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

摘要 在美国，黑人女性的肥胖率最高，患2型糖尿病的风险也很高。 糖尿病的虽然达到8-10%的临床显著体重减轻可能会降低风险，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导致 因子事实上，近30%的肥胖黑人女性报告有暴食行为;那些暴食的人是 可能以更快的速度恢复体重，退出行为减肥干预（SBWL）， 健康状况较差。然而，黑人妇女参与心理健康治疗的可能性要小得多， 暴食。此外，在初级保健和社区中往往没有对暴饮暴食的治疗。 基于环境的地方，黑人妇女更有可能接受治疗，他们的饮食和体重- 相关关注。考虑到黑人妇女在接受暴食治疗时面临的障碍， 数字治疗平台可以提供机会， 治疗选择目前针对黑人妇女暴食症的干预研究很少。填补这一 差距，我希望成为一个领先的健康差距独立调查员与研究计划的重点 关于预防和治疗暴饮暴食的干预措施的制定、实施和评估， 肥胖，但需要额外的训练。NIH指导以患者为导向的研究职业发展 奖励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 提议的研究。我的短期培训目标是发展高级专业知识：（1）设计和 实施肥胖症临床试验;（2）在暴食症临床试验中使用数字健康工具， 肥胖;（3）实施科学理论和方法;（4）开发和提交独立， 政府发起的研究赠款。我已经制定了一个强大的培训计划和指导团队，由 Carmen Samuel-Hodge，PhD（co-primary mentor），Cynthia M. Bulik，博士（共同主要导师），Dori Steinberg， 博士（共同导师）和一个专家顾问团队。研究策略：本研究的目的是 修改经过验证的干预措施，开发数字健康工具，以治疗暴饮暴食并防止体重增加， 黑人妇女，并检查这种工具的可行性和初步疗效在一个务实的临床试验。我会 让暴饮暴食的黑人妇女（BMI > 30 kg/m2）参与，以确定检测和 治疗暴饮暴食，采用经验证的饮食行为和营养干预，由利益相关者的输入指导， 并使用Semblie，这是一个由UNC托管的免费在线平台，提供构建，交付和跟踪数字化的工具， 健康干预来构建工具。这一培训和研究计划将成为未来的基础 多中心临床试验测试数字健康工具对改善暴饮暴食和体重的功效 在K23结束之前，在R 01拨款申请中提出的暴食成年人的结果 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.