Developing a Behavioral Weight Loss Intervention for Emerging Adults Implemented within College Health Service Centers

项目概要/摘要 40%的新兴成年人（18-25岁）超重或肥胖，这是不太可能缓解和 会对健康造成严重影响然而，新兴的成年人在传统的减肥中代表性不足 计划，辍学率高，并削弱了减肥的结果。一种潜在的改善方法 参与的目的是在大学健康服务中心提供BWLI，以减少参与的障碍。 大约40%的新兴成年人在中学后教育机构和大学健康中心注册 被学生广泛使用。此外，提供具有响应于 新出现的成人偏好和生活方式也可能提高干预的有效性和吸引力。的 “小变化”（SC）减肥方法通过关注以下方面来解决新出现的成人参与障碍： 通过一些自我选择的，具体的改变目前的肥胖行为，减少热量， 时间和精力比传统的行为减肥干预（BWLI）和促进自主性和自我 功效SC方法已有效用于其他人群的减肥。K23的目标是 是开发和完善一个新的和有效的BWLI的基础上，供应链的方法，旨在 新兴的成年人和实施在大学健康中心，一个可访问的护理设置。到 为了实现这一研究目标，我将开发一个原型BWLI新兴成人大学生（BWLI-College） 这将整合1）与大学利益相关者群体进行定性访谈的结果， 在卫生中心实施的障碍和促进因素，以及2）关于新兴成人的先前发现 减肥干预的偏好（目标1A和1B）。接下来，我将迭代地调整BWLI-学院 通过2-3个不受控制的试点试验，从新兴的成年学生的反馈， 超重/肥胖（N=10/试验），以最大限度地提高可行性、可接受性和体重减轻（目标2）。最后，我将测试 在一个小型随机对照试验中，BWLI-大学与一个一次性心理教育对照组的比较 试验（N=60;目标3）。这个项目将填补一个关键的需要，以证据为基础的体重管理干预 可以通过大学校园提供给新兴的成年人。为了完成这项K23研究，我 建议接受培训1）设计和测试肥胖干预措施，2）新兴的独特功能， 3）将肥胖干预措施转化为真实的的实施原则和方法- 世界环境和4）先进的统计方法，从疗效和有效性试验的纵向数据。 有了这个培训和研究计划，我组建了一个全面的导师团队， 进步，以及布朗大学和米里亚姆医院严格的学术和培训环境，我 将有能力开始我的职业生涯，作为一个独立的调查员，致力于开发，测试， 以及实施新的肥胖干预措施，以提供肥胖的早期治疗，并预防相关的 下游健康后果在成年后期。

PROJECT SUMMARY/ABSTRACT Forty percent of emerging adults (age 18-25) have overweight or obesity, which is unlikely to remit and has significant health consequences. However, emerging adults are underrepresented in traditional weight loss programs, drop-out at high rates, and have blunted weight loss outcomes. One potential way to improve participation is to offer BWLIs in college health service centers to reduce barriers to participation. Approximately 40% of emerging adults are enrolled in a postsecondary institution and college health centers are used widely by students. Moreover, delivering an intervention with design features that are responsive to emerging adult preferences and lifestyles may also improve intervention effectiveness and attractiveness. The “small change” (SC) approach to weight loss addresses emerging adult barriers to engagement by focusing on reducing calories through a few self-selected, specific changes to current obesogenic behaviors, requiring less time and effort than traditional behavioral weight loss interventions (BWLI) and promoting autonomy and self- efficacy. The SC approach has been used effectively for weight loss in other populations. The goal of this K23 is to develop and refine a novel and effective BWLI based on a SC approach that is designed for emerging adults and for implementation in college health centers, an accessible care setting. To achieve this research goal, I will develop a prototype BWLI for emerging adult college students (BWLI-College) that will integrate 1) results from qualitative interviews with college stakeholder groups regarding perceived barriers and facilitators of implementation in health centers and 2) previous findings regarding emerging adult preferences for weight loss interventions (Aim 1A & 1B). Next, I will iteratively adapt the BWLI-College prototype through 2-3 uncontrolled pilot trials with feedback from emerging adult students with overweight/obesity (N=10/trial) to maximize feasibility, acceptability, and weight loss (Aim 2). Finally, I will test BWLI-College against a one-session psychoeducational control group in a small randomized-controlled pilot trial (N=60; Aim 3). This project will fill a critical need for an evidence-based weight management intervention for emerging adults that can be delivered via college campuses. To complete this K23 research study, I propose to receive training in 1) designing and testing obesity interventions, 2) the unique features of emerging adult populations, 3) implementation principles and methods for the translation of obesity interventions to real- world settings and 4) advanced statistical methods for longitudinal data from efficacy and effectiveness trials. With this training and research plan, the comprehensive team of mentors I have assembled to facilitate my progress, and the rigorous academic and training environment of Brown University and The Miriam Hospital, I will be well-positioned to launch my career as an independent investigator dedicated to developing, testing, and implementing novel obesity interventions to provide early treatment of obesity and prevent the associated downstream health consequences in later adulthood.