, menopausal hormone have been women. These scholars will further therapy, substance abuse, cancer, and advance and support the interdisciplinary arthritis/musculoskeletal health. team approach to science and health care, providing valuable knowledge in overcoming the fragmentation of women’s health care delivery. Support for the BIRCWH program comes from ORWH; multiple institutes, centers, and offices at the NIH; and AHRQ.

ORWH INTERDISCIPLINARY RESEARCH AND CAREER DEVELOPMENT PROGRAMS

BIRCHW—29 Programs SCOR—11 Centers

24 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

SPECIALIZED CENTERS across the lifespan. By integrating sex OF RESEARCH ON SEX AND differences research into broad experimental GENDER FACTORS AFFECTING methodologies and scientific approaches, WOMEN’S HEALTH SCORs ensure that new therapies and diagnostic The Specialized Centers of Research (SCOR) tools will be developed that will ultimately on Sex and Gender Factors Affecting Women’s improve the future practice of health care. Health program consists of 11 currently funded P50 centers that conduct interdisciplinary Support for the SCOR program comes research focused on major medical problems from ORWH; multiple institutes, centers, affecting women and examine the influence and offices at the NIH; and the FDA. of sex/gender on health and disease. A SCOR consists of at least three individual ADVANCING NOVEL SCIENCE but interrelated research projects, each IN WOMEN’S HEALTH RESEARCH with high scientific merit and clear research Established in 2007, the Advancing Novel objectives and, in the aggregate, devoted Science in Women’s Health Research to a specific major health area. Basic, (ANSWHR) program is aimed at stimulating translational, and clinical research must be new approaches to women’s health research included. Each center has an administrative using a 2-year R21 grant mechanism. The core to coordinate the research program, program solicits investigator-initiated, providing intellectual leadership as well as innovative, interdisciplinary research that basic management functions. Many programs will advance new concepts in women’s include one or more core resources, defined health research and the study of sex/ as a resource shared by multiple investigators gender differences. Since its inception, that enhances research productivity and the ANSWHR program has partnered with increases the functional capacity of the most of the institutes and centers at the SCOR. Collaboration and sharing of scarce NIH to support research in multiple areas of resources among institutions is encouraged science, including cancer, human genetics, within any given SCOR. drug and alcohol abuse, heart diseases, immune disorders, lupus, infectious diseases, The currently funded SCOR programs mental health, pain, obesity, pulmonary are interdepartmental, intercollegiate, dysfunction, pregnancy, ovarian dysfunction, and interinstitutional, covering research and stress. Prevention research is one of the on depression, pain, urinary tract health, areas of special emphasis for the ANSWHR reproductive issues, substance abuse, and program. Such research spans the continuum osteoporosis. With a focus on sex/gender from the most basic biological studies to research, the SCOR program hopes to understanding the basis and effects of improve the lives of girls and women through risk behaviors across the lifespan and the research that examines how health or disease interventions to change them, including a may differ between women and men, as well focus on wellness and healthy behaviors. The as how such differences affect diagnosis, program is highly competitive and between progression, and treatment of diseases 80 and 165 applications are received annually. 25 RESEARCH ENHANCEMENT to identify and cofund meritorious research AWARDS PROGRAM grants. The REAP program broadens and ORWH developed a trans-NIH Research enhances the NIH women’s health research Enhancement Awards Program (REAP) in portfolio by supporting a wide range of the mid-1990s as a mechanism to facilitate scientific areas. co-funding of NIH institute and center peer reviewed research that might otherwise not ORWH BUDGET be funded. The REAP program spans basic, The ORWH was established in 1990 with clinical, behavioral, and translational research. a budget that covered staff requirements The program offers 1-year of support for and minor programmatic activities. As meritorious research in women’s health that increases took place, ORWH developed the has just missed the payline for funding by programmatic initiatives that would have an institute or center at the NIH. The “out a major influence on women’s health and year” funds are provided by the primary career development and training. Early NIH institute or center. This program was planning in 1999, coupled with increases in developed to increase the number of new the budget between 2001 and 2002, led to research studies of women’s health and the the development and implementation of the study of sex/gender factors by collaborating BIRCWH and SCOR programs. An additional with the NIH institutes, centers, and offices, increase in the 2007 budget facilitated the development of the ANSWHR program. The following graphic shows the budget history of ORWH since its founding.

ORWH FUNDING HISTORY

$50,000,000

$37,500,000

$25,000,000

$12,500,000

$0 FY 1991 FY 1992FY 1993FY 1994FY 1995FY 1996FY 1997FY 1998FY 1999FY 2000FY 2001FY 2002FY 2003FY 2004FY 2005FY 2006FY 2007FY 2008FY 2009FY 2010 26 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

APPENDIX A: HOSTS AND WORKING GROUP COCHAIRS OF THE REGIONAL SCIENTIFIC MEETINGS

WASHINGTON UNIVERSITY IN ST. LOUIS SCHOOL OF MEDICINE ST. LOUIS, MISSOURI • MARCH 4–6, 2009 � HOST: Scott Hultgren, Ph.D., Helen L. Stoever Professor in Molecular Microbiology and Director, Center for Women’s Infectious Disease Research �

