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

项目摘要/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， 而失去对饮食的控制(LOC；无法控制一个人吃什么或吃多少)会带来更大的影响 超重的发展和维持的风险。25%-44%的黑人青年会发生LOC 超重和肥胖，黑人青年在LOC发作期间比白人青年摄入更多卡路里， 增加了超重的风险。然而，现有的LOC解释模型并没有捕捉到 LOC在黑人青年中出现的独特社会背景，特别是LOC在 人口和少数群体特有的社会压力因素的作用，如种族歧视。使用一种合成的 定性数据和生态瞬时评估，这项K23提案试图了解社会 在黑人青少年中发生LOC的背景，特别是探索种族之间的联系 歧视和LOC。将首先使用焦点小组(N=4-5)来获得对以下内容的定性了解 LOC发生的背景，黑人青年用来描述它的特定语言，以及它可能是如何 与种族歧视有关。然后，这些小组的数据将被用来在第二时间通知EMA协议 一组同时患有OWOB和LOC的青少年(N=30)，这将评估 LOC的个人脆弱性和更大的社会背景，包括种族歧视。要实现这一点 K23，我将得到肥胖和饮食失调领域领先专家团队的指导， 健康差距和生态瞬时评估。这款K23将特别方便我在 对LOC和种族歧视的文化敏感性评估，参与社区参与 研究、设计和实施EMA研究。这次培训将使我能够实现我的长期目标 成为一名专注于理解大规模背景因素的领先独立调查员 这导致了种族和少数民族青年中与肥胖相关的健康差距。此外，执行此K23 还将使我能够实现两个短期目标：1)提交后续的R03，以创建文化上的 LOC的适应性测量，可用于在研究和临床中识别这种问题行为 设置和2)整合来自此K23的调查结果，以创建针对LOC和 在随后的R01中，黑人青少年中的肥胖。因此，除了与NIH的联合倡议保持一致外， 旨在解决结构性种族主义和促进生物医学研究中的健康公平，这一K23 建议书将成为我职业生涯的起点，因为我利用了 这一奖项旨在成为种族和青少年肥胖预防和干预领域的领导者 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.