Developing a Culturally-Relevant Digital Health Intervention to Treat Binge Eating and Obesity

摘要 黑人女性肥胖率是美国最高的，患2型肥胖症的风险很高 糖尿病。虽然在临床上实现8%-10%的显著减肥可能会降低风险，但黑人女性 有不同的行为减肥治疗结果。未经治疗的暴饮暴食可能是一个原因 因素。事实上，近30%的肥胖黑人女性报告有暴饮暴食的行为；那些暴饮暴食的人 有可能以更快的速度恢复体重，退出行为减肥干预(SBWL)，并拥有 健康状况更差。然而，黑人女性从事心理健康治疗的可能性要小得多。 暴饮暴食。此外，在初级保健和社区中往往无法获得暴饮暴食的治疗- 基于的设置，黑人女性更有可能在饮食和体重方面接受治疗- 相关的担忧。鉴于黑人女性在获得暴饮暴食的面对面治疗方面面临的障碍， 数字化治疗平台可能会提供机会，构建一个与文化相关的、可访问的 治疗选项。目前针对黑人女性暴饮暴食的干预研究很少。为了填满这个 Gap，我希望成为一名领先的健康差距独立调查员，专注于研究计划 关于制定、实施和评估预防和治疗暴饮暴食和 肥胖，但需要额外的培训。美国国立卫生研究院指导以患者为中心的研究事业发展 获奖将提供受保护的时间来寻求这种培训，并进一步提高我的技能和能力，以实施 拟开展的研究。我的短期培训目标是发展以下方面的高级专业知识：(1)设计和 实施肥胖临床试验；(2)在暴饮暴食临床试验中使用数字健康工具 肥胖；(3)实施科学的理论和方法；(4)发展和提交独立的， 由研究人员发起的研究资助。我已经制定了一个强大的培训计划和指导团队，由 卡门·塞缪尔·霍奇(Carmen Samuel-Hodge)博士(联合小学导师)、辛西娅·M·布里克(Cynthia M.Bulik)博士(联合小学导师)、多里·斯坦伯格(Dori Steinberg)、 博士(共同导师)和一支专家顾问团队。研究策略：本研究的目的是 修改一项有效的干预措施，以开发一种数字健康工具来治疗暴饮暴食并防止体重增加 黑人妇女，并在一项务实的临床试验中检查该工具的可行性和初步疗效。这就做 让暴饮暴食的黑人女性(BMI&GT；30公斤/平方米)识别障碍和促进者，以检测和 治疗暴饮暴食，在利益相关者的意见指导下，调整有效的饮食行为和营养干预， 并使用Semblie，这是一个由北卡罗来纳大学托管的免费在线平台，提供构建、交付和跟踪数字产品的工具 卫生干预以构建该工具。这项培训和研究计划将构成未来的基础 多中心临床试验测试数字健康工具改善暴食和体重的效果 暴饮暴食的成年人的结果，将在K23结束前的R01拨款申请中提出 获奖。

Abstract Black women have the highest rates of obesity in the United States and are at heightened risk for type 2 diabetes mellitus. While achieving clinically significant weight loss of 8-10% may reduce risk, Black women have disparate behavioral weight loss treatment outcomes. Untreated binge eating may be a contributing factor. Indeed, nearly 30% of Black women with obesity report binge eating behaviors; those who binge eat are likely to regain weight at a faster rate, drop out of behavioral weight loss interventions (SBWL), and have poorer health outcomes. Black women, however, are far less likely to engage in mental health treatment for binge eating. Furthermore, treatment for binge eating is often not available in primary care and community- based settingsplaces where Black women are more likely to receive treatment for their eating and weight- related concerns. Given the barriers Black women face in accessing in-person treatment for binge eating, digital treatment platforms may provide the opportunity to construct a culturally-relevant and accessible treatment option. Current intervention research to treat binge eating among Black women is scarce. To fill this gap, I desire to become a leading health disparities independent investigator with a research program focused on the development, implementation, and evaluation of interventions to prevent and treat binge eating and obesity, but require additional training. The NIH Mentored Patient-Oriented Research Career Development Award will provide protected time to seek this training and further my skills and ability to implement the proposed research. My short-term training goals are to develop advanced expertise in: (1) the design and implementation of clinical trials for obesity; (2) using digital health tools in clinical trials for binge eating and obesity; (3) implementation science theory and methods; and (4) development and submission of independent, investigator-initiated research grants. I have developed a strong training plan and mentoring team, led by Carmen Samuel-Hodge, PhD (co-primary mentor), Cynthia M. Bulik, PhD (co-primary mentor), Dori Steinberg, PhD (co-mentor), and a team of expert consultants. RESEARCH STRATEGY: The objective of this study is to modify a validated intervention to develop a digital health tool to treat binge eating and prevent weight gain in Black women, and examine the feasibility and preliminary efficacy of this tool in a pragmatic clinical trial. I will engage Black women who binge eat (BMI > 30 kg/m2) to identify barriers and facilitators to detecting and treating binge eating, adapt a validated eating behavior and nutrition intervention guided by stakeholder input, and use Semblie, a UNC-hosted, no-cost online platform that provides tools to build, deliver, and track digital health interventions to construct the tool. This training and research plan will form the basis for a future multicenter clinical trial testing the efficacy of the digital health tool for improving binge eating and weight outcomes among adults who binge eat, to be proposed in an R01 grant application before the end of the K23 award.