by Becky Marquez

According to the Eliminating Disparities in Clinical Trials Project, there are key people missing from the life-saving projects, tests, and trials that help inform “better prevention…and treatment methods for disease.” Eliminating Disparities in Clinical Trials Project describes them as “those who bear a disproportionate burden” or “people with low income, the elderly, racial/ethnic minorities, women and those who live in rural areas.” This is often true of behavioral studies as well. Take those on obesity. 

Knowing what works. Today, researchers are making efforts to develop weight loss programs to better address the unique needs of minority communities. One person who is especially interested in behavior and lifestyle is Dr. Rena Wing, the director of the Weight Control and Diabetes Research Center in Providence. Wing ran the Diabetes Prevention Program, a national study that found that lifestyle treatment produced significant weight loss and that even modest weight loss reduced the risk of developing diabetes among different ethnic groups. Lifestyle treatment of obesity means that to promote behavior changes that support healthy eating and increased physical activity, you focus on skills such as self-monitoring, goal setting, and problem solving. 

Learning from the community. To help inform the development of a behavioral weight loss program for Latinos and Latinas in the area, I administered a bilingual survey at various community organizations across Rhode Island. The surveys were followed up with group discussions on weight loss strategies and perceived barriers to weight loss. 

The majority of survey respondents were overweight or obese women. Although most had not participated in a weight loss program before, interest in a weight loss program was very high, and their preference was for a program that they could attend with a female friend or family member. Additionally, disease prevention and improved health were reported as the most important reasons for their interest in weight loss. During group discussions, however, individuals often expressed low confidence in their ability to lose weight because they believed they could not stick to a diet that did not include their “rice and beans.” 

Community-informed research. Using the responses from the community survey, I developed a recent pilot study based on Wing’s Diabetes Prevention Program called the Comadres Weight Loss Program. To test whether weight loss could be improved for Latinas through their participation with a female partner, we recruited 27 women to a twelve-week program where they attended group sessions either individually or with a female partner. 

The program emphasized health benefits associated with healthy eating and activity to foster motivation. Nutrition education, for instance, focused on portion control and modified cooking methods for cultural foods to encourage continued consumption of traditional meals. We specifically discussed and showed how calories and fat could be reduced by more than half without sacrificing the taste of foods. For example, in a cooking demonstration, sweet plantains and empanadas were baked instead of deep-fried and flan was prepared with less sugar and nonfat dairy instead of whole fat. In their evaluations of the program, women commented that they felt part of a “family” and appreciated that they could still eat “Spanish food and lose weight.” Some women lost as much as 20 pounds.

Women help us better serve the Latino community. Researchers are making efforts to improve inclusion of minorities in clinical trials. 

Locally, we will examine the Comadres feedback and weight loss results to assess the program’s effectiveness and participant acceptance. And if necessary, we will make improvements – for Latinos and minorities in the community today, and for those in the community tomorrow.

Becky Marquez, Ph.D. is a postdoctoral fellow at Brown University/The Miriam Hospital. She works at the Weight Control & Diabetes Research Center in Providence and can be contacted at 401-793-8940 or bmarquez@lifespan.org.

For additional information about Eliminating Disparities in Clinical Trials, visit www.bcm.edu/edict.

photo by Agapao Productions