WHAM Update: What we’ve done and where we are going

Posted Wednesday, October 22, 2014
WHAM signs

WHAM participants at the Dyke March

When Dawn first came to Lyon-Martin from New York, the Board of Directors said they wanted Lyon-Martin to be a center for research. With Women’s Health and Mindfulness (WHAM), we are finally able to start that. WHAM is the first research project where Lyon-Martin fully participates in all aspects of the research process.

You may remember our announcement of this new program about a year ago. We now have some exciting updates to report including data from our provider trainings, presenting at conferences such as GLMA, where we stand with our support groups and plans for the future of the program.

A refresher, what is WHAM?

WHAM was funded by the Office of Women’s Health along with five other projects across the country, all focused on improving the health of lesbian and bisexual women of size over age 40.

WHAM has two parts:

1. Training for healthcare providers on how to talk to lesbian and bisexual women about weight and its connections to health.

2. A 12-week support group for lesbian and bisexual women that includes mindfulness-based stress reduction, mindful eating, nutrition counseling and exercise.

WHAM Provider Training

The WHAM provider training was developed in the Fall of 2013 and the first two trainings were held at Lyon-Martin in November 2013. The first training is a one-hour training for all health center staff members that interact with patients and focuses on cultural competency for sexual orientation, gender identity and body size. The second training is a two-hour workshop for nurses and medical providers (i.e., staff members who counsel patients on behavior change) focused on motivational interviewing techniques.

The goals of these two trainings were to 1) increase staff and provider knowledge about cultural competency issues related to LB women of size and 2) to increase use of motivational interviewing techniques and community referrals for LB patients. These goals were evaluated using pre and post knowledge tests for the staff trainings and pre and post chart review for the provider training.

The Lyon-Martin staff training showed increased knowledge about body size cultural competency and written feedback from staff showed a positive response to the training with helpful suggestions such as increased discussion of how issues like race and poverty might factor into weight concerns for these patients as well.

The chart review examined 101 patient charts during time period 3 months before and 3 months after the November LMHS trainings. We found that while we are not weighing more people, as we had hoped, providers are completing twice as many Brief Action Plans (a motivational interviewing technique that sets small, achievable goals for patients) and are making more referrals to community-based resources.

Dawn at GLMA

Dawn presenting at the GLMA Conference in Baltimore

We have also completed two WHAM staff trainings outside of LMHS. The first training was at the SF Community Clinic Consortium in August 2014 and the second was with the SFCCC AmeriCorps members in September 2014. Both trainings resulted in increased knowledge about body size cultural competency as well as increased knowledge about interacting with LGBT patients.

Finally, Dawn presented the chart review results at the recent Gay & Lesbian Medical Association (GLMA) meeting in Baltimore in August 2014. The GLMA presentation reviewed the main components of both staff and provider trainings as well as the results of chart review. Natalie Ingraham, WHAM Project Coordinator, will also be presenting this data at the American Public Health Association meeting in New Orleans in November 2014.

WHAM Health Program

We’re wrapping up the last of our 8 support groups and data collection will be complete this month. Data collection includes a survey of mindfulness, quality of life, stress levels, nutrition information, physical activity and basic demographic information as well as a blood test to examine cholesterol levels and blood sugar control. We plan to provide each participant with individual results from before and after their groups as well as hosting a community forum to present aggregated data from the full project. We will also be holding focus groups with participants to learn how to make the program better as well as address recruitment and retention issues.

Future Directions for WHAM

WHAM was a pilot program and we are hoping to expand to a full program by applying for more funding. This grant focused on the importance of WHAM as a community-based participatory research project, the first for Lyon-Martin where community members help decide on how the study is designed, what questions are asked, and gives feedback throughout the entire process. Dawn was also accepted, along with our research partner from RTI, Alexandra Minnis, to the QuickStart program which helps train community researchers on how to create new community based participatory research projects and apply for grant funding.

Other collaborations include working with the four other sites funded by the Office of Women’s Health on joint papers that will be submitted and published in scientific and professional journals, such as Women’s Health Issues and LGBT Health.

We are very excited about moving forward with WHAM as the first of many community-based research projects for Lyon-Martin!