Healthy Weight in Lesbian and Bisexual Women Aged 40 and Older: An Effective Intervention in 10 Cities Using Tailored Approaches

Abstract

Background: Lesbian and bisexual women are more likely to be overweight or obese than heterosexual women, leading to increased weight-related health risks.Methods: Overweight women aged 40 or older who self-identified as lesbian, bisexual, or "something else" participated in five pilot interventions of 12 or 16 weeks' duration. These tailored interventions took place at lesbian and bisexual community partner locations and incorporated weekly group meetings, nutrition education, and physical activity. Three sites had non-intervention comparison groups. Standardized questionnaires assessed consumption of fruits and vegetables, sugar-sweetened beverages, alcohol, physical activity, and quality of life. Weight and waist-to-height ratio were obtained through direct measurement or self-report.Analytical Plan: Within-person changes from pre-intervention to post-intervention were measured using paired comparisons. Participant characteristics that influenced the achievement of nine health objectives were analyzed. Achievement of health objectives across three program components (mindfulness approach, gym membership, and pedometer use) was compared with the comparison group using generalized linear models.Results: Of the 266 intervention participants, 95% achieved at least one of the health objectives, with 58% achieving three or more. Participants in the pedometer (n = 43) and mindfulness (n = 160) programs were more likely to increase total physical activity minutes (relative risk [RR], 1.67; 95% confidence interval [CI], 1.18-2.36; p =.004; RR, 1.38; 95% CI, 1.01-1.89; p =.042, respectively) and those in the gym program (n = 63) were more likely to decrease their waist-to-height ratio (RR, 1.89; 95% CI, 0.97-3.68, p =.06) compared with the comparison group (n = 67).Conclusion: This effective multisite intervention improved several healthy behaviors in lesbian and bisexual women and showed that tailored approaches can work for this population. (C) 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc.