Examining Loss of Control Eating in Black Adolescents with Overweight/Obesity: The Role of Social Contexts and Racial Discrimination

项目总结/摘要 黑人青少年的肥胖率是美国所有种族或民族中最高的， 吃东西的时候，不能控制自己吃什么，吃多少， 发展和维持超重的风险。25-44%的黑人青年发生性行为， 超重和肥胖，黑人青年比他们的白色同龄人吃更多的热量在肥胖发作， 增加了体重增加的风险。然而，现有的解释性模型并没有捕捉到 黑人青年中发生暴力的独特社会背景，特别是这种暴力的社会性质， 少数群体特有的社会压力因素的作用，如种族歧视。使用合成的 定性数据和生态瞬时评估，这K23建议旨在了解社会 在黑人青少年中发生性行为的背景下，特别是为了探讨种族之间的联系， 歧视和歧视。焦点小组（N = 4-5）将首先被用来获得定性的理解， 黑人青年用来描述它的具体语言，以及它可能是如何发生的。 与种族歧视有关。然后，这些组的数据将用于通知EMA方案， 一组同时患有OWOB和OWOB的青少年（N = 30），将评估OWOB和OWOB之间的相互作用。 个人对种族歧视的脆弱性和更大的社会背景，包括种族歧视。开展这项 K23，我将接受来自肥胖和饮食失调领域的领先专家团队的指导， 健康差异和生态瞬时评估。这K23将特别促进我的培训， 对性别歧视和种族歧视进行具有文化敏感性的评估， 研究，设计和进行EMA研究。这次培训将使我能够实现我的长期目标 成为一名领先的独立调查员，专注于了解大规模的背景因素， 这导致了种族和少数民族青年中与肥胖相关的健康差异。此外，执行此K23 也将使我能够实现两个短期目标：1）提交后续R 03，以创建一个文化 可用于在研究和临床中识别这种有问题的行为的适应性测量 2）整合K23的研究结果，以创建针对儿童的干预计划， 肥胖的黑人青少年在随后的R 01。因此，除了与NIH的UNITE倡议保持一致外， 旨在解决结构性种族主义和促进卫生公平的生物医学研究，这K23 该提案将作为我职业生涯的起点，因为我利用了以下机构提供的培训和研究技能： 该奖项旨在成为青少年肥胖预防和干预种族和 少数民族青年。

PROJECT SUMMARY/ABSTRACT Rates of obesity for Black adolescents are among the highest of any racial or ethnic group in the United States, and loss of control over eating (LOC; being unable to control what or how much one is eating) confers greater risk for the development and maintenance of excess weight. LOC occurs in 25-44% of Black youth with overweight and obesity, and Black youth eat more calories than their White counterparts during LOC episodes, compounding the risk of excess weight gain. Nevertheless, existing explanatory models of LOC do not capture the unique social contexts in which LOC occurs in Black youth, specifically the social nature of LOC in this population and the role of minority-specific social stressors, such as racial discrimination. Using a synthesis of qualitative data and ecological momentary assessment, this K23 proposal seeks to understand the social contexts in which LOC occurs in Black adolescents, and specifically to probe the association between racial discrimination and LOC. Focus groups (N = 4-5) will first be employed to gain a qualitative understanding of the contexts in which LOC occurs, the specific language that Black youth use to describe it, and how it may be linked to racial discrimination. Data from these groups will then be used to inform the EMA protocol in a second set of adolescents with concurrent OWOB and LOC (N = 30), which will assess the interplay between individual vulnerabilities for LOC and the larger social context, including racial discrimination. To carry out this K23, I will receive mentorship from a leading team of experts in the areas of obesity and eating disorders, health disparities, and ecological momentary assessment. This K23 will specifically facilitate my training in culturally sensitive assessment of both LOC and racial discrimination, engagement in community-involved research, and design and conduct of EMA research. This training will enable me to achieve my long-term goal of becoming a leading independent investigator focused on understanding the large-scale contextual factors that drive obesity related health disparities in racial and ethnic minority youth. Additionally, executing this K23 will also enable me to achieve two short-term goals: 1) submitting a subsequent R03 to create a culturally adaptive measure of LOC that can be used to identify this problematic behavior in both research and clinical settings and 2) integrating the findings from this K23 to create an intervention program targeting LOC and obesity in Black adolescents in a subsequent R01. Therefore, in addition to aligning with NIH’s UNITE initiative aimed at addressing structural racism and promoting health equity within biomedical research, this K23 proposal will serve as a launching point for my career as I leverage the training and research skills afforded by this award to become a leader in the field of adolescent obesity prevention and intervention for racial and ethnic minority youth.