SCALE: Small Changes and Lasting Effects

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The goal of the Cornell Center for Behavioral Intervention Development is to translate basic behavioral and social science discoveries into effective behavioral interventions that reduce obesity in Black and Latino communities. To achieve this goal, we have brought together an accomplished interdisciplinary team of scientists who have expertise in conducting translational research in communities of color. Primary aim: Among overweight or obese Black or Latino adults who live in Harlem or the South Bronx, the objectives are: 1) to establish an infrastructure for translating basic and social science discoveries to develop effective behavioral interventions targeted at preventing and treating obesity; and 2) to further develop and refine mindful eating interventions in order to achieve a >7% within-patient reduction in weight through small sustained changes in eating behavior coupled with sustained increases in lifestyle physical activity. Phase I Defining the intervention We will further develop and refine our mindful eating intervention through focus groups in three different settings: individual, family and faith-based. Then small pilot tests of the mindful eating intervention with and without a positive affect/self affirmation intervention will be done. Phase II Characterizing the intervention effects: In three parallel 'proof of concept' randomized trials, the refined mindful eating intervention will be compared in each setting to a education intervention. In these trials, the mindful eating intervention will be coupled with a positive affect/self affirmation intervention which our recently completed randomized trial has shown to significantly increase physical activity in overweight/obese patients. At 12 months, the primary outcome will be % change in weight. Phase III Assessing feasibility and refining the intervention: The phase II proof of concept trials will be analyzed and the intervention will be refined. A formative study of those who fared the best and the worst in each of the settings will be done. A large scale trial will be planned to test the effectiveness of the optimized intervention. Long term objective: The Center will identify which mindful eating intervention in which setting (individual, family or faith-based) coupled with positive affect/self affirmation to increase lifestyle physical activity have the potential to be more effective in creating sustainable eating and physical activity behavior change and weight loss in a scalable way in Black and Latino communities.