00:00:00 Redmond.L.2056_AllInterviews
Fri, 3/19 10:47AM • 1:17:50
SUMMARY KEYWORDS
women, people, study, hrt, health, recruitment, whi, low fat diet, called, site,
questions, talked, interviews, research, coordinating center, oral history,
involved, clinic, recruiting, community
SPEAKERS
Maddy McGlone, Lezli Redmond
Maddy McGlone 00:01
Okay, it is Thursday, November 19 2020. My name is Maddy McGlone, and I am here
with Lezli Redmond. Lezli, can you just test our sound by saying your full name
and how you're affiliated with the university?
Lezli Redmond 00:12
Sure, it's Leslie Redmond. And I retired a couple years ago after 26 years with
the School of Medicine and Public Health. And though in June, I got a job, again
with the university as an ombuds. So I'm back back at work.
Maddy McGlone 00:30
Okay, great. Great. So my first question, I just wanted you to tell me a little
bit, just to start about your earlier life and growing up, and maybe anything
there that influenced your career path, eventually, later in life.
Lezli Redmond 00:47
Um, I was always attracted to medical sorts of things. But at the same time, I
was squeamish about hospitals, blood and that sort of stuff. I thought I would
become a veterinarian. But then I thought, No, I want to be with people. So my
career path took a little bit of a winding road. I got a degree in medical
sociology from the UW, I came to the UW from a suburb of Chicago, where I went
to high school. And I loved the main thing I loved about that, you know, was
that there were two lakes, and downtown right there. So and I knew it was a
great school. So I started there. And I finished my degree and got a job at
what's now called Journey. But it's the mental mental health center, it was
called the mental health center of Dane County at that point, and it was a full
time job. And I did that for four or five years, it was really interesting. But
then I thought, I'm kind of stuck here unless I get a Master's. And it's sort of
and then it, it turned out that my former spouse, got a job teaching at City
College of New York. So we moved there, got married, had a little girl. And in
the meantime, I worked at first the Planned Parenthood Federation of America,
and they paid for my Master's in Public Health. And I thought that would be a
good match for me, because I could be involved in research and health and
medical stuff without having to like do hands on like he would as a nurse or
whatever. So and it has turned out to be a really good choice for me. And then
after I finished my work at the Planned Parenthood Federation, I went and that
was during the time of AIDS and HIV in their city. And they were just starting
to realize a couple things. One was that women and others, besides gay men, were
getting it. And then the other thing was that there were new interventions or
treatments that could, that could help. And so I worked with a library and
00:03:00actually, and we started a resource center at the New York City Department of
Health. And we, I that's how I got started kind of in the research realm,
because what we would do is bring new research findings about HIV to
communities. And it wasn't, you know, zoom calls or anything like that. It was
like, walking through community with information and resources. And a lot of
times they were communities that were at risk for a lot of different things. So.
So I really liked that. But then I wanted to move back to New York, or, to
Madison. And I thought, if I come back to Madison, I want to work at the UW
because I had developed such a fondness for it as I got my undergraduate degree.
And I thought that I'd have maybe have a chance. That was before the School of
Medicine was the School of Medicine and Public Health, but I still thought I'd
have a chance doing some kind of public health research epidemiology kind of
work. And I did I was hired right away, why don't right away that fall by the
Department of Psychiatry, and worked on a big epidemiological study about
women's eating patterns, and worked with a psychiatrist on his research
portfolio. And then we weren't really getting any funding. So I decided that I
needed to look around and that's when the job at the Women's Health Initiative
opened up. And I really in I was a research manager in psychiatry, but didn't
have a lot of experience. And I wondered if if I would even be, you know,
considered, and I knew it was a high profile kind of project. And I hadn't been
back in Madison for that long, but long story short, I got the job. In 1995, and
was charged with setting up the Clinical Center, the whole, everything having to
do with recruiting and seeing women that were involved that we were to recruit
to the Women's Health Initiative. There were, I think, 10 other sites that
started a couple years before we did, they were called the vanguard study sites.
And their job was to kind of iron out all the wrinkles, like everything across
the country in the 40 sites needed to have everything uniform. And, and because
it was research on everything had to be done, I've done it, and I've done in
identical ways. So we had this huge, huge manuals on how to do everything from
weighing somebody to drawing blood to doing a pap and pelvic to doing
everything. So, I love startups. So I loved getting things going, getting things
00:06:00off the ground, and almost immediately, I mean, this project was really quite
underfunded. But almost immediately, we had to get into recruiting women for
this study. Gotcha. And we had very ambitious timelines that were sent to us, by
the coordinating center in Seattle.
Maddy McGlone 06:24
Yeah, um, so you mentioned when we talked before that you wanted to talk a
little bit about the background of whi I want to give you the space to do that
now. And also, for anyone who's listening who doesn't know what WHI is, you can
kind of explain the background of the project and what your work was there.
Lezli Redmond 06:43
Well, the Women's Health Initiative is a landmark study, and it's called the
landmark study for several reasons. One, it was the largest preventive study
ever done in the country. One, it was definitely the largest study involving
women that was ever done. That was during the time when we were just starting to
see women in leadership positions in medicine and in research, including
Bernadine Healy, who was at NIH National Institutes of Health, and she's the one
that really got the project off the ground, and may underlie or I don't know if
it was underlying, but the purpose was to redress the inequities in research for
women, because most of what we knew about medical research, medical treatments,
that sort of thing, were really about men who were in the clinical trials. So we
needed to, to make sure that women were involved in this and we wanted to, or
they wanted to make sure that we had a cross section of the United States
involved. So some sites had goals that had to do with higher racial and ethnic
minorities being involved. We actually were asked to focus on rural, rural
women, who often aren't, you know, a lot of times in cities women are sometimes
are involved, but and, you know, small towns and rural areas, they don't have
the opportunities to be involved in research. And for a lot of women. Well, it's
surprised us I guess, because a lot of women, we thought would be nervous about
joining such a big national study. And, you know, especially people, especially
black women, let's say or others, from small towns that just really didn't
really totally trust universities.
