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

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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.