BLADDER AND PELVIC FLOOR Rajita Sinha, Ph.D. Denise E. Wilfley, Ph.D. DISORDERS Professor of Psychiatry Professor Jeanette Brown, M.D. Director, Yale Stress Center Departments of Psychiatry, Medicine, Professor of Obstetrics, Gynecology, and Yale University Pediatrics, and Psychology Reproductive Sciences; Epidemiology and New Haven, Connecticut Washington University in St. Louis School Biostatistics; and Urology of Medicine Director, Women’s Continence Center CHRONIC PAIN SYNDROMES St. Louis, Missouri University of California, San Francisco Leslie J. Crofford, M.D. San Francisco, California Professor of Internal Medicine GENETICS AND MICROBIAL Chief, Division of Rheumatology COMMUNITIES (METAGENOMICS/ Kimberly S. Kenton, M.D., M.S., FACOG University of Kentucky MICROBIOME) Associate Professor, Department Lexington, Kentucky Larry Forney, Ph.D. of Obstetrics and Gynecology and Professor, Biological Sciences Department of Urology Emeran A. Mayer, M.D. University of Idaho Director, Female Pelvic and Director, UCLA Center for Neurobiology Moscow, Idaho Reconstructive Surgery of Stress Fellowship Program University of California, Los Angeles Maria Y. Giovanni, Ph.D. Loyola University Medical Center Los Angeles, California Assistant Director for Microbial Genomics Maywood, Illinois National Institute of Allergy and Chris Mullins, Ph.D. Infectious Diseases Chris Mullins, Ph.D. Director of Basic Cell Biology Programs in National Institutes of Health Director of Basic Cell Biology Programs in Urologic and Kidney Disease Bethesda, Maryland Urologic and Kidney Disease National Institute of Diabetes and National Institute of Diabetes and Digestive and Kidney Diseases Jacques Ravel, Ph.D. Digestive and Kidney Diseases National Institutes of Health Associate Professor National Institutes of Health Bethesda, Maryland Institute for Genome Sciences Bethesda, Maryland University of Maryland School of Medicine Linda I. Porter, Ph.D. Baltimore, Maryland Estella Parrott, M.D., M.P.H. Program Director, Extramural Research Medical Officer Program INFECTIOUS DISEASES OF Eunice Kennedy Shriver National Institute National Institute of Neurological THE URINARY AND of Child Health and Human Development Disorders and Stroke REPRODUCTIVE TRACTS National Institutes of Health National Institutes of Health Carolyn Deal, Ph.D. Bethesda, Maryland Bethesda, Maryland Branch Chief Sexually Transmitted Disease Branch BRAIN AND EATING DISORDERS National Institute of Allergy and PSYCHIATRIC DISORDERS Mark Chavez, Ph.D. Infectious Diseases Nancy L. Desmond, Ph.D. Associate Director for Research Training National Institutes of Health Associate Division Director National Institute of Mental Health Bethesda, Maryland Division of Neurosciences and Basic National Institutes of Health Behavioral Science Bethesda, Maryland Eve M. Lackritz, M.D. National Institute of Mental Health Division of Reproductive Health National Institutes of Health B. Timothy Walsh, M.D. Centers for Disease Control Bethesda, Maryland Professor of Psychiatry and Prevention College of Physicians and Surgeons Atlanta, Georgia Jill M. Goldstein, Ph.D. Columbia University Professor of Psychiatry New York, New York Director of Research for Women’s Health Brigham and Women’s Hospital Harvard Medical School 27 Boston, Massachusetts Uma M. Reddy, M.D., M.P.H. OBESITY WOMEN IN Medical Officer Graham A. Colditz, M.D., Dr.P.H. BIOMEDICAL CAREERS Eunice Kennedy Shriver National Institute Niess-Gain Professor of Surgery, Phoebe S. Leboy, Ph.D. of Child Health and Human Development Professor of Medicine President, Association for Women National Institutes of Health Washington University in St. Louis School in Science Bethesda, Maryland of Medicine Professor Emerita of Biochemistry St. Louis, Missouri University of Pennsylvania School of Craig Rubens, M.D., Ph.D. Dental Medicine Executive Director, Global Alliance to Samuel Klein, M.D. Narberth, Pennsylvania Prevent Prematurity & Stillbirth Chief, Division of Geriatrics and Seattle Children’s Hospital/University Nutritional Science Walter Schaffer, Ph.D. of Washington Director, Center for Human Nutrition Senior Scientific Advisor for Seattle, Washington Washington University in St. Louis Extramural Research School of Medicine Office of Extramural Research St. Louis, Missouri National Institutes of Health Bethesda, Maryland Charlotte A. Pratt, Ph.D., RD Program Director National Heart, Lung, and Blood Institute National Institutes of Health Bethesda, Maryland

UNIVERSITY OF CALIFORNIA, SAN FRANCISCO (UCSF) SAN FRANCISCO, CALIFORNIA • MAY 27–29, 2009 HOSTS: Linda C. Giudice, M.D., Ph.D., M.Sc., Robert B. Jaffe MD Endowed Professor and Chair � UCSF Obstetrics, Gynecology & Reproductive Sciences • Nancy Milliken, M.D., Vice Dean of the UCSF School of Medicine & Director of the UCSF National Center of Excellence in Women’s Health �

GLOBAL WOMEN’S HEALTH Lynne M. Mofenson, M.D. Nadya L. Lumelsky, Ph.D. Kirsten Bibbins-Domingo, M.D., Ph.D., Eunice Kennedy Shriver National Institute Program Director M.A.S. of Child Health and Human Development Division of Extramural Research Associate Professor of Medicine and of National Institutes of Health National Institute of Dental and Epidemiology and Biostatistics Bethesda, Maryland Craniofacial Research UCSF Center for Vulnerable Populations National Institutes of Health at San Francisco General Hospital and Paula Tavrow, Ph.D. Bethesda, Maryland Trauma Center Director and Assistant Professor University of California, San Francisco Bixby Program in Population and Pamela Robey, Ph.D. San Francisco, California Reproductive Health Craniofacial and Skeletal Diseases Branch UCLA School of Public Health National Institute of Dental and Warner C. Greene, M.D., Ph.D. University of California, Los Angeles Craniofacial Research Director and Professor Los Angeles, California National Institutes of Health Gladstone Institute of Virology Bethesda, Maryland and Immunology Linda L. Wright, M.D. University of California, San Francisco Deputy Director Zena Werb, Ph.D. San Francisco, California Eunice Kennedy Shriver National Institute Professor and Vice Chair, Department of Child Health and Human Development of Anatomy Gray Handley, M.S.P.H. National Institutes of Health University of California, San Francisco Associate Driector for International Bethesda, Maryland San Francisco, California Research Affairs National Institute of Allergy and STEM CELLS WOMEN’S HEALTH & THE Infectious Diseases Susan J. Fisher, Ph.D. ENVIRONMENT National Institutes of Health Professor, Oral Biology; Professor Lawrence H. Kushi, Sc.D. Bethesda, Maryland of Pharmaceutical Chemistry; Associate Director, Division of Research Professor of Anatomy Kaiser Permanente Amy J. Levi, Ph.D., CNM Faculty Director, Biomolecular Oakland, California Associate Clinical Professor Resource Center University of California, San Francisco University of California, San Francisco 28 San Francisco, California San Francisco, California A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