Maddy McGlone 08:46
Yeah.
Lezli Redmond 08:47
So we were surprised that that many women did actually step forward. The
clinical trials. I just got to make sure I say this, right. It was designed to
address risk factors for cardiovascular disease, cancer and osteoporosis, the
00:09:00most frequent causes of death, disability and poor quality of life in
postmenopausal women. So the population that we recruited across the country
were women 50 to 79. And it was a huge observational study, plus three clinical
trials. And 161,000 women enrolled at these sites nationwide. And that's a lot,
the, we also looked at we tested the effects of postmenopausal hormone therapy,
you know, we didn't know then, what we know more now, it's still kind of tricky
to figure out but but post menopausal women and hormone therapy isn't
necessarily the best combination because we found an increase risk of
cardiovascular issues and breast cancer. So that was kind of unexpected. The
other thing that was really interesting about it, I thought at the time, but
it's not as much now it was that during that time, there was a big fad, like a
big, trend towards thinking it was healthy to eat a low fat diet. So lots of
people were buying all these little fat products and with lots of sugar-
Maddy McGlone 10:29
Yeah, because then they're higher in sugar.
Lezli Redmond 10:32
And are not losing any weight so were not happy about that. But um, so we were
also testing the, the impact of a of a low fat diet with one that's high in
fruits and grains and vegetables. So that was a big part of it. So for example,
at our clinical center, we had a really big, beautiful kitchen, and a big table
where women could come to classes and learn how to cook low fat foods. And then
we had several other there are like five nutritionists that work there. Yeah, so
it was kind of fun. And then we also, yeah, so there's the low fat diet, and
then looking at calcium and vitamin, vitamin D supplements, and whether that has
any kind of risk, or any kind of impact on heart disease fractures, breast
cancer, and colorectal cancer. So those were the main questions we were looking
into. We did, like all sides had had what we call the ancillary studies. So for
example, there was a physician at Madison who did, who had an ancillary study on
Alzheimer's disease. So it could, you know, invite the women in our study to be
in his study. And there were several of those that were going on at the same time.
00:12:00
Maddy McGlone 12:03
Yeah, cool. I'm just wondering, you talked about the women and cooking classes,
and that sort of more community, kind of providing a service to the community.
Did you feel like the the women responded really positively to that? Was there
like a good energy when that was going on?
Lezli Redmond 12:27
Yeah there was a really good energy and they loved their nutritionist. And they
also, I mean, I think we were able, and part of it had to do with the National
Office and the materials and the little goodies they supplied and things like
that as but we were able to create this loyalty. We I mean, we did it
deliberately, because we want people to follow people for five to seven years or
longer. So we wanted them to feel attached to the study, and that it was really
significant that they were in at which it was. So um, yeah, they, they really
did. And it was such a positive place to work because of that. And people drove,
you know, because like I said, we were we recruited women from rural areas and
little towns, they drove for hours to get to their visits, and to get to their
classes. I think the ones like you said in the dietary intervention were the
most devoted probably, because it was such an important part of part of their
lives. But the other kind of fun thing we did was we asked, we had a newsletter
that we distributed once a month to just sort of keep them engaged and show them
like what are we already finding out? What's happening at our center and stuff
like that. So um, but one thing that we did was to invite women who were
interested to submit a quilt square, and that was in the days, like quilting was
kind of trendy then to so they could they could submit a quilt square that
signified to them, what it what it meant to be involved in the Women's Health
Initiative, or what the significance was. So some had like, their daughter's
name and picture. And so you know, they had all different things. So there were,
I think, 44 women who submitted squares, and then one of the women in this study
volunteered to quilt them together and finish it. And then we had it hanging in,
kind of in the reception area. So people would come in and see that and that was
pretty meaningful to them, I think.
Maddy McGlone 14:48
Yeah, that's really cool. So your title was project manager, right?
Lezli Redmond 14:56
Well, my title was project director,
Maddy McGlone 14:59
Ah, director
Lezli Redmond 15:00
But at every site, the coordinating center required a person who took the role
00:15:00of data manager, somebody who was where the other ones Data Manager, recruitment
director, oh, and clinic manager. But especially in the beginning, when we were
on this, like, tight budget, and we wanted to spend all of our money on
recruiting women. I was appointed all four, all three of those, which meant,
which was fine. But what it meant was, I had to go to Seattle a lot to the, the
Fred, Fred Hutchinson Cancer Center, which was the coordinating center for, you
know, a training and Data Manager, and then training and recruitment, and
training in less than that, and it was fine. I mean, I got to know the study
really well. The only hard part was I had two young kids at home. And when I
started at WHI, my son was only six months old, and my daughter was five or six.
So that was kind of hard, but and it was a long haul.
Maddy McGlone 16:15
Oh, yeah.
Lezli Redmond 16:18
But actually being there was fun. And I got to participate then in several
different leadership committees. Because people knew me at that point. So in our
site, I mean, I don't want to, you know, brag, but we had a really good site.
And it was because of the women and because they met their participation. And we
met all of our goals, and we got outstanding performance and a bunch of
different things. So. So that was kind of rewarding, too.
Maddy McGlone 16:55
Yeah, yeah, I can imagine. Yeah. Um, so your role as clinic manager, tell me a
bit about setting up the clinic and also about recruitment. I don't know how
tied together those two processes work.
