Lessons learned in developing a research partnership with the Transgender community.

The challenge facing the authors was to develop a relationship with members of the Transgender community in a large urban city in order to develop research that would benefit this group. The situation is presented from the differing perspectives of the three women involved (one Transgender woman and two biological women); they provide their accounts of a meeting with key members of the Transgender community where the challenge became apparent. During the meeting, the issue of representation arose resulting in a discussion of whether the research agenda should be focused on a specific subgroup under the Transgender umbrella or be open to all members of this diverse and underserved group. Reflections on what was learned about the diversity of individuals under the Transgender umbrella and the lessons that helped them respond to the challenge are discussed.

Seeking community input to improve implementation of a lifestyle modification program.

OBJECTIVES: Obesity increases a person's risk for diabetes, which is becoming the most common chronic disease in the United States. Latina and African-American women in disadvantaged communities are at higher risk for becoming overweight and subsequently developing diabetes. The purpose of this focus-group study was to guide our adaptation of an evidence-based lifestyle intervention and implementation of the Community-Based Lifestyle Balance program (CLSB). DESIGN, SETTING, AND PARTICIPANTS: We conducted 11 focus-group discussions with 87 African-American and Latina women in disadvantaged communities, including schools, senior centers, subsidized housing communities, and churches. We also conducted informal key informant interviews with community service providers and leaders. RESULTS: Discussions revealed high knowledge of healthy behavior and strong interest in making lifestyle changes. However, barriers such as competing demands on these women prevented long-term practice of healthy behaviors. Women frequently expressed feelings of guilt and self-blame in their attempts and failures to make healthy changes in their daily routine. Some patterns were identified that varied by age and race/ethnicity. These findings suggest guidelines for implementing this lifestyle intervention in a variety of community settings. CONCLUSIONS: Community-level changes such as safer streets and better access to quality grocery stores or markets, with affordable, healthy, fresh food can take years to accomplish. In the interim, CLSB can provide women with skills and strategies that can help improve their health and the health of their families.