Estella Parrott, M.D., M.P.H. HIV/AIDS AND WOMEN Barbara A. Rapp, Ph.D. Program Director Anissa Brown, Ph.D. Chief, Office of Planning and Analysis Eunice Kennedy Shriver National Institute Office of AIDS Research National Library of Medicine of Child Health and Human Development Office of the Director National Institutes of Health National Institutes of Health National Institutes of Health Bethesda, Maryland Bethesda, Maryland Bethesda, Maryland WOMEN IN SCIENCE AND Eveline Shen, M.P.H. Ruth Greenblatt, M.D. HEALTH CAREERS Executive Director Professor of Clinical Pharmacy Elena Fuentes-Afflick, M.D., M.P.H. Asian Communites for University of California, San Francisco Professor of Pediatrics, Epidemiology, Reproductive Justice San Francisco, California and Biostatistics Oakland, California San Francisco General Hospital Susan Plaeger, Ph.D. University of California, San Francisco Kristina Thayer, Ph.D. Director, Basic Sciences Program San Francisco, California Staff Scientist Division of AIDS National Institute of Environmental National Institute of Allergy and J. Taylor Harden, Ph.D. Health Sciences, National Infectious Diseases Office of the Director Toxicology Program National Institutes of Health National Institute on Aging Center for the Evaluation of Risks to Bethesda, Maryland National Institutes of Health Human Reproduction Bethesda, Maryland National Institutes of Health Dawn K. Smith, M.D., M.S., M.P.H. Durham, North Carolina Associate Chief for Science, Joan Y. Reede, M.D., M.P.H., M.B.A. Epidemiology Branch Dean for Diversity and Deborah Winn, Ph.D. Division of HIV/AIDS Prevention Community Partnership Deputy Director Centers for Disease Control Harvard Medical School Division of Cancer Control and and Prevention Boston, Massachusetts Population Sciences Atlanta, Georgia National Cancer Institute Joan P. Schwartz, Ph.D. National Institutes of Health INFORMATION TECHNOLOGY Assistant Director Bethesda, Maryland Irene Sue Dubman, M.A. Office of Intramural Research Senior Director, Standards & Architecture Office of the Director Tracey Woodruff, Ph.D., M.P.H. Genzyme National Institutes of Health Associate Professor and Director Cambridge, Massachusetts Bethesda, Maryland Program on Reproductive Health and the Environment Laura J. Esserman, M.D., M.B.A. University of California, San Francisco Director, Carol Franc Buck Breast Oakland, California Care Center University of California, San Francisco San Francisco, California

THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY AND WOMEN & INFANTS HOSPITAL OF RHODE ISLAND � PROVIDENCE, RHODE ISLAND • SEPTEMBER 21–23, 2009 � HOSTS: Joanna M. Cain, M.D., Chace/Joukowsky, Professor and Chair, Obstetrics and Gynecology � Assistant Dean for Women’s Health • Constance A. Howes, J.D., President, Women & Infants Hospital �

