Group interventions improve health for older lesbian, bisexual women

The Bay Area has long been one of the nation's leading advocates for LGBT equality and community support. Recent studies, however, reveal that one population — aging lesbian and bisexual women — are overlooked in the realm of health care and the promotion of healthy lifestyle choices tailored to their needs.

The results of a nationwide study conducted by a team of researchers, including San Francisco State University Professor of Health Education Michele Eliason, suggest that group intervention is an effective tool to help women in this demographic improve their overall health behaviors. The study, published today in a supplement to the journal Women's Health Issues, addresses growing concerns over health disparities amongst older lesbian and bisexual women, which include elevated levels of stress, anxiety, substance abuse and larger body sizes in comparison to their heterosexual counterparts.

Preliminary studies and surveys of older sexual minority women have suggested that many face challenges with openly discussing health and lifestyle issues with their health care providers. According to Eliason, many participants voiced their frustrations with the difficulties of finding tailored support communities in the Bay Area, which has left many of them feeling isolated and helpless at times. "It's important to have support from others in order to make changes in one's own life," Eliason said. "Having a place for these women to gather where they could feel safe and talk about issues they were concerned about was really crucial."

The study was conducted as part of the Healthy Weight in Lesbian and Bisexual Women: Striving for a Healthy Community (HWLB) initiative, funded by the U.S. Department of Health and Human Services' Office on Women's Health. Researchers conducted culturally tailored interventions in 10 cities across the United States, involving five different programs developed through partnerships between research organizations and LGBT community organizations. Aimed at improving the physical and mental quality of life for their participants, the programs enrolled more than 375 lesbian and bisexual women ages 40 and older who were overweight, and involved weekly group meetings, nutrition education and physical activity, as well as pre- and post-intervention surveys.

Post-intervention findings showed nearly 60 percent of the HWLB participants increased their weekly physical activity minutes by 20 percent or more, while 95 percent of HWLB participants achieved at least one of their health improvement objectives. Fifty-eight percent achieved three or more health goals.

Eliason was the principal investigator of the Bay Area intervention project titled Doing It For Ourselves (DIFO), in which she implemented a holistic method of tracking the body's response to food and activity rather than highlighting weight loss as a primary goal. The goal of her "mindful approach" interventions was to help women get in touch with their own bodies to find out how different foods affected them and to find comfortable, pleasurable physical activities that best fit their needs, rather than forcing all participants into one type of physical activity or diet.

"It is important to gauge the local community norms and desires for health interventions," Eliason explained. "In some parts of the country, lesbian and bisexual women are more accepting of mainstream health interventions, whereas in the Bay Area, women were much more suspicious of mainstream approaches to health. We were successful in recruiting women to our program because we culturally tailored the approach to community norms.”

Though the federally funded intervention programs have concluded, Eliason plans to begin a new community group in the near future. Several of the former DIFO groups have continued to meet after the original interventions had ended. "I feel that there's a big need for focus groups like these in the Bay Area," Eliason said. "And simply bringing people together in these communities was probably the thing that has made the biggest difference in improving their quality of life."

Eight articles on HWLB appear in the July/August Women’s Health Issues supplement. Eliason is first author of one of the articles, "The 'Something Else' of Sexual Orientation: Measuring Sexual Identities of Older Lesbian and Bisexual Women Using National Health Interview Survey Questions."

Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at Milken Institute School of Public Health at the George Washington University.