Lezli Redmond 17:08
We had to have a clinic together before we recruited women and not everybody had
to have a clinical appointment. The people that were in the hormone replacement
therapy kind of interventions would have pap and pelvic and breast exams. So in
our clinic wasn't huge, but it had like maybe four exam rooms, and then a room
where we could do blood draws, and everybody at some point, I can't remember,
but I know in the beginning, they had to have a blood draw. Maybe if they
weren't in the observational, maybe if they were in the observational study,
they didn't. But um, so we had to find a phlebotomist and I had a trainer and
eventually, eventually, the clinic got staffed with some nurse practitioners and
the nurse manager type who took over that role. But I pretty much had to set it
00:18:00up. And make sure and it wasn't that hard to set up. Because like I said, there
were specific directions on you have to have this kind of scale, you have to
have, you know, this kind of equipment. We had to have a freezer that was like
30, below or something so that we could send really frozen blood samples to the
coordinating center. But, as long as I had the budget, which I did, to set up
the clinic, it was fine. I'm not, as you know, a nurse, and I really needed
somebody like Sharon is the one to take over the day to day management of the
clinic. And then as far as recruitment goes, our recruitment goal was daunting,
because we needed to include we needed to recruit 3500 women and our population.
I mean, if you live in Los Angeles, it's not so if you live in Madison, you
know, the populations not that big. So which meant that we had to reach out to
Appleton and Oshkosh, and all these Janesville all these other places to try to
recruit women. And it actually was there during the whole recruitment that I met
so many women, they were so enthusiastic. And I thought, all these people are so
interesting, I'd like to capture more about their lives, you know, rather than
just their medical research data. So, yeah, so recruitment we had to I had
students were amazing. And they had, God we had we had like three students at a
time. I think just doing recruitment calls and they had the screen 10,000 women
in order to get enough people to the study, and that's a lot, what we what we
would do is send out postcards to see if people were interested in being part of
the answer was called. And then we would get the recruitment, students would get
back to the women and do a little phone interview with them. And that was just
the beginning of what they had to do. But, um, but yeah, so and then the other
thing we did, like I said, is we, I don't know why we call them off site,
because it wasn't off site for the people we were going to. But anyway, we did
these recruitment meetings, and we would try to get any important person in
their community to come like a legislator or somebody. And so then we would, I
mean, we had meetings. And it was partly because I had by then I had a
recruitment person who set them up and, and publicize them and all, but we would
00:21:00have like hundreds of women at our meeting at our recruitment events. And they
weren't part of it. They just wanted to hear about the study. But once they did,
they got like, kind of excited about it, which was so. And we also I work
closely with a person and Lisa Burnett, who was the communications staff on that
staff, what do you call a spokesperson for UW hospital and clinics, and she is
very talented. And so she would help us too, with getting as many women as we
could to this to the screenings to the meetings. And then the other thing we did
was have people, we had meetings all the time at our clinic where people could
come, and they'd hear about the dietary program or whatever it was. And then,
though, when we did these off site ones, eventually we got to the point where
like, let's just get them now while they're interested. And so we would bring
our phlebotomist, we took a van, we would go and have them fill out some
paperwork, get their blood draw, you know, so they were like, already, like,
three steps ahead of being enrolled. And that I think, was helpful.
Maddy McGlone 22:23
Yeah, so so you mentioned all those recruitment tactics, calls, postcards,
important speakers, was there anything you felt was particular spoke to the
women particularly well, and got them enthusiastic?
Lezli Redmond 22:37
I think, you know, one of the, one of the slogans, the Women's Health Initiative
had to do with contributing to health legacy, which is why I called the oral
history program to help like that legacy project, but also to improve the
health, not just their own health, and they wouldn't have and I would say this,
and they liked it, an extra pair of eyes watching them. Besides their own
doctor, we didn't replace their own physician or anything like that. But they
would have some people that care about them and keep an eye on their health. For
them, and then. But they really wanted to contribute to better health for their
daughters and their granddaughters. I think that was the most significant thing
to them. Because you gotta think they're 50 to 79. I mean, they really want to
do something that helps the younger generation.
Maddy McGlone 23:39
Yeah. Oh, that's great. Yeah. Um, do you feel like this was similar to other WHI
clinics around the country? Or was there was this or anything else unique to
Wisconsin's clinics?
Lezli Redmond 23:53
Well our, what was unique to ours, and there was a clinical site, I should
mention in Milwaukee, but they had the City of Milwaukee to pull from. And I was
00:24:00close to the director of the Milwaukee site, too. But, um, so we contribute, or
we collaborated, when we could, but I think, what was we were probably one of
the sites that had the smallest population. And then we have the rural and small
town people.
Maddy McGlone 24:27
Was there a community aspect? Maybe because of that? Because it was smaller?
Lezli Redmond 24:33
Yeah, I think there was and I think, um, you know, we had, it wasn't us, really,
I mean, the coordinating center, they were brilliant, the scripts, they gave us
the instructions that they offered, you know, and so we used to really, I mean,
I did a million talks about the Women's Health Initiative, but I really used
what they gave us and you know, so a nutshell would tell them what they're
getting into. But it would also, would also kind of tie into their emotions a
little bit and about how they could contribute. But I don't think we're that
much different. In general, I know we did business exactly the same, you know
our data that I did get a Data Manager then but you know, it was all, not
synchronized, but you know, and it made more, it's all identical.
Maddy McGlone 25:33
Yeah. Cool.
Lezli Redmond 25:36
So what's nice about Madison is it was recognized by we had some really neat
co-PIs, on the study, like Pat McBride, who was still working, he retired but
came back but he, he was a cardiologist, or preventive cardiologist, and so he
was involved. That's what they call an adjudicator. So if there was a case of
heart disease, he would look at it and try to figure out what it was exactly.
And then, Doug Lowby, who I actually worked with at ob gyn and my last job he
was the was the PI. But there were just lots of interesting people. We had an
amazing recruitment, recruitment advisory group that had ideas for what we could
do in the communities and knew people. And then I got I had a really great good
oral history advisory. Yeah, I was fun to work with all these people.
Maddy McGlone 26:56
yeah. Um, I want to get into the oral history in a second. But I did have one
follow up question. I was wondering the students that you worked with on
00:27:00recruitment that UW students, I'm assuming, how did they get involved? And where
were they usually coming from on campus? Do you think?
Lezli Redmond 27:13
Oh, I think they came from all over the place I can remember right. Pay was not
bad for students. The work was hard. I mean, they had to sit there with a huge
pile of postcards and just keep calling people and then doing questionnaires
over the phone with people. You know, I think of a couple. I can't remember
where they were from exactly. There was a person who was a graduate student, but
she's the one that did the oral history stuff.