PRENATAL, INFANCY, AND Melissa Jo Kottke, M.D., M.P.H. ADOLESCENT YEARS CHILDHOOD YEARS Cochair Christine A. Bachrach, Ph.D. Gilman Grave, M.D. Emory University School of Medicine Acting Director Endocrinology, Nutrition, and Atlanta, Georgia Office of Behavioral and Social Growth Branch Sciences Research Eunice Kennedy Shriver National Institute Louise E. Wilkins-Haug, M.D., Ph.D. National Institutes of Health of Child Health and Human Development Division, Director, Maternal-Fetal Bethesda, Maryland National Institutes of Health Medicine and Reproductive Genetics Bethesda, Maryland Brigham and Women’s Hospital Boston, Massachusetts 29 Michelle Berlin, M.D., M.P.H. Lucia Larson, M.D. ELDERLY, FRAIL ELDERLY, Vice Chair, OB/GYN & Director Director, Division of Obstetric and AND HEALTHY AGING OHSU Center of Excellence in Consultative Medicine Richard Besdine, M.D. Women’s Health Women & Infants Hospital of Professor of Medicine Oregon Health & Science University Rhode Island Director of the Center for Gerontology Portland, Oregon The Warren Alpert Medical School of and Health Care Research at Brown University Brown University Sandra A. Carson, M.D. Providence, Rhode Island Director of the Division of Geriatrics in Medical Director of Women & Infants’ the Department of Medicine Center for Reproduction and Infertility Donald R. Mattison, M.D. Chief of Geriatrics for Lifespan Director of the Division of Reproductive Senior Advisor Greer Professor of Geriatric Medicine Endocrinology and Infertility Eunice Kennedy Shriver National Institute The Warren Alpert Medical School of Women & Infants Hospital of of Child Health and Human Development Brown University Rhode Island National Institutes of Health Providence, Rhode Island The Warren Alpert Medical School of Bethesda, Maryland Brown University Stefan Gravenstein, M.D., M.P.H., CMD, Providence, Rhode Island Errol R. Norwitz, M.D., Ph.D. FACP, AGSF Professor Clinical Director, Quality Partners REPRODUCTIVE AND Yale University School of Medicine of Rhode Island MIDDLE YEARS New Haven, Connecticut Division of Geriatrics, Department Robert Barbieri, M.D. of Medicine Chairperson, Obstetrics and Gynecology Katharine Wenstrom, M.D. The Warren Alpert Medical School Brigham and Women’s Hospital Director, Maternal-Fetal Medicine Division of Brown University Harvard Medical School Women & Infants Hospital of Providence, Rhode Island Boston, Massachusetts Rhode Island Providence, Rhode Island Stacy Tessler Lindau, M.D., M.A.P.P. Alan DeCherney, M.D. Assistant Professor Program Head MENOPAUSAL TRANSITION University of Chicago Eunice Kennedy Shriver National Institute Paul A. DiSilvestro, M.D. Chicago, Illinois of Child Health and Human Development Principal Investigator for Gynecologic National Institutes of Health Oncology Group Susan M. Resnick, Ph.D. Bethesda, Maryland The Warren Alpert Medical School of Senior Investigator Brown University National Institute on Aging Valerie C. Montgomery Rice, M.D. Women & Infants Hospital National Institutes of Health Executive Director, CWHR Providence, Rhode Island Baltimore, Maryland Meharry Medical College Nashville, Tennessee Andrew A. Monjan, Ph.D., M.P.H. Bernadette Tyree, Ph.D. Scientist Consultant Health Scientist Administrator Cynthia Casson Morton, Ph.D. National Institute on Aging National Institute of Arthritis and Professor National Institutes of Health Musculoskeletal and Skin Diseases Brigham and Women’s Hospital Columbia, Maryland National Institutes of Health Harvard Medical School Bethesda, Maryland Boston, Massachusetts Robert W. Rebar, M.D. Executive Director ORAL HEALTH AND PREGNANCY American Society for SYSTEMIC CONDITIONS Alicia Y. Armstrong, M.D., MHSCR Reproductive Medicine Jane C. Atkinson, D.D.S. Associate Fellowship Director, Birmingham, Alabama Director, Center for Clinical Research Reproductive Endocrinology Fellowship National Institute of Dental and Eunice Kennedy Shriver National Institute Jacques E. Rossouw, M.D. Craniofacial Research of Child Health and Human Development Branch Chief National Institutes of Health National Institutes of Health Women’s Health Initiative Bethesda, Maryland Walter Reed Army Medical Center National Heart, Lung, and Blood Institute Bethesda, Maryland National Institutes of Health Raul Garcia, D.M.D., M.M.Sc. Bethesda, Maryland Professor and Chair Henry M. Goldman School of Marcia L. Stefanick, Ph.D. Dental Medicine Professor of Medicine and Professor Boston University of OB/GYN Boston, Massachusetts 30 Stanford Prevention Research Center Stanford University Stanford, California A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

Brenda Heaton, M.P.H. Catherine K. Kuo, Ph.D. Valerie Wilson, Ph.D. Investigator Assistant Professor Associate Provost and Director of Henry M. Goldman School of Biomedical Engineering Institutional Diversity Dental Medicine Tufts University Brown University Boston University Medford, Massachusetts Providence, Rhode Island Boston, Massachusetts Brenda Korte, Ph.D. Michelle M. Henshaw, D.D.S. Program Director Assistant Dean National Institute of Biomedical Imaging Henry M. Goldman School of Dental and Bioengineering Medicine National Institutes of Health Boston University Bethesda, Maryland Boston, Massachusetts Belinda Seto, Ph.D. CAREERS IN DENTISTRY, Deputy Director BIOENGINEERING, AND OTHER National Institute of Biomedical Imaging NON-M.D. DISCIPLINES and Bioengineering Paula K. Friedman, D.D.S., M.S.D., M.P.H. National Institutes of Health Associate Dean for Strategic Initiatives Bethesda, Maryland Henry M. Goldman School of Dental Medicine Boston University Boston, Massachusetts

NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE, � NORTHWESTERN MEMORIAL HOSPITAL � CHICAGO, ILLINOIS • OCTOBER 14–16, 2009 � HOST: Andrea Dunaif, M.D., Charles F. Kettering, Professor of Medicine Chief, � Division of Endocrinology, Metabolism, and Molecular Medicine

