Using the Multiphase Optimization Strategy to Optimize a Culturally Tailored Online Behavioral Weight Loss Intervention for Sexual Minority Women

项目摘要 肥胖对性别少数族裔女性的影响不成比例。这款K23的目标是改善肥胖 通过定制和优化基于证据的在线行为权重对性少数族裔妇女的治疗 减肥计划，以增强这一群体的减肥效果。这一目标与 美国国立卫生研究院对性少数群体和性别少数群体健康研究的特别关注通知(NOT-MD-19-001)。 行为减肥计划是治疗轻度到中度肥胖症的黄金标准。RX体重减轻 是一种在线行为减肥计划(由这款K23的导师共同开发)，它有效、低成本、 并且高度可扩展。然而，现有的研究和候选人的试点工作表明，量身定做治疗 要解决性别少数女性的3个公认的减肥障碍，对于最大限度地提高 对这一群体来说，行为减肥的相关性和有效性。这款K23将量身定做Rx减肥解决方案 性少数族裔女性的减肥障碍(即少数族裔压力、社会支持程度低、身体形象负面) 并进行优化试验，以确定定制组件是否以及如何增强减肥效果 使用多阶段优化策略(MOST)对性少数群体妇女的结果。准备工作 阶段(目标1)将涉及开发3个针对性少数群体妇女体重的新治疗成分 基于试点测试和定性访谈的反馈，损失障碍和改进干预措施 20名性少数族裔女性。优化阶段(目标2)将涉及进行析因实验。88 性少数族裔女性将接受12周的Rx减肥并随机获得0-3个量身定制的 组件。这些数据将被用来确定新组件--单独和组合-- 影响平均体重减轻和在6个月内达到临床显著减肥效果的女性比例 (目标2A)，并通过测试假设的机制来阐明定制组件如何影响减肥 行动(目标2B)。使平均减重≥提高2%或达到5%以上的新成分 体重下降10%的≥将保留在最终的肥胖治疗方案中，以在未来的随机对照试验中进行评估。 该项目建立在候选人先前在性少数群体妇女方面的工作基础上，并将与 来自高素质和经验丰富的指导团队的指导。这位候选人的首要目标是 这门K23课程将建立应用文化定制和创新方法的技能(例如，技术- 基础治疗，MOST)，以改善行为减肥的相关性、有效性和影响 针对性少数群体妇女的方案。K23提供的指导、培训和经验将 允许应聘者获得这些技能，并利用这些技能开始独立的研究生涯 解决性少数群体和其他服务不足群体中肥胖差距的技能。

PROJECT ABSTRACT Obesity disproportionately impacts sexual minority women. The goal of this K23 is to improve obesity treatments for sexual minority women by tailoring and optimizing an evidence-based online behavioral weight loss program to enhance weight loss in this group. This objective aligns with the research priorities outlined in NIH’s Notice of Special Interest in Research on the Health of Sexual and Gender Minorities (NOT-MD-19-001). Behavioral weight loss programs are the gold standard treatment for mild to moderate obesity. Rx Weight Loss is an online behavioral weight loss program (co-developed by mentors on this K23) that is effective, low-cost, and highly scalable. However, existing research and the Candidate’s pilot work suggest that tailoring treatment to address 3 well-established weight loss barriers in sexual minority women will be critical for maximizing the relevance and efficacy of behavioral weight loss for this group. This K23 will tailor Rx Weight Loss to address sexual minority women’s weight loss barriers (i.e., minority stress, low social support, negative body image) and conduct an optimization trial to identify whether and how tailored components enhance weight loss outcomes in sexual minority women using the Multiphase Optimization Strategy (MOST). The Preparation Phase (Aim 1) will involve developing 3 novel treatment components targeting sexual minority women’s weight loss barriers and refining the intervention based on pilot testing and feedback from qualitative interviews with 20 sexual minority women. The Optimization Phase (Aim 2) will involve conducting a factorial experiment. 88 sexual minority women will receive 12 weeks of Rx Weight Loss and randomization to receive 0-3 tailored components. This data will be used to determine whether novel components - alone and in combination - impact mean weight loss and the proportion of women achieving clinically significant weight loss at 6 months (Aim 2A) and to clarify how tailored components affect weight loss by testing hypothesized mechanisms of action (Aim 2B). Novel components that increase mean weight loss by ≥2% or the proportion achieving 5+% weight loss by ≥10% will be retained in a final obesity treatment package to evaluate in a future RCT. This project builds on the Candidate’s prior work in sexual minority women and will be completed with guidance from a highly qualified and experienced mentorship team. The Candidate’s overarching goal in this K23 is to establish skills in applying cultural tailoring and innovative methods (e.g., technology- based treatment, MOST) to improve the relevance, efficacy, and impact of behavioral weight loss programs for sexual minority women. The mentorship, training, and experience provided by the K23 will allow the Candidate to acquire these skills and to launch an independent research career leveraging these skills to address obesity disparities in sexual minority women and other underserved groups.