Maddy McGlone 27:51
Gotcha. Yeah. Cool. Well, then going into oral history, as you mentioned
earlier, that you got an the idea for it for meeting these Wisconsin women. Tell
me more about how you how this idea like got into your mind and how you started
the project?
Lezli Redmond 28:08
Well, I have to include my recruitment person at the time. Susan, Susan Donower
and she would arrange for these meetings off site. And then we would do our, I
would do my schpeel she would do whatever. And then it never failed. After we
had one of these meetings, people would come up to us and say, Oh, I'm really
excited about blah, blah. But a lot of times they would say like, I've always
wanted to be I have always been involved in health in my community, like they
weren't nurses or you know, health care providers or anything. They were just
people who who manage the health of their families and communities. Some were
like one was when I think I told you was in an internment camp when she was
young, and people were sick and everything. And then she made the commitment to
go to medical school. But a lot of them especially in these little towns and
stuff were just ordinary people who would never consider themselves feminists or
anything. But who were so amazing, like they told us about their health
situations and their kids and you know, the different things they had done and
and they were obviously interested in health to begin with, or they wouldn't
have come to these meetings and include inquiry in a looked into whether or not
they want to be involved. But every time and then Susan and I would say we have
to capture this somehow because it's so inspiring. So that's how it's that's
00:30:00was, like very beginning.
Maddy McGlone 30:11
Yeah, how did you learn about the process of doing oral history? And how did you
get informed that way?
Lezli Redmond 30:21
Yeah, I was no expert in it whatsoever. And I'm still not. What I did was I read
a lot about it, there were actually even one of me, but some quotes about women
and health that were particularly relevant. I think I wrote them in that one
paper I have. But um, I, what I did was I assembled a group of people who, some
were oral historians, some one, but they were in the history of, our Chair of
the history of medicine. It was just kind of a mixture of people that would have
the right skills, maybe and could advise us on how to do that. So Susan, and I
came up with the questions we wanted to ask women and sort of the protocol. And,
you know, then they wouldn't review it and say, well, one was Carol Reve, who's
in Institute on Aging, there were just a bunch of really smart women. So they
would review the questions and give us feedback. And then once we get the
questions down to what made sense to us. We had, I don't know how I came across
her. But I wound up somehow with this amazing PhD student who wanted to do an
oral history project. Michelle, and she did all the interviews over the phone, I
think she did. And, and then there was another person who transcribed
everything. And the original intent was, I had like, grandiose, that's where I
wanted to interview like 50 women. And out of the 50 women, somehow, videotape.
10 of them, and then do some kind of an exhibit that would travel around and
there was somebody from a couple of the State Historical I'd have to look at the
list, there was somebody from some museum and somebody from a funding agency. I
mean, that advisory group was pretty well balanced. But, um, but what happened
is we did 17 of the interviews, no, no, videotape interviews. And then we
00:33:00transcribed those. And then, you know, I talked to a few people on oral history
where they talked about identifying themes. So if there are certain themes that
are coming up over and over again, significant, so we tried to analyze that we
didn't know really what we were doing. But Rochelle then typed up this 17 women
where they were from, what the themes of their interviews were. And that's
about, you know, we never analyzed those interviews, which was, some of them
were long, too, but, um, which we could have done. And then really done an oral
history analysis of the things and so on, but we never got that far. Yeah, and
the reason why we wanted to do it was not just because oh, my gosh, the stories
are so cool. But it was also, you know, here's this huge study, and these women
have really sacrificed a lot and you don't know, like, when you're on a clinical
trial, you're taking a pill every day, you don't want to know if it's real, or
the placebo and, you know, it's just a lot of it's a lot to ask of people. And
we wanted to kind of recognize and celebrate the women that we're not in only in
our study, but if there was some way like I thought we could send our little
exhibit and see if other sites have done anything like that. And we could do you
know, parties, but we never got that far.
Maddy McGlone 34:48
Well, we are very excited to have these added to our collection. So they're
they're going to a good place. Um, so you you said the women are were very
enthusiastic about the study. Were they hesitant about the oral histories? Were
they? Was there, like kind of a different attitude? Or was it the same?
Lezli Redmond 35:06
No. And we didn't, we did. Oh, what do we call stratified samples. So it wasn't
like we only did people who said they do it, people were actually fine about
doing it. And we've wanted to capture it was stratified by age so that we got,
as many of the older people like in their 80s by then, wanted to participate.
You know and I, I feel a little bad. I did some one note before I love self
initiative to our women. So they I mean, I still feel like we should let them
and their daughters and whoever else they put down, know what we're doing. And
00:36:00maybe there's some way we can work on that so that we could let people know,
because if I were a daughter, but I would love to know, like, what my mom
thought was significant about our health history. You know, how she felt like
she was willing to do and those kinds of things, it would be really nice to be
able to share it with whoever's if they're not alive with whoever it is.
Maddy McGlone 36:36
Yeah, yeah. Well, we can definitely talk to Troy and try and get that that set
up. Because I agree, I think that would, that would be really nice,
Lezli Redmond 36:45
I have one summary sheet that has their company has their full address, it has
their town and their phone numbers and stuff.
Maddy McGlone 36:53
Yeah, I will mention that to Troy see what we can do there. Um, were there any
particular stories you wanted to share? Either like stories from women? I know
you already talked about a few women that that stood out? Or about the setup
anything, just that you thought be interesting to share?
Lezli Redmond 37:15
Yeah, you know, I'd have to look at the interviews again. To remember what they
said, because I haven't looked at them for a while. But maybe we could talk
about that.
Maddy McGlone 37:29
Yeah, definitely.
