Balanced and Empowered EaTing (BEET) in Diabetes: A feasibility trial

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PROJECT SUMMARY Up to 20% - or nearly 7,000,000 – adults with diabetes (T2DM) concurrently experience disordered eating behaviors (DEBs, e.g., significant overeating with loss of control), resulting in higher body mass index and lower adherence to diet and exercise recommendations. DEBs are often disregarded by medical providers and patients, and therefore undertreated in clinical settings. Research is limited on whether treatment for DEBs impacts diabetes self-management and glycemic functioning. To address this, we developed the Balanced and Empowered EaTing (BEET) in Diabetes, or the BEET Diabetes Program, a novel cognitive-behavioral therapy- based program to designed to specifically treat DEBs in T2DM and improve diabetes self-management. By designing with implementation science methods and engaging integrated behavioral health providers (BHPs) in real clinical settings, we aim to 1) address an important treatment need for people with T2DM and concurrent DEBs, and 2) improve the integration of BHPs in collaborative diabetes care in clinical settings. Candidate and Mentors: I am an Assistant Professor in the Department of Psychiatry at the University of Colorado. As a clinical health psychologist with training in implementation science methods, my program of research aims to implement and evaluate evidence-based programs for mental health conditions that could worsen diabetes and other endocrinopathies. I have built a strong mentorship team to guide my training including primary mentor, Dr. C. Neill Epperson (neuroendocrinology of risk and resilience), and co-mentor, Dr. Bethany Kwan (dissemination & implementation science). Research and Training: I propose short term scientific, educational, and training goals that will build upon my prior research training through three research aims: 1) engage BHPs to refine the BEET Diabetes Program for implementation in clinical settings, 2) evaluate the feasibility of the BEET Diabetes Program, and 3) determine the reach and estimate the effectiveness of the BEET Diabetes Program on patient-reported and clinical outcomes. The complementary training goals to establish scientific independence through training in: 1) advanced mixed-methods analytical skills by learning configurational comparative methods for implementation science, 2) clinical trial design for behavioral research and longitudinal data analysis, and 3) methods for biological data collection, analysis, and interpretation in T2DM. Summary: DEBs in T2DM are a serious yet under-recognized clinical problem. There is a significant dearth of research examining associated risk factors and treatments of DEBs in T2DM. My ultimate career goal is to transform our approach to the prevention of endocrine- and metabolic-conditions by developing and implementing evidence-based mental/behavioral programs in clinical settings. Completion of this career development award will accelerate my path towards becoming a national expert in the biobehavioral management of endocrinopathies.