Multi-dimensional Approach to Address Excess Weight and Pre-Diabetes Health Disparities in Young Adults

项目摘要/摘要-项目2

Project Summary / Abstract - Project 2 Obesity is a major risk factor for many of the preventable chronic diseases in the US and is a leading driver to rising healthcare costs. Of particular concern are young adults transitioning to college as they are more prone to weight gain compared to their peers who do not attend college. This weight gain is attributed to poor nutrition and decreased physical activity. Further, young adults attending a Minority Serving Institution (MSI)/Historically Black College or University (HBCU) experience several unique barriers and facilitators to health promotion efforts. Addressing health behaviors in the university environment is an opportunity to build resiliency, capacity and improve health literacy at a critical period in young adulthood. A comprehensive approach is essential for examining the relationships between the social environment, the community in which a person lives and works, the individuals' personal beliefs, and physiological factors that may influence the effectiveness of any efforts. Additionally, leveraging digital technologies has shown success in delivering weight management interventions. Programs report more significant effect sizes when using behavioral techniques (i.e., tailored feedback, self- monitoring) compared to education-only internet-based interventions. Thus, to increase buy-in and sustainability, there is a need to develop and evaluate weight loss interventions for African-American/Black (AA/B) young adults using culturally tailored and community-based strategies. To address the barriers associated with weight control in at-risk groups, studies have adapted the intensive Diabetes Prevention Program (DPP), including a trial for AA/Black postpartum women. BeFAB, a novel digital postpartum weight management intervention, was designed and previously tested. The flagship BeFAB program serves overweight and obese AA women and is culturally specific, tailored, easy to use, engaging, and branded as a trusted source. With support and consultation by the original BeFAB MPIs, the proposed research builds on the evidence supporting BeFAB feasibility and seeks to adapt it to a young adult population and conduct an efficacy trial. This efficacy trial will 1) integrate BeFAB-HBCU for young adults attending an MSI in Durham, NC, and 2) evaluate its impacts on physical activity-related and nutrition-related behavior change, weight loss, biomarkers, and stress management outcomes over 12 months. Phase 1 of this project includes the adaption and development phase. Phase 2 consists of the implementation and efficacy trial of the intervention. This study will establish a Community Advisory Board (CAB) and conduct a community-environment assessment in and around the Durham, NC study site to include geo-mapping of assets and risk factors. The trial conducted at a Durham, NC HBCU will examine effects of the BeFAB-HBCU treatment (mHealth comprehensive intervention that includes web-based, social media, SMS/text messaging, community support, and group activities) compared to an attention control/delayed waitlist control group, which includes general nutrition and physical activity content, on body weight and biomarkers at 4-time points.