Lezli Redmond 37:32
Yeah, it's just, I mean, it was a special group of people. In fact, we, the
people, the staff, we got together for years, like once a year, something like
that we haven't for a couple of years now. But it was just a really neat place
to work. Because when you're dedicated to making something better, and actually
doing it, it's really rewarding. And there were people you know, there were
nutritionists and nurses and nurse practitioners and Maryanne was our
receptionist person and who I'm still friends with. And, you know, it was just a
really neat group.
Maddy McGlone 38:24
Yeah, for sure. All right, um, is there anything else you wanted to talk about
today? I'm gonna look through my notes and see if there's anything else I wanted
to ask you.
Lezli Redmond 38:44
Yeah, I can't really. You know, I'm going to review the interviews next time,
and we can talk about that. Because they're cool.
Maddy McGlone 38:58
Well, then, I guess we can wrap up for today. I'm going to end the recording.
00:39:00All right. It is Friday, December 11 2020. My name is Maddie McGlone, and I am
here with Lezli Redmond. Lezli, can you just say hello to test our audio real quick?
Lezli Redmond 39:17
Hi, I'm Leslie Redmond. Is it too low?
Maddy McGlone 39:25
I think we should be good. Yeah, it's coming through pretty well. Um, cool. So
you mentioned last time that you were interested in, like gathering up some
stories, some stories from your history in the program stories about the women
who participated in the program. I just want to give you the space right now to
share anything that you you wanted to, you know, put on record?
Lezli Redmond 39:49
Well, I just looked through the summaries of the interviews. And there's really
some themes that come through Rule, one being over and over again, being the
managers of the health of their family, being the one that talks to the doctor
that makes sure the kids go in for checkups that, you know, on and on takes care
of elderly parents. Make sure they have health insurance. And it's, it's so
predominant that women have been carrying the responsibility of taking care of
their families in terms of health. We had people that were interested in the
study because a one one, for example, worked with in a medical setting with deaf
children, one was really interested in participating because her mother died of
breast cancer. And the study was all about breast cancer. One was, and this one
I thought was interesting, I've mentioned it before, but she was in an
internment camp. And as a Japanese American, as an immigrant, when she was
little. And she said the health status of others in that camp was really poor,
and it made her think she wanted to contribute to health in some ways. She also
was at an osteoporosis study at the same time. So and in, you know, the details
of these interviews really get at some of the moving. I mean, this sounds kind
of perfunctory, but if you, if you listen to the interviews, and the way they
talk about things, it's really quite moving. Some people tell everybody, at
least to had kids, which was most of our talked about childbirth, that was a
really hot topic for these women to want to talk about what it was like for them
00:42:00when they had their babies. A lot of them, you know, they were 50 to 79, when
they joined this study, so some already had personal health issues. So they
talked about that. And often, again, it was related to the study. But then also,
they talked about other preventive kinds of things like health, diet, exercise,
you know, those kinds of attributes that they had to try to keep their health
as, as good as it could be. And this was really, I mean, like I said, before,
this was 25 or so years ago. And it was really before the trends around, but
there were still trends around diet, for sure, and eating a low fat diet, but
some of the other things around exercise and other health, preventive behaviors,
personal health behaviors were not as popular I guess. They all, almost all of
them. Not all but a lot of them talked about their about their relationships
with taking care of family members as they age or whatever. One in particular, a
lot of them talked about their relationship with one of our questions was what,
what have your relationships been like with your health care providers, and the
childbirth thing, there were many who weren't real thrilled with their
experiences and childbirth. And this was before I think things have changed
around childbirth, but they weren't really liking their providers around that
many of them. They also talked about, one in particular talked about how much
she appreciates working with female practitioners likes that better. Let me see.
One was a surgical pediatrics nurse in Germany and World War Two. She worked in
the TB hospitals in Switzerland post war and was a pediatric nurse in Madison.
She experienced domestic abuse with her husband, you know, even well, she was
very, very accomplished. But that, as we know, doesn't matter. She's had a lot,
a lot of different many of them. I've had a lot of different health challenges
over the years, which makes sense. I mean, if they're like 60-70 years old. Um,
00:45:00I think those were sort of the highlights. But like I said, the themes, oh, they
talked about, um, one of our questions had to do with experience, changes, I
should say, and health attitudes over the years. This person talked, it was
really interesting. This person, I remember her she talked about her experience
of being a Native American early in the century and the lack of resources on the
reservation, and how they struggled with health kinds of things. I think those
were sort of you know, if you were going to look at themes. I think those were
the themes that emerged from the interviews. Yeah.
Maddy McGlone 46:02
It sounds like you had a really wide ranging group of experiences, even though I
think many people might think overall, Wisconsin, it's very homogenous, but it
seems like that wasn't the case. I'm wondering, what do you mentioned a couple
of questions that you asked them? And what were the questions that you had asked
all of the women in the oral histories? And how did you guys come up with those questions?
Lezli Redmond 46:23
I don't have the questions right in front of me, I guess, though, Maddy, I,
unless they're in this folder, but the way we came up with the questions was to
run them by our advisory council, which included experts in oral history and
conducting oral histories. And, and they were familiar with the study. So they
were good resources for us. And I think there were- Okay, wait, that's the view.
But one is, why did you join the Women's Health Initiative? Oh, this was from a
woman who it's the Japanese woman who became a physician. She has been involved
in research before. The question had to do with what, oh, what projects are what
efforts that they've been involved with? That have to do with women's health? I
mean, this one was about like, why did you become a physician? I mean, so each
study, or each interview went off and a little bit of a tangent? Because? Not
really, I mean, it was the way it was supposed to be. But depending on who the
person was, the questions there ate a little bit, but we always tried to get in.
I think there were about eight basic questions. And like I said, I don't I have
00:48:00them somewhere listed out-
Maddy McGlone 48:05
there being added to the collection, and then people can find them there.
That's, that's totally fine. Um, I'm also wondering, um, you mentioned that one
of the interviewees had participated in other studies. Do you think that a lot
of the women in the study were also involved in other medical research? Or do
you think that was a rare case?
