McElroy Jane A, Haynes Suzanne G, Eliason Michele J, Wood Susan F, Gilbert Tess, Barker Linda Toms, Minnis Alexandra M
Department of Family & Community Medicine, University of Missouri, Columbia, Missouri.
U. S. Department of Health & Human Services, Office on Women's Health, Washington, DC.
Womens Health Issues. 2016 Jul 7;26 Suppl 1:S18-35. doi: 10.1016/j.whi.2016.05.002.
Lesbian and bisexual women are more likely to be overweight or obese than heterosexual women, leading to increased weight-related health risks.
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.
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.
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).
This effective multisite intervention improved several healthy behaviors in lesbian and bisexual women and showed that tailored approaches can work for this population.
女同性恋和双性恋女性比异性恋女性更易超重或肥胖，导致与体重相关的健康风险增加。
40岁及以上自我认定为女同性恋、双性恋或“其他”的超重女性参与了五项为期12周或16周的试点干预措施。这些量身定制的干预措施在女同性恋和双性恋社区合作伙伴地点进行，包括每周小组会议、营养教育和体育活动。三个地点设有非干预对照组。标准化问卷评估水果和蔬菜、含糖饮料、酒精的摄入量、体育活动和生活质量。通过直接测量或自我报告获取体重和腰高比。
使用配对比较法测量干预前到干预后的个体内部变化。分析影响九个健康目标达成的参与者特征。使用广义线性模型将三个项目组成部分（正念方法、健身房会员资格和计步器使用）的健康目标达成情况与对照组进行比较。
在266名干预参与者中，95%至少实现了一个健康目标，58%实现了三个或更多。计步器项目（n = 43）和正念项目（n = 160）的参与者增加总体育活动分钟数的可能性更大（相对风险[RR]，1.67；95%置信区间[CI]，1.18 - 2.36；p = .004；RR，1.38；95% CI，1.01 - 1.89；p = .042），而健身房项目（n = 63）的参与者与对照组（n = 67）相比，降低腰高比的可能性更大（RR，1.89；95% CI，0.97 - 3.68，p = .06）。
这种有效的多地点干预改善了女同性恋和双性恋女性的多种健康行为，并表明量身定制的方法对该人群有效。
