Developing a Culturally-Relevant Digital Health Intervention to Treat Binge Eating and Obesity

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Abstract Black women have the highest rates of obesity in the United States and are at heightened risk for type 2 diabetes mellitus. While achieving clinically significant weight loss of 8-10% may reduce risk, Black women have disparate behavioral weight loss treatment outcomes. Untreated binge eating may be a contributing factor. Indeed, nearly 30% of Black women with obesity report binge eating behaviors; those who binge eat are likely to regain weight at a faster rate, drop out of behavioral weight loss interventions (SBWL), and have poorer health outcomes. Black women, however, are far less likely to engage in mental health treatment for binge eating. Furthermore, treatment for binge eating is often not available in primary care and community- based settingsplaces where Black women are more likely to receive treatment for their eating and weight- related concerns. Given the barriers Black women face in accessing in-person treatment for binge eating, digital treatment platforms may provide the opportunity to construct a culturally-relevant and accessible treatment option. Current intervention research to treat binge eating among Black women is scarce. To fill this gap, I desire to become a leading health disparities independent investigator with a research program focused on the development, implementation, and evaluation of interventions to prevent and treat binge eating and obesity, but require additional training. The NIH Mentored Patient-Oriented Research Career Development Award will provide protected time to seek this training and further my skills and ability to implement the proposed research. My short-term training goals are to develop advanced expertise in: (1) the design and implementation of clinical trials for obesity; (2) using digital health tools in clinical trials for binge eating and obesity; (3) implementation science theory and methods; and (4) development and submission of independent, investigator-initiated research grants. I have developed a strong training plan and mentoring team, led by Carmen Samuel-Hodge, PhD (co-primary mentor), Cynthia M. Bulik, PhD (co-primary mentor), Dori Steinberg, PhD (co-mentor), and a team of expert consultants. RESEARCH STRATEGY: The objective of this study is to modify a validated intervention to develop a digital health tool to treat binge eating and prevent weight gain in Black women, and examine the feasibility and preliminary efficacy of this tool in a pragmatic clinical trial. I will engage Black women who binge eat (BMI > 30 kg/m2) to identify barriers and facilitators to detecting and treating binge eating, adapt a validated eating behavior and nutrition intervention guided by stakeholder input, and use Semblie, a UNC-hosted, no-cost online platform that provides tools to build, deliver, and track digital health interventions to construct the tool. This training and research plan will form the basis for a future multicenter clinical trial testing the efficacy of the digital health tool for improving binge eating and weight outcomes among adults who binge eat, to be proposed in an R01 grant application before the end of the K23 award.