Lezli Redmond 48:30
I think some of them were because they had this really major interest in women's
health and then research. But I'd say the majority weren't in other research
studies. And it was a little dicey, too, because if they decided that they
wanted, I mean, they had choice and what they wanted to join, but then they also
had to be eligible. So if they wanted to join the HR- in the hormone replacement
therapy arm of the study. And they were, I mean, most women that were taking
hormone replacement therapy at that age. I mean, it was very common. So they had
to talk to their doctor about going off all HRT and then being randomized to
either active HRT, or a placebo. So some of their doctors were not real
supportive of that idea. In fact, some of the husbands were not supportive of
them being in the study. And I, what I remember is that was one of the big
sticking points is they didn't want their wife to go off of HRT. So that was a
little troubling, but
Maddy McGlone 49:48
tell me about the I guess the the culture and the perception of HRT at the time.
And maybe also if you feel like that has changed since you guys started the study.
Lezli Redmond 49:59
Yeah, absolutely, at that time, it was really routine to prescribe hormone
replacement therapy to women. Although, of course, it had never really been
tested on long term studies. So and there are symptoms around menopause that
most women experience. You know, sleeplessness, hot flashes, lack of libido, it
goes on and on. But so most women, including myself, went on HRT, and I had mood
problems, actually. And that when I started taking, that were all around my
cycle. When I started taking HRT, I was like, good. So it was just really
normal. And there were actually books that were written. And I don't remember
their names right now. But I remember looking at them, then about, one was
00:51:00called forever feminine, or feminine. And it was all pro HRT that pretty much
prevents aging basically, is what they were saying. So the also, the other thing
we didn't know is how much testosterone should be in the mix there with the
estrogen. And there was some evidence that testosterone prevented some of the
negative impacts of estrogen. So that was really common for people to take the
combination. And that's actually what we were testing, because we knew that HRT
alone was probably not so great for you, but so we were testing the combo. But
what happened is they had to, and that part of the study early, because they
found out that according to the research, that women that were taking estrogen
had a HRT had a higher rate of heart disease, and we were thinking that it was
going to prevent heart disease, right? By making you healthy, but higher rates
of heart disease, higher rates of breast cancer, for sure. And it's still, you
know, it depends on it's like any big, I mean, this is a big research study. So
these are big clinical trials, and usually you don't have them and people and a
study, but um, but even the findings of this study are are not are argued, you
know, is it everyone should not be on HRT, or people that have severe mood
issues, and whatever else problems should be on HRT, but only around the time of
menopause, you know, there's a lot of different nuances to it. So it really
depends on the prescriber, the physician or the internist, or whatever, in terms
of what they recommend. And I haven't looked at you know, I got breast cancer a
little bit after that, and I was taking HRT, and so I can never take HRT again.
But that's fine. But um, so I don't know. I know, there's a debate about who and
when can still do HRT, but yes, there's been a huge change. Yeah, for sure. Now,
it's a discussion rather than an automatic thing.
Maddy McGlone 53:42
Yeah. That That makes a lot of sense. Yeah. I'm kind of in a similar vein, you
mentioned that that women then were had not been satisfied with their experience
giving birth. And you said that, that there have been some changes. Can you talk
a little bit about that?
Lezli Redmond 54:00
Sure. You know, I don't want to make it sound like it's like, so different now
00:54:00than it was then. But I know that women for example, were given this Twilight,
sleep, drug. And so even though they could actually feel the pain and everything
else, they didn't remember when they woke up. So they stopped doing that. So
that's good. They also and I had a midwife with both my kids a nurse midwife,
but um, so it was a little bit more less medicalized, I guess. But it became you
know, Lamaz became popular that gave women the opportunity to have control over
some control over their childbirth. There's also been the trend which is a good
one, towards breastfeeding, you know, sometimes a double edged sword if women
are trying to work and everything else and be the best mom ever, but it just I
mean, we've been able to put more control in the hands of the pregnant and
childbearing woman. Yeah, then we did in the past. And I think having I mean,
this is just my bias, but having female practitioners and I used to work in ob
gyn and there were plenty of great ob gyn that were men. And so I like I said,
this is my own feeling, but I really appreciated having a woman to coach me
through that whole time. Yeah, but they're still I mean, I still, like I said, I
worked in ob gyn till I retired. And there's still the thing where the physician
comes in at the last minute and catches the baby, quote, unquote, and, you know,
isn't like with a woman, that still happens. And it still happens that there are
lots of C sections. And maybe if people had nurse midwives, which the evidence
showed shows that they wouldn't be as likely to have a C section. So I think
it's changed, but I don't think it's changed enough.
Maddy McGlone 56:36
Yeah, yeah. Thanks for those thoughts. Um, you also mentioned, I know, we talked
a lot about the diet studies before and also, I'm really interested in your
thoughts on the woman being involved. I know you just talked about this, but
involved in the health of their communities. You said that sort of low fat diet
trends hadn't come into play yet with the women. So that wasn't really a part of
00:57:00how that they were dealing with health like in their, their daily lives? Maybe
Lezli Redmond 57:08
they had come into, oh, it was very, very trendy to think that a low fat diet I
mean, there were nutritionists pushing it and everything. Yes, but that alone, a
diet, a low fat diet would be good. And they didn't find that out. So like 20
years later that is wasn't so great. But but there was, what we experienced is a
lot of these women in our study that were so health conscious, I mean, more than
average probably are they wouldn't have been in this study, but they were
already eating a really low fat diet. And so if they were randomized to not
eating a low fat diet, they were still eating a low-fat diet. So we couldn't see
a difference between, you know, the ones that were in the intervention group and
the ones weren't you know.
Maddy McGlone 58:02
Yeah, yeah.
Lezli Redmond 58:05
But the ones long, the ones that were in the groups, they love the group. And
they love the nutrition. I mean, like I said they would drive hours today and
study. Yeah, yeah. And they would then have to go to these classes once a week,
if they were in the dietary, if they were randomized to the intervention, the
dietary intervention. And they would, we had a beautiful kitchen that was
perfectly designed for this study, and five nutritionists and so they, the women
loved getting recipes. In fact, in our newsletter, we always put a healthy
recipe, because they liked that. And they would cook and try different things in
each class. So and then they got to be friends with the nutritionist and with
one another. Oh, it was a really neat thing.
