Developing a Behavioral Weight Loss Intervention for Emerging Adults Implemented within College Health Service Centers

项目总结/摘要 40%的新兴成年人（18-25岁）超重或肥胖，这是不太可能缓解和 会对健康造成严重影响然而，新兴的成年人在传统的减肥中代表性不足 计划，辍学率高，并削弱了减肥的结果。一种潜在的改善方法 参与的目的是在大学健康服务中心提供BWLI，以减少参与的障碍。约 40%的新兴成年人就读于高等教育机构，大学健康中心被广泛使用 被学生们此外，提供具有响应新兴成人的设计特征的干预措施， 偏好和生活方式也可提高干预的有效性和吸引力。“小变化” (SC)一种减肥方法通过关注减少卡路里来解决新出现的成人参与障碍 通过一些自我选择的，具体的改变目前的肥胖行为，需要更少的时间和精力， 传统的行为减肥干预（BWLI）和促进自主性和自我效能。的SC 这种方法已被有效地用于其他人群的减肥。K23的目标是开发 并完善一个新的和有效的BWLI的基础上SC的方法，是专为新兴的成年人， 在大学健康中心实施，一个无障碍的护理环境。为了实现这一研究目标，我 我将为新兴成人大学生开发一个BWLI原型（BWLI-学院），它将整合1）结果 从定性访谈与大学利益相关者群体有关的感知障碍和促进者， 在健康中心的实施和2）关于新兴的成人减肥偏好的先前发现 （目标1A和1B）。接下来，我将通过2-3个不受控制的 从超重/肥胖的新兴成年学生（N=10/试验）中获得反馈的试点试验，以最大限度地提高可行性， 可接受性和重量损失（目标2）。最后，我将测试BWLI-学院对一个会议的心理教育 在一项小型随机对照初步试验中，将其作为对照组（N=60;目标3）。该项目将填补一个关键的需要， 以证据为基础的体重管理干预，可以通过大学提供新兴的成年人 校园。为了完成这项K23研究，我建议接受1）设计和测试肥胖的培训 干预措施，2）新兴成年人口的独特特征，3）实施原则和方法 将肥胖干预措施转化为现实世界的环境; 4）先进的统计方法， 疗效和有效性试验的纵向数据。通过这项培训和研究计划， 我组建了一个导师团队，以促进我的进步，以及严格的学术和培训环境 布朗大学和米里亚姆医院，我将很好地开始我的职业生涯作为一个独立的 研究人员致力于开发，测试和实施新的肥胖干预措施，以提供早期 治疗肥胖症并预防成年后期相关的下游健康后果。

PROJECT SUMMARY/ABSTRACT Forty percent of emerging adults (age 18-25) have overweight or obesity, which is unlikely to remit and has significant health consequences. However, emerging adults are underrepresented in traditional weight loss programs, drop-out at high rates, and have blunted weight loss outcomes. One potential way to improve participation is to offer BWLIs in college health service centers to reduce barriers to participation. Approximately 40% of emerging adults are enrolled in a postsecondary institution and college health centers are used widely by students. Moreover, delivering an intervention with design features that are responsive to emerging adult preferences and lifestyles may also improve intervention effectiveness and attractiveness. The “small change” (SC) approach to weight loss addresses emerging adult barriers to engagement by focusing on reducing calories through a few self-selected, specific changes to current obesogenic behaviors, requiring less time and effort than traditional behavioral weight loss interventions (BWLI) and promoting autonomy and self-efficacy. The SC approach has been used effectively for weight loss in other populations. The goal of this K23 is to develop and refine a novel and effective BWLI based on a SC approach that is designed for emerging adults and for implementation in college health centers, an accessible care setting. To achieve this research goal, I will develop a prototype BWLI for emerging adult college students (BWLI-College) that will integrate 1) results from qualitative interviews with college stakeholder groups regarding perceived barriers and facilitators of implementation in health centers and 2) previous findings regarding emerging adult preferences for weight loss interventions (Aim 1A & 1B). Next, I will iteratively adapt the BWLI-College prototype through 2-3 uncontrolled pilot trials with feedback from emerging adult students with overweight/obesity (N=10/trial) to maximize feasibility, acceptability, and weight loss (Aim 2). Finally, I will test BWLI-College against a one-session psychoeducational control group in a small randomized-controlled pilot trial (N=60; Aim 3). This project will fill a critical need for an evidence-based weight management intervention for emerging adults that can be delivered via college campuses. To complete this K23 research study, I propose to receive training in 1) designing and testing obesity interventions, 2) the unique features of emerging adult populations, 3) implementation principles and methods for the translation of obesity interventions to real-world settings and 4) advanced statistical methods for longitudinal data from efficacy and effectiveness trials. With this training and research plan, the comprehensive team of mentors I have assembled to facilitate my progress, and the rigorous academic and training environment of Brown University and The Miriam Hospital, I will be well-positioned to launch my career as an independent investigator dedicated to developing, testing, and implementing novel obesity interventions to provide early treatment of obesity and prevent the associated downstream health consequences in later adulthood.