UNDERSTUDIED AND Rebecca L. Clark, Ph.D. Derrick Tabor, Ph.D. UNDERREPRESENTED Extramural Program Staff Centers of Excellence Program, Office of POPULATIONS Demographic & Behavioral Scientific Programs Vickie M. Mays, Ph.D., M.S.P.H. Sciences Branch National Center on Minority Health and Department of Health Services Eunice Kennedy Shriver National Institute Health Disparities University of California, Los Angeles of Child Health and Human Development National Institutes of Health School of Public Health National Institutes of Health Bethesda, Maryland Los Angeles, California Bethesda, Maryland UNDERSTUDIED AND Gloria Sarto, M.D., Ph.D. Naomi Lynn Gerber, M.D. UNDERREPRESENTED Professor, Department of Director, Center for the Study of Chronic POPULATIONS SUBGROUP Obstetrics & Gynecology Illness and Disability 2: LESBIAN, BISEXUAL, Co-Director, Center for Women’s George Mason University TRANSGENDER, AND INTERSEX Health Research Fairfax, Virginia ISSUES University of Wisconsin–Madison Christine A. Bachrach, Ph.D. Madison, Wisconsin Celia J. Maxwell, M.D. Acting Director Assistant Vice President for Office of Behavioral and Social UNDERSTUDIED AND Health Sciences Sciences Research UNDERREPRESENTED Howard University Hospital National Institutes of Health POPULATIONS SUBGROUP 1: Washington, D.C. Bethesda, Maryland MINORITIES, URBAN, RURAL, AND ISSUES OF POVERTY Anne E. Sumner, M.D. Judith Bradford, Ph.D. Pamela K. Brown, M.P.A. Investigator Professor, Institute for Women’s Health Associate Director, Mary Babb Randolph National Institute of Diabetes and Virginia Commonwealth University Cancer Center Digestive and Kidney Diseases Co-Chair, The Fenway Institute, Past Chair, Intercultural Cancer Council National Institutes of Health Fenway Health Morgantown, West Virginia Bethesda, Maryland Boston, Massachusetts 31 Tonda L. Hughes, Ph.D. NEW TECHNOLOGIES/ Andrea Dunaif, M.D. Research Director, Professor, BIOENGINEERING/IMAGING Professor and Chief, Division of Department Head John O. De Lancey, M.D. Endocrinology, Metabolism and National Center of Excellence in Professor, Department of Obstetrics Molecular Medicine Women’s Health and Gynecology Feinberg School of Medicine College of Nursing University of Michigan Northwestern University University of Illinois at Chicago Ann Arbor, Michigan Chicago, Illinois Chicago, Illinois Guoying Liu, Ph.D. David A. Ehrmann, M.D. Alicia Matthews, Ph.D. Program Director Professor of Medicine Associate Professor, Department of National Institute of Biomedical Imaging Associate Director, University of Chicago Health Systems Science and Bioengineering Clinical Research Center University of Illinois at Chicago National Institutes of Health Director, University of Chicago Chicago, Illinois Bethesda, Maryland Center for PCOS University of Chicago Diane Abbe Sabin, D.C. Belinda Seto, Ph.D. Chicago, Illinois Executive Director Deputy Director Lesbian Health & Research Center National Institute of Biomedical Imaging NEUROSCIENCE University of California, San Francisco and Bioengineering Jon E. Levine, Ph.D. San Francisco, California National Institutes of Health Professor, Department of Neurobiology Bethesda, Maryland and Physiology CLINICAL AND Northwestern University TRANSLATIONAL RESEARCH Teresa K. Woodruff, Ph.D. Evanston, Illinois Mary A. Foulkes, Ph.D. Professor of Obstetrics and Gynecology Research Professor, Department Professor of Biochemistry, Molecular Cheryl L. Sisk, Ph.D. of Epidemiology and Biostatistics, Biology, and Cell Biology Director, Neuroscience Program Department of Health Policy Northwestern University Michigan State University The George Washington University Chicago, Illinois East Lansing, Michigan Washington, D.C. � GENETICS AND EPIGENETICS WOMEN IN SCIENCE CAREERS Stacie E. Geller, Ph.D. Geoff Hayes, Ph.D. Molly L. Carnes, M.D., M.S. Professor, Department of Obstetrics Assistant Professor, Endocrinology Professor and Center Director and Gynecology Northwestern University University of Wisconsin–Madison Center for Research on Women Chicago, Illinois Madison, Wisconsin and Gender University of Illinois at Chicago Kathryn Sandberg, Ph.D. Sandra Kazahn Masur, Ph.D. Chicago, Illinois Professor of Medicine Director, Office for Women’s Careers Director, Center for the Study of Department of Ophthalmology Martha Hare, Ph.D., RN Sex Differences Mount Sinai School of Medicine Health Scientist Administrator/ Georgetown University New York, New York Program Director Washington, D.C. National Cancer Institute Rodney E. Ulane, Ph.D. National Institutes of Health Susan Taymans, Ph.D. Director, Division of Scientific Programs Bethesda, Maryland Program Director Office of the Director Eunice Kennedy Shriver National Institute National Institutes of Health Carole Ann Heilman, Ph.D. of Child Health and Human Development Bethesda, Maryland Director, Division of Microbiology and National Institutes of Health Infectious Diseases Bethesda, Maryland Judith G. Regensteiner, Ph.D. National Institute of Allergy and Professor of Medicine Infectious Diseases SEX HORMONES AND DISEASE University of Colorado Denver National Institutes of Health Louis V. DePaolo, Ph.D. School of Medicine Bethesda, Maryland Chief, Reproductive Sciences Branch Aurora, Colorado Eunice Kennedy Shriver National Institute Kwame Osei, M.D. for Child Health and Human Development Professor of Medicine National Institutes of Health The Ohio State University Bethesda, Maryland Columbus, Ohio

32 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

EMORY UNIVERSITY SCHOOL OF MEDICINE ATLANTA, GEORGIA • FEBRUARY 16–17, 2010 HOST: Nanette K. Wenger, M.D., Professor of Medicine (Cardiology) �

PREGNANCY AND MICROVASCULAR DISEASE, Leslee Shaw, Ph.D. CARDIOVASCULAR DISEASE BIOMECHANICS, AND Professor RESEARCH AND ETHICAL APPLICATION OF NEW Department of Cardiology CONSIDERATIONS TECHNOLOGIES TO Emory University School of Medicine Janet W. Rich-Edwards, M.P.H., Sc.D. CARDIOVASCULAR RESEARCH Atlanta, Georgia Director of Developmental Epidemiology Barbara D. Boyan, Ph.D. Division of Women’s Health, Department Professor ISSUES OF CARDIOVASCULAR of Medicine Biomedical Engineering PREVENTION ACROSS Brigham and Women’s Hospital Georgia Institute of Technology THE LIFESPAN WITH AN Boston, Massachusetts Atlanta, Georgia EMPHASIS ON GENDER AND UNDERSERVED POPULATIONS Catherine Y. Spong, M.D. Gary Gibbons, M.D. Jane L. Harman, D.V.M., Ph.D., M.S. Chief, Pregnancy and Perinatology Director, Cardiovascular Research National Heart, Lung, and Blood Institute Branch Institute National Institutes of Health Eunice Kennedy Shriver National Institute Professor, School of Medicine Bethesda, Maryland of Child Health and Human Development Cardiovascular Research Institute National Institutes of Health Morehouse School of Medicine Catherine (Cay) Loria, Ph.D., M.S. Bethesda, Maryland Atlanta, Georgia Nutritional Epidemiologist National Heart, Lung, and Blood Institute Robert N. Taylor, M.D., Ph.D. George Sopko, M.D., M.P.H. National Institutes of Health Professor and Vice Chair for Research Medical Officer and Program Director Bethesda, Maryland Gynecology and Obstetrics National Heart, Lung, and Blood Institute Emory University School of Medicine National Institutes of Health Peter W.F. Wilson, M.D. Atlanta, Georgia Bethesda, Maryland Professor of Medicine Medicine/Cardiology CARDIOVASCULAR DISEASE STEM CELLS, PROGENITOR Emory University School of Medicine IN ELDERLY AND FRAIL CELLS, AND THE VISTA Atlanta, Georgia ELDERLY WOMEN: OPTIMAL OF CARDIOVASCULAR MANAGEMENT AND RESEARCH REGENERATIVE MEDICINE Jackson T. Wright, Jr., M.D., Ph.D. Elizabeth O. Ofili, M.D. Martha Shauck Lundberg, Ph.D. Professor of Medicine Professor of Medicine, Chief of Program Director Nephrology and Hypertension/Medicine Cardiology, and Associate Dean of National Heart, Lung, and Blood Institute Case Western Reserve University Clinical Research National Institutes of Health Cleveland, Ohio Clinical Research Center Bethesda, Maryland Morehouse School of Medicine WOMEN’S CAREERS IN THE Atlanta, Georgia Robert Nerem, Ph.D. BIOMEDICAL SCIENCES Parker H. Petit Distinguished Chair for Nakela Cook, M.D., M.P.H. Jacques E. Rossouw, M.D. Engineering in Medicine Medical Officer Chief, Women’s Health Initiative Branch Institute Professor National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute Georgia Institute of Technology National Institutes of Health National Institutes of Health Atlanta, Georgia Bethesda, Maryland Bethesda, Maryland Arshed A. Quyyumi, M.D., FRCP Judith G. Regensteiner, Ph.D. Viola Vaccarino, M.D., Ph.D. Professor of Medicine, Division Professor of Medicine Professor of Medicine (Cardiology) of Cardiology University of Colorado Denver School Emory University School of Medicine Emory University School of Medicine of Medicine Atlanta, Georgia Atlanta, Georgia Aurora, Colorado

UNMET NEEDS IN DIAGNOSTIC TESTING FOR WOMEN WITH CARDIOVASCULAR DISEASE Patrice Desvigne-Nickens, M.D. Medical Officer National Heart, Lung, and Blood Institute National Institutes of Health Bethesda, Maryland 33 APPENDIX B: ADVISORY COMMITTEE ON RESEARCH ON WOMEN’S HEALTH • FY 2009–2011

Vivian W. Pinn, M.D., Chairperson Scott J. Hultgren, Ph.D. Claire Pomeroy, M.D., M.B.A. Associate Director for Research on Helen L. Stoever Professor of Vice Chancellor, Human Health Sciences Women’s Health Molecular Microbiology Dean, School of Medicine Director, Office of Research on Director of the Center for Women’s Professor of Internal Medicine and Women’s Health Infectious Disease Research Microbiology/Immunology National Institutes of Health Department of Molecular Microbiology University of California, Davis Washington University School of Joyce Rudick, Executive Secretary Medicine Sally Rosen, M.D., M.F.S. Director, Programs and Management Founding Director, Center for Women’s Office of Research on Women’s Health Paula A. Johnson, M.D., M.P.H. Health Research, Leadership National Institutes of Health Executive Director, Connors Center for and Advocacy Women’s Health and Gender Biology Temple University Francisco Garcia, M.D., M.P.H. Chief, Division of Women’s Health Distinguished Outreach Professor Brigham and Women’s Hospital Jeanne Craig Sinkford, D.D.S., Ph.D. of Obstetrics and Gynecology and Professor and Dean Emeritus Public Health Karen Kim, M.D., M.S. Howard University College of Dentistry Director, Center of Excellence in Associate Professor of Medicine Associate Executive Director and Director, Women’s Health The University of Chicago Center for Equity and Diversity The University of Arizona American Dental Education Association Nancy H. Nielsen, M.D., Ph.D. Margery L.S. Gass, M.D. Immediate Past President, American Susan P. Sloan, M.D. Executive Director Medical Association Program Director, Internal Medicine North American Menopause Senior Associate Dean Drexel University College of Medicine Society (NAMS) SUNY at Buffalo School of Medicine and Biomedical Sciences Farida Sohrabji, Ph.D. Ronald S. Gibbs, M.D. Office of Medical Education Associate Professor and Associate Professor, Department of SUNY at Buffalo Department Head Obstetrics & Gynecology Department of Neuroscience and Associate Dean, Continuing Nancy Norton Experimental Therapeutics Medical Education Founder and President, International Texas A&M System Health Science Center University of Colorado Denver Foundation for Functional College of Medicine School of Medicine Gastrointestinal Disorders Chairperson, Digestive Disease Gary E. Striker, M.D. Linda C. Giudice, M.D., Ph.D. National Coalition Professor The Robert B. Jaffe, M.D., Endowed University of Miami School of Medicine Professor and Chair Mary Beth O’Connell, Pharm.D., Department of Obstetrics, Gynecology BCPS, FASHP, FCCP Paul F. Terranova, Ph.D. and Reproductive Sciences Associate Professor, Wayne Vice Chancellor for Research University of California, San Francisco State University Senior Associate Dean for Research Eugene Applebaum College of & Graduate Education Ronda S. Henry-Tillman, M.D. Pharmacy & Health Sciences The University of Kansas Medical Center Practice Director, Ladies’ Oncology Clinic School of Medicine Director, Cancer Control Mary I. O’Connor, M.D. Winthrop P. Rockefeller Cancer Institute Chair, Department of Orthopedic Surgery Debra Toney, Ph.D., RN University of Arkansas for Department of Orthopedics, Mayo Clinic President, TLC Health Care Service Medical Sciences President, National Black Nurses Eugene P. Orringer, M.D. Association Constance A. Howes, J.D. Executive Associate Dean for Faculty President and Chief Executive Officer Affairs and Faculty Development Barbara Yee, Ph.D. Women & Infants Hospital of School of Medicine Professor and Chair Rhode Island University of North Carolina, Chapel Hill Department of Family and Consumer Sciences University of Hawaii at Manoa 3434 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