Maddy McGlone 58:58
Yeah, definitely sounds like it.
Lezli Redmond 59:02
Yeah, the problem was the ones that weren't in the intervention group. I mean,
they said they wanted to be in the dietary program, right. So they were hoping
that they'd be in the intervention. But if they were assigned to not begin the
intervention, then they were still doing things that were what we thought were
helpful with them.
Maddy McGlone 59:25
I'm wondering, um, you previewed some ways women were involved in the health of
their communities. I'm just wondering if you could expand a little bit about the
specific roles that these women were taking in, you know, taking their children
to the doctor being the primary health, primary person looking after the health
of their family. Could you talk about that?
59:48
Yeah, I mean, for one thing, they were the ones to communicate with their
healthcare provider, or their child's health care provider or their husbands.
Men I mean, I don't want to be super, make assumptions that aren't necessarily
01:00:00true. But a lot of men then relied on their women around the healthcare stuff.
And were reluctant themselves go to a doctor. I'm just like, totally generalizing,
Maddy McGlone 1:00:24
Oh, no, yeah, that's fine.
1:00:27
But one way that they did for sure to I mean, they took care of their own kids.
And that's one thing that has changed, I think, to some degree is that men are
taking care of their kids. Now, more often, like they would maybe take them to
the pediatrician, let's say, I think that's a difference. And in those, and then
now, the women were pretty much responsible for the health of their kids. And
then if their parents or their mother in law, or whatever, were sick or had a
chronic illness, or their husband rally, they were responsible for taking care
of them. And it's not like they complained about it. Really. I mean, I think
they there's always good things about taking care of people. But I think for a
lot, it was a lot of responsibility. And, you know, some work, a lot didn't
work, some worked, and some didn't, but the ones that worked felt really
stretched. Yeah. And then they were also in charge. No, I have men did- some
anyway, we're in charge of making sure of like choosing their primary care
provider for their family and whatever.
Maddy McGlone 1:02:00
Yeah. Um, how, what do you think the makeup was of women who worked versus women
who didn't in the study?
Lezli Redmond 1:02:07
I just was wondering that. Um, I don't know. Sorry, Maddy, I think-There were
more that didn't work. And there were some that were retired for sure. Yeah. Or
some that had gone to part time. But I don't know for sure.
Maddy McGlone 1:02:32
Yeah. Yeah. That's, that's totally fine. Um, I was also wondering, um, I know,
we've already talked a ton about differences, obviously, between this study
being woman centric, but is there are there any other ways you you felt that
this study had to be different from studies that had been majority male in the
past, like other things that set this study apart?
Lezli Redmond 1:02:59
I think one thing was looking at the major health issues of older women that had
01:03:00never been studied before. Like, you know, heart disease, osteoporosis. What it
what eating a healthy diet does for you, that was more on heart disease, too.
But um, so even though women have as much heart disease as men do, what we knew
about heart disease, then, and probably still, to some extent, is what happens
with men who have heart disease. That's just where the research has been done.
And this was partly done in a population of older women, because we could look
at the main, you know, breast cancer and the main things that interfere with
older women's health, but it was also because you probably know this, but even
now, like, let's say with the COVID-19 vaccine, we don't know if it's safe for
pregnant women, because they weren't in the study.
Maddy McGlone 1:04:12
I was just seeing that the other day. Yeah.
Lezli Redmond 1:04:15
Pregnant women were not involved in studies for good reason, in a way and you
know, but it was sort of a blanket thing. It didn't have to be as strict as it
was about but um, thalidomide, did you ever hear about that? They gave it to
women and kids, and so everybody was really scared. And I think still are doing
anything that would harm an unborn fetus. Yeah, sure. So I think those are the
main things that they were the main health issues, that there was a big
observational study that asked a million different questions or I don't know
what they are. But um, and I think what what I liked about it was that we were
doing this study with exactly the same protocols exactly the same everything as
39 other sites and the US. So you could then combine all the data. Sure. So that
was neat. And then the other thing that was kind of interesting about it is that
we could do each site could do ancillary studies. So if there were scientists,
physicians, whenever who were interested in other issues that affected women of
this age, like we had somebody, Mark Segher is his name who did a study on
Alzheimer's with our same patient, or people. So I just felt like wow, you know,
01:06:00it's about time we do a big Women's Health Study, and never been done like that.
So it was such a groundbreaking, you know, incredible effort.
Maddy McGlone 1:06:21
Yeah, yeah. I definitely see that. Yeah. Um, I was also wondering, I'm sort of
from a maintenance perspective, was it difficult to keep the woman in contact?
And in the program and up? Did you have a lot of drop off? Or? Tell me a little
bit about that? And the strategies used to keep them involved?
Lezli Redmond 1:06:45
Yeah, it was, it was challenging to keep people engaged in study. We lost women
that wanted to be in the dietary intervention. Yeah. Sign to that for sure. We
did a lot like everything we could think of. And the national office helped us
with ideas like incentives, like mugs and this and that, you know, on cookbooks
and different things that we could give our women Yeah. Even when we were
recruiting, we would do we would do visits, like, let's say we'd go to Appleton
in a van with all the blood drawing equipment, and a medical assistant who could
do that. The paperwork so that people could get enrolled without having to come
to Madison, because we figured that wouldn't be a disincentive. But then we had
to keep them coming. Yeah. It was pretty good, though. I mean, people were so we
were always trying to give them tidbits that would make them feel that this was
such an important which was important thing for them to be involved in. And
sometimes they we would help them find a friend who was not a friend then they
didn't know each other, but I'm somebody who lived in you know? MacFarlane
there, I don't know where but Portage. And then they could come together to
their visits. We tried to make it really flexible in terms of when they could
come in, which made the staffing hard of course. But like, we always had to have
somebody on site who could do blood draws. Yeah.
