Testing Intervention Strategies for Addressing Obesity and Binge Eating

项目总结 肥胖是一个重大的公共卫生问题，有医学和心理社会疾病，质量受损 生命、更高的死亡率和高昂的医疗费用。高达30%的寻求治疗的个人患有 肥胖症与暴饮暴食并存，这是一种饮食失调行为，其特征是大量进食 食物和经历失控。一线干预是针对肥胖或狂欢的面对面治疗 但是，目前的方法不能解决这两种情况，也不能惠及所有有需要的人。抢断 肥胖和暴饮暴食并存，需要设计一种干预措施：1)同时针对体重和暴饮暴食 进食；2)在保持其效力的同时提高干预的效率；3)可扩展到大型 用户群体。因此，我提出了一个研究议程，以设计一种针对以下目标的移动干预 肥胖和暴饮暴食，这与美国国立卫生研究院呼吁进行的研究相一致，以提高 干预性交付。我将对肥胖(体重指数≥30)和经常暴饮暴食的成年人进行两项研究 (≥在过去3个月里狂欢了12集)。首先，我将采用以用户为中心的设计方法来设计16- 会议引导的自助、移动干预，结合了心理和行为的组成部分 体重减轻(BWL)干预。高估体重和体型，不健康的体重控制做法，以及 消极情绪是暴饮暴食心理干预的主要治疗目标，但不是 BWL的组件。因此，我将设计一个将这三个组件作为辅助组件集成在一起的干预 BWL.我将在试运行之前进行可用性测试，以便为干预改进提供信息(目标1)。第二，我会 进行随机试点试验，以确定交付干预方案的可行性，并 生成关于干预对16周后体重和暴饮暴食的影响的初步数据 (干预后)和干预后3个月(随访)(目标2和3)。我将使用23个完全析因试验 设计将参与者随机分配到3个组件的组合(n=8个条件)，以便 分离出3种干预成分中哪些是有效成分。我将应用多阶段优化 优化干预的战略框架。这些目标支持我的培训计划，在该计划中，我将获得 以用户为中心的设计和可用性测试方面的专家指导和培训(培训目标1)；使用 框架和有效的试验设计(培训目标2)；临床试验的纵向数据分析 (培训目标3)。指导团队的专业知识，以及 西北大学，将确保我的成功。这项研究的结果将用于优化干预措施， 然后我将在随后的R01试验中对其进行测试。这一K01指导研究科学家发展奖将 为我配备技能和数据，以促进我的职业目标，即成为增加访问高- 使用可扩展的干预措施，为肥胖和与体重相关的问题(如暴饮暴食)提供高质量的医疗保健。

PROJECT SUMMARY Obesity is a significant public health problem, with medical and psychosocial morbidities, impaired quality of life, increased mortality, and substantial health care costs. Up to 30% of treatment-seeking individuals with obesity have comorbid binge eating, an eating disorder behavior characterized by eating a large amount of food and experiencing loss of control. First-line interventions are face-to-face treatments for obesity or binge eating, but current approaches fail to address both conditions and cannot reach all people in need. To tackle comorbid obesity and binge eating, an intervention needs to be designed that: 1) targets both weight and binge eating; 2) improves the efficiency of the intervention while preserving its potency; and 3) is scalable to large populations of users. Thus, I propose a research agenda to design a mobile intervention that targets obesity and binge eating, which aligns with the NIH’s call for research that enhances the precision of intervention delivery. I will conduct two studies with adults with obesity (BMI ≥30) and recurrent binge eating (≥12 binge episodes in the past 3 months). First, I will employ a user-centered design approach to design a 16- session guided self-help, mobile intervention that combines components of psychological and behavioral weight loss (BWL) interventions. Overvaluation of weight and shape, unhealthy weight control practices, and negative affect are key treatment targets in psychological interventions for binge eating, but are not components of BWL. Thus, I will design an intervention that integrates these three components as adjuncts to BWL. I will conduct usability testing to inform intervention refinements prior to a pilot trial (Aim 1). Second, I will conduct a randomized pilot trial to determine the feasibility of delivering the intervention protocol and to generate preliminary data on the effect of the intervention on changes in weight and binge eating at 16 weeks (post-intervention) and 3 months post-intervention (follow-up) (Aims 2 & 3). I will use a 23 full factorial trial design to randomly assign participants to a combination of the 3 components (n=8 conditions) in order to isolate which of the 3 intervention components are active ingredients. I will apply the Multiphase Optimization Strategy framework to optimize the intervention. These aims support my training plan in which I will receive expert mentorship and training in user-centered design and usability testing (Training Goal 1); using novel frameworks and efficient trial designs (Training Goal 2); and longitudinal data analysis of clinical trials (Training Goal 3). Expertise of the mentorship team, along with the academic and training environment of Northwestern University, will ensure my success. Results of this study will be used to optimize the intervention, which I will then test in a subsequent R01 trial. This K01 Mentored Research Scientist Development Award will equip me with the skills and data to facilitate my career goal of becoming a leader in increasing access to high- quality health care for obesity and weight-related issues, such as binge eating, using scalable interventions.