APPENDIX C: EXTERNAL ADVISORS ON THE NIH WOMEN’S HEALTH RESEARCH AGENDA

Francisco Garcia, M.D., M.P.H. Paula A. Johnson, M.D., M.P.H. Valerie C. Montgomery Rice, M.D. Distinguished Outreach Professor Executive Director, Connors Center for Senior Vice President for Health Affairs of Obstetrics and Gynecology and Women’s Health and Gender Biology Dean, School of Medicine Public Health Chief, Division of Women’s Health Meharry Medical College Director, Center of Excellence in Brigham and Women’s Hospital Women’s Health Nancy H. Nielsen, M.D., Ph.D. The University of Arizona Linda M. Kaste, D.D.S., Ph.D., M.S. Senior Associate Dean, SUNY at Buffalo Associate Professor School of Medicine and Jill M. Goldstein, Ph.D. University of Illinois at Chicago, Biomedical Sciences Director of Research, Connors Center for College of Dentistry Office of Medical Education Women’s Health and Gender Biology SUNY at Buffalo Division of Women’s Health Phoebe S. Leboy, Ph.D. Brigham and Women’s Hospital President, Association for Judith G. Regensteiner, Ph.D. Women in Science Professor of Medicine Scott J. Hultgren, Ph.D. Professor General Internal Medicine/Cardiology Helen L. Stoever Professor of University of Pennsylvania University of Colorado-Denver School Molecular Microbiology of Medicine Director of the Center for Women’s Jon E. Levine, Ph.D. Infectious Disease Research Professor, Neurobiology and Physiology Janet W. Rich-Edwards, M.P.H., Sc.D. Department of Molecular Microbiology Northwestern University Director of Developmental Epidemiology Washington University School Division of Women’s Health/ of Medicine Department of Medicine Brigham and Women’s Hospital

35 APPENDIX D: COORDINATING COMMITTEE ON RESEARCH ON WOMEN’S HEALTH NATIONAL INSTITUTES OF HEALTH • 2010

Margaret V. Ames, Ph.D Gale A. Dutcher, M.L.S., M.S. Barbara R. Marzetta, M.S. Acting Director Head Deputy Director Office of Science Planning Office of Outreach and Office of Science and Technology and Assessment Special Populations National Heart, Lung, and Blood Institute National Cancer Institute National Library of Medicine Kate Nagy, M.A. Jane C. Atkinson, D.D.S. Paula Flicker, Ph.D. Program Analyst Director, Center for Clinical Research Program Director National Institute on Aging National Institute of Dental and National Institute of General Craniofacial Research Medical Sciences Lisa A. Neuhold, Ph.D. Program Director for Retinal Diseases Sanja Basaric Eleanor F. Hoff, Ph.D. National Eye Institute Program Analyst Health Science Policy Analyst National Human Genome Office of Scientific Program and Sheila A. Newton, Ph.D., M.S. Research Institute Policy Analysis Director National Institute of Diabetes and Office of Policy, Planning, and Evaluation Gina M. Brown, M.D. Digestive and Kidney Diseases National Institute of Environmental Director, Women and Girls Section Health Sciences Office of AIDS Research Tanya Hoodbhoy, Ph.D. Office of the Director Program Director Wendy J. Nilsen, Ph.D. Office of Strategic Coordination Health Scientist Administration John T. Burklow Division of Program Coordination, Office of Behavioral and Social Sciences Director, Office of Communications Planning, and Strategic Initiatives Research Office of the Director Office of the Director Office of the Director

Sheila Caldwell, Ph.D. Bonnie Kalberer Kathleen M. O’Leary, M.S.W. Program Officer Contractor Deputy Chief, Women’s Programs National Center for Complementary and Office of Science Policy National Institute of Mental Health Alternative Medicine Office of Science Education Karen L. Parker, M.S.W. Victoria A. Cargill, M.D., M.S.C.E. Linda E. Kupfer, Ph.D. Senior Health Science Analyst Director of Minority Research and Deputy Director Office of Science Planning Clinical Studies Division of International Science Policy, and Assessment Office of AIDS Research Planning, and Evaluation National Cancer Institute Office of the Director John E. Fogarty International Center Mary Frances A. Picciano, Ph.D. Deborah F. Cohen Tamara E. Lewis Johnson, M.P.H., M.B.A. Senior Nutrition Research Scientist Director, Summer and Postbac Women’s Health Program Manager Office of Dietary Supplements IRTA Programs Office of Special Populations and Office of Intramural Training Research Training Linda Porter, Ph.D. and Education National Institute of Allergy and Program Director Office of the Director Infectious Diseases Systems and Cognitive Neuroscience Cluster Deborah Dozier-Hall, M.S.W. Padma Maruvada, M.D. Division of Extramural Research Assistant Chief Health Scientist Administrator and Training Social Work Department Division of Research Infrastructure National Institute of Neurological Warren Grant Magnuson Clinical Center National Center for Research Resources Disorders and Stroke

