Letter to the editor

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Funding

This work was supported by NIH grants R25DK099080, R25HL124208, R25GM116167, and T32DK07658-26. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any other organization.

Authors’ Response (Tomisek, A., Flinn, B., Balsky, T., Gruman, C. & Rizer, A. M.)

To the editor:

Thank you for the opportunity to respond to Dr. Halliday et al.’s letter concerning our work “Strong, Healthy, Energized: Striving for a Healthy Weight in an Older Lesbian Population.” This work was an important step in identifying opportunities for healthy weight interventions designed for older lesbian and bisexual women. Strong. Healthy. Energized. (SHE) was one of five healthy weight intervention pilots funded by the Office of Women’s Health. Dr. Halliday and colleagues note that our assessment of the intervention data may have resulted in unjustified conclusions regarding the intervention. Specifically, that regression to the mean (RTM) could explain one of the study’s findings rather than providing support for the intervention’s effectiveness. We appreciate this insight and recommendation to consider RTM.

As noted by Dr. Halliday et al., the article notes that our analyses demonstrated the intervention’s “effectiveness in improving health behaviors and short-term health outcomes in the target population.” In the original article, our study team noted multiple reasons to support, or justify, the intervention’s effectiveness in addition to the step increase for those with the lowest baseline step count. This includes:

1. Waist circumference: Waist circumference decreased by 3.7% across the group (p < .01). This did not meet the program’s set goal of a 5% decrease; however, the overall waist circumference decrease provides evidence that the intervention was impactful in improving short-term health outcomes.

2. Impact of social support: Participants coming into the program with fewer close friends and family lost more weight, implying that SHE is more effective for people with less social support at baseline. As noted in the article, this may be because the SHE program provided social support for individuals who did not have as much of it at baseline.

3. Goal achievement: Nineteen percent of participants met all of their goals set at the start of the program, and 46% met half of their goals or more, which includes important goals such as improved exercise knowledge, nutritional knowledge, and endurance.

4. Nutrition impact: When controlling for serving size, 51% of SHE participants reported drinking fewer sugar-sweetened beverages at the end of the program in comparison to consumption at program start.

Additionally, through focus groups, participants noted that the pedometer was the most motivating factor for them. It is important not to discount the full body of evidence in assessing the effectiveness of a nutrition education, social support, and steps-based intervention for an older lesbian and bisexual population.

Additional information

Funding

This work was supported by NIH grants R25DK099080, R25HL124208, R25GM116167, and T32DK07658-26. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any other organization.