Testing Intervention Strategies for Addressing Obesity and Binge Eating

项目摘要 肥胖症是一个重要的公共卫生问题，具有医学和心理社会发病率， 增加的死亡率和大量的医疗保健费用。高达30%的寻求治疗的个人， 肥胖与暴饮暴食共病，暴饮暴食是一种饮食失调行为，其特征是吃大量的 食物和经历失控。一线干预措施是面对面治疗肥胖或暴食 粮食安全是一个重要的问题，但目前的办法无法解决这两个问题，也无法惠及所有需要帮助的人。解决 肥胖和暴饮暴食并存，需要设计一种干预措施：1）针对体重和暴饮暴食 吃; 2）提高干预的效率，同时保持其效力;以及3）可扩展到大规模 用户群体。因此，我提出了一个研究议程，设计一个移动的干预，目标是 肥胖和暴饮暴食，这与美国国立卫生研究院呼吁进行研究，以提高精确度， 干预交付。我将对肥胖（BMI ≥30）和反复暴食的成年人进行两项研究 （过去3个月内≥12次暴食发作）。首先，我将采用以用户为中心的设计方法来设计一个16- 会话引导自助，移动的干预，结合心理和行为的组成部分， 体重减轻（BWL）干预。对体重和体型的高估，不健康的体重控制方法， 负面情绪是暴食心理干预的关键治疗目标，但不是 BWL的组成部分。因此，我将设计一个干预措施，将这三个组成部分作为一个整体， BWL。我将进行可用性测试，以便在试点试验（目标1）之前为干预措施的改进提供信息。第二，我会 进行随机试验，以确定实施干预方案的可行性， 生成16周时干预对体重和暴食变化影响的初步数据 （干预后）和干预后3个月（随访）（目标2和3）。我将使用23完全析因试验 设计将参与者随机分配到3个组成部分的组合（n=8个条件），以便 分离3种干预成分中的哪一种是有效成分。我将应用多阶段优化 优化干预的战略框架。这些目标支持了我的培训计划， 专家指导和培训以用户为中心的设计和可用性测试（培训目标1）;使用新的 框架和有效的试验设计（培训目标2）;以及临床试验的纵向数据分析 （培训目标3）。导师团队的专业知识，沿着的学术和培训环境， 西北大学，将确保我的成功。本研究的结果将用于优化干预措施， 我将在随后的R 01试验中进行测试K 01指导研究科学家发展奖将 为我提供技能和数据，以促进我的职业目标，即成为一名领导者， 使用可扩展的干预措施，为肥胖和体重相关问题（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.