36 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

Svetlana Radaeva, M.D. Paul Cotton, Ph.D. Lonnie L. Lisle Program Director Program Director, Division of Office of Health Communication Division of Metabolism and Health Effects Extramural Programs and Public Liaison National Institute on Alcohol Abuse National Institute of Nursing Research National Institute on Deafness and Other and Alcoholism Communication Disorders Anthony Demsey, Ph.D. Mona Rowe, M.C.P. Director, Extramural Policy Sheila A. McClure, Ph.D. Associate Director National Institute of Biomedical Imaging Health Scientist Administrator Science Policy Analysis and and Bioengineering National Center for Research Resources Communication Eunice Kennedy Shriver National Institute Phyllis Frosst, Ph.D. Sharon L. Milgram, Ph.D. of Child Health and Human Development Head, Policy and Program Analysis Director, Office of Intramural Training National Human Genome and Education Lana O. Shekim, Ph.D. Research Institute Office of Intramural Training Director and Education Voice and Speech Program Mary M. Gant, M.S. National Institute on Deafness and Other Interagency Liaison Walter Mitton Communication Disorders National Institute of Environmental Community Relations Specialist Health Sciences National Institute of Diabetes and Derrick C. Tabor, Ph.D. Digestive and Kidney Diseases Program Official Jodi Gilman, Ph.D. Centers of Excellence Health Policy Analyst Samia D. Noursi, Ph.D. National Center on Minority Health and National Institute of Neurological Deputy Coordinator, Women and Health Disparities Disorders and Stroke Gender Research National Institute on Drug Abuse Xenia Tigno, Ph.D., M.S. Ruth S. Grossman, D.D.S. Program Director National Institute of Biomedical Imaging Ruth E. Nowjack-Raymer, Ph.D. National Institute of Nursing Research and Bioengineering Program Director, Health Disparities Research Bernadette Tyree, Ph.D. Mary C. Hanlon, Ph.D. National Institute of Dental and Program Officer Health Science Policy Analyst Craniofacial Research National Institute of Arthritis and National Institute of Diabetes and Musculoskeletal and Skin Diseases Digestive and Kidney Diseases Estella C. Parrott, M.D., M.P.H. Program Director, Reproductive Cora Lee Wetherington, Ph.D. Walter Jones Sciences Branch Women and Sex/Gender Differences Deputy Director for Management and Eunice Kennedy Shriver National Institute Research Coordinator Diversity Operations of Child Health and Human Development National Institute on Drug Abuse Warren Grant Magnuson Clinical Center Rose E. Pruitt Denise G. Wiesch, Ph.D. Karin L. Kolsky Federal Women’s Program Manager Scientific Review Officer Writer-Editor Office of Equal Opportunity and Epidemiology of Cancer Study Section National Institute on Aging Diversity Management Center for Scientific Review Donna Krasnewich, M.D., Ph.D. Deidra Roach, M.D. CCRWH ALTERNATES Program Director Health Scientist Administrator Diane Adger-Johnson National Institute of General National Institute on Alcohol Abuse Minority Health and Research Medical Sciences and Alcoholism Training Analyst National Institute of Allergy and Natalie Kurinij, Ph.D. Catherine A. Roca, M.D. Infectious Diseases Health Scientist Administrator Contractor National Eye Institute National Institute of Mental Health Marin P. Allen, Ph.D. Deputy Director Anita M. Linde, M.P.P. Louise Rosenbaum, Ph.D. Office of Communications Director, Office of Program Planning Science Policy Analyst and Evaluation National Institute of Arthritis and Anissa J. Brown, Ph.D. National Institute of Arthritis and Musculoskeletal and Skin Diseases Office of AIDS Research Musculoskeletal and Skin Diseases

37 Jacques Rossouw, M.D. Elaine Sierra-Rivera, Ph.D. Susanne S. Strickland, M.S. Project Officer, Women’s Health Initiative Scientific Review Administrator/ Chief, Strategic Coordination Branch and National Heart, Lung, and Blood Institute Deputy Chief Women’s Health Center Oncology Sciences Integrated National Cancer Institute Milagros Ruiz Review Group Program Analyst/Contractor Center for Scientific Review Stacy Wallick John E. Fogarty International Center Public Health Analyst Lana R. Skirboll, Ph.D. National Institute of Biomedical Imaging Joan P. Schwartz, Ph.D. Acting Director and Bioengineering Assistant Director Division of Program Coordination, Office of Intramural Research Planning, and Strategic Initiatives

Susan Scolnik Nathaniel Stinson, M.D. Program Analyst National Center on Minority Health and National Heart, Lung, and Blood Institute Health Disparities

38 A VISION FOR 2020 FOR WOMEN’S HEALTH RESEARCH

APPENDIX E: ORWH STAFF

Vivian W. Pinn, M.D., Dorie A. Hightower, Communications Director Associate Director for Research on Women’s Health Director, Office of Research on Women’s Health Sharron Jernigan-Jones, Program Support Assistant

Janine Austin Clayton, M.D., Deputy Director Indira P. Jevaji, M.D., Medical Officer

Lisa Begg, Dr. P.H., R.N., Director, Research Programs Teresa R. Kendrix, Administrative Officer

Joyce E. Rudick, Director, Programs & Management Joslyn Yudenfreund Kravitz, Ph.D., Program Analyst

Angela C. Bates, M.B.A., Program Analyst Kimberly S. Kurilla-Gray, Secretary to the Director

Gerald Boston, Contractor Mary G. Lawrence, M.S., Contractor

Nida H. Corry, Ph.D., AAAS Science & Technology Policy Fellow Dennis F. Mangan, Ph.D., Health Scientist Administrator

Mary A. Foulkes, Ph.D., Suzanne Medgyesi-Mitschang, Ph.D., Consultant Under an Intergovernmental Personnel Act Agreement between George Washington University and the NIH Joan Davis Nagel, M.D., Medical Officer

Sharon E. Gist, Program Specialist Maya W. Peterson, Contractor

Charlie Hampp Jr., Administrative Technician Marc L. Stern, Consultant

Eleanor Z. Hanna, Ph.D., Associate Director, Charles A. Wells, Ph.D., Senior Advisor to the Director Special Projects and Centers

ACKNOWLEDGEMENTS The Office of Research on Women’s Health wishes to acknowledge the contributions of the working group co-chairs, the many scientists, advocacy representatives and members of the public who participated in the five regional scientific meetings. A note of thanks also goes to the graduate and post-graduate students, and fellows at the various academic institutions who volunteered to assist the working group co-chairs in capturing the discussions of the individual working groups. A special thanks to Mary Blehar, Ph.D. and Barbara Lynch, Ph.D. for their work as the overall science writers for this effort, with a further acknowledgement to Dr. Blehar for her assistance to ORWH staff in developing this volume.

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NIH Publication No. 10-7606