Maddy McGlone 1:08:49
Yeah. Awesome. Awesome.
Lezli Redmond 1:08:51
And then we did the quilts, which was fun.
Maddy McGlone 1:08:56
there anything you wanted to say about the quilt I know, we talked about it a
lot last time. But did you have any other thoughts about it?
01:09:00
Lezli Redmond 1:09:02
No
Maddy McGlone 1:09:02
Okay yeah. Then my next question is just about kind of the the present and
future of the program, what you see what what you've seen them do since you left
the program and what they you think they'll do in the future, what you know
about what they're doing now?
Lezli Redmond 1:09:21
Well, the main thing is they'll officially stopped seeing WHI not seeing but
doing like questionnaires for participants at the end of this calendar year. And
because there's still a whole bunch of observational study people involved, but
then they'll also articles that I say 1800 articles have been published already,
so that they'll keep doing that. And they'll keep finding, you know, mining that
data for, for findings and then publish and that's one thing that we did to help
women stay in the study is we would give them well, the what we what we said to
them as you have another pair of eyes watching your health now, you know, so
even though some of this stuff is redundant, like you already got a pap and
pelvic, our breast exam, but this isn't, you know, this is we're looking out for
Yeah, yeah. And so that kind of resonated, but anyway, um, so they'll keep
publishing articles. And then there's still some ancillary or I don't know what
they call them, studies that have that started up there, they'll probably keep
doing. But officially, officially in terms of studying the women, it's almost
over. Gotcha.
Maddy McGlone 1:10:47
Yeah. Yeah. Um, yeah, you look at other questions. Well, I'm then turning to
your own life. What have you done since Well, how did you come to leave WHI,
what did you do after? And did your work at WHI like, prepare you at all for Is
there any, any takeaways you had from the job as a whole that you've like,
carried throughout your life?
Lezli Redmond 1:11:11
Yeah, I, it was such a good learning for me, because I had been a research
manager and the psychiatry department. But I was a novice, and to have to learn
how to run a big research study, like that was so amazing. And what was good
about it is I had the shelter of these huge protocol forks, and of all the
people in Seattle, and I have other colleagues that I met across the country to
help me figure out how to do it. And but I left I had been there five years. And
what happened, I, Maddy, to tell you the truth is that I. I love startup kinds
of things. And so once we were in the retention mode, and we weren't recruiting
01:12:00anymore, and we weren't out there, and we weren't giving presentations much and
stuff like that. I was like, Oh, well, I think I've done my I've done my job
here. So it was just coincidence too that I applied, well, this job came open at
the Center for Tobacco research and intervention. And not only was it research,
which I wasn't a researcher, but I use the research all the time. But it was
creating programs. And that's really what I liked doing. Yeah. So, but I will
never, ever forget the Women's Health Initiative. And the people I worked with,
oh my gosh, they they were so dedicated and fun and amazing. And they loved our
women. And yeah, it was just a really unique, incredible experience.
Maddy McGlone 1:13:08
Yeah, that's great. Um, I know you you're affiliated the university. Now, an
ombuds. Can you tell us what that is? And about that what you've been doing there?
Lezli Redmond 1:13:17
Well, let me tell you a quick. I worked at, I started the Wisconsin tobacco quit
line and a bunch of programs to train physicians how to intervene with their
patients around tobacco use. And I like, you know, traveling around and going in
and going other places and all that stuff. And I love training. So that was
great. And then, and I also love things that make a difference that can help
people, and which, WHI I did and so did the Center for Tobacco research, and
intervention. So I was there for 10 years, which was a long time. And I started
to worry, it was the one it was 2008 and nine during that recession, and I was
worried about our budgets and like, am I gonna I needed to support my family,
like, am I going to have enough money. And it was hard to constantly find
millions of dollars to pay my staff. So I decided to go back into women's
health. And that's when I went to the Department of ob gyn and did some other
programming there. But um, but yeah, so then I retired a couple of years ago,
and then I came back to the university in the role of an ombuds. And what that
is, is that an ombuds, they have them all over the world, really, and some are
in academic settings like ours, and somewhere in business or whatever, but it's
what we do, and there's a team of five of us and what we do is help people that
are struggling with work issues and not really how I mean, help is kind of a
01:15:00strong more, it's more like talking it over with them and coming up with options
that might make sense for them to make their situation better. That kind of
thing, but it's only part time. Which was perfect because I do a bunch of other
stuff. So I was lucky, I got this job. I like it a lot. Yeah, great. Um, well,
those were all of the questions I had. Is there anything else I wanted to talk
about today? No, the only thing I'm wondering. I mean, I guess when I turn in, I
haven't started cataloging all the documents and all that stuff yet. But do I
like identify like, these are the questions. This is the summary of the
interviews. I mean, how do you know how much
Maddy McGlone 1:16:04
I can check in with Troy on that and get back to you. But in terms of the
interview, then do you have any final thoughts, any big takeaways, anything else
you wanted to just say like about your time with the program about how you feel
about WHI and working with women of Wisconsin?
Lezli Redmond 1:16:25
Well, I felt really honored to be part of it. And I was so impressed by the
women of Wisconsin. And I still have like a major soft spot in my heart for WHI.
Because I mean, to be involved, if you're someone like me, and a really
ambitious project that was kind of under funded and is like such an incredible
challenge that it was it made it fun. And I think to that, so I'll always
remember all the people that I worked with too, we used to get together about
once a year, but we haven't lately. But the other thing, what I'd like to do if
it was all possible is I'd love to give these interviews to these women are
probably pretty old by now. But I'd love to be able to give the interviews to
their kids. Yeah. And to let them know more about what their mom contributed to.
Maddy McGlone 1:17:37
Yeah. I'll mentioned that to Troy for sure. Coordinate on that. Well, yeah, if
those are all the thoughts you had, I think we can stop the recording here.
Thank you so much.
Lezli Redmond 1:17:47
You're welcome.
