Designing a Mobile Obesity & Binge Eating Intervention for Implementation in Clinical Settings

五分之二的美国成年人患有肥胖症，高达30%的肥胖寻求治疗的成年人参与狂欢 吃凭借我的K 01研究科学家发展奖，我正在设计和试点测试FoodSteps， 通过移动终端进行干预，解决肥胖和暴饮暴食问题，以提高可扩展性。 我对这项研究计划的最终目标是将FoodSteps建立为一种基于证据的干预措施， 可以广泛应用于常规临床实践。为了实现这个目标，我需要设计干预措施， （我的K 01的重点），了解如何在实践中实现它（本R 03提案的重点），并验证其 混合试验的有效性和实施（未来R 01提案）。因此，我对R 03的总体目标是 小额赠款计划是应用服务设计方法，了解如何实施干预， 不同的诊所。由于将新干预嵌入现有工作流程具有挑战性，因此服务设计 专注于改善患者和临床医生如何相互参与和技术的过程 在实践中进行干预时。然而，数字干预研究在很大程度上忽视了服务 设计，创造不是为用户和实施环境设计的干预措施。 为了确保FoodSteps最大限度地发挥临床影响，我必须参与服务设计，以便目标用户 在实践中实施干预时，能够并将使用干预措施。我将与三家诊所合作 这些都是典型的肥胖和暴饮暴食的人接受治疗的地方， 未来R 01试验的地点：一个初级保健诊所，一个生活方式药物体重管理计划，和一个 门诊饮食失调症项目使用4阶段双钻石模型设计过程，我将申请 服务设计方法来创建两个设计产品，描述如何将FoodSteps嵌入到每个 背景：服务蓝图（目标1）和实施路线图（目标2）。服务蓝图是 当人与人和人与技术的交易发生在整个 干预交付过程。实施路线图将具体说明实施战略， 对支持FoodSteps提供所需的干预措施和环境进行调整。专门关注 在R 01试验之前进行服务设计将（a）加强与诊所的伙伴关系， 进行更长期的合作;（B）加快向患者提供干预措施的时间轴，因为已经 在开始数据收集之前完成必要的实施准备活动;以及（c） 解决在现实世界环境中进行研究时可能出现的潜在挑战， 避免以后。我非常适合领导这项研究，因为我的K 01进度学习和应用设计方法， 包括服务设计。综上所述，设计用于肥胖症的移动的干预的递送， 暴饮暴食将加速我的科学从K 01到R 01试验，并推动数字干预研究走向 通过将数字化工具与其实施环境相结合，改善参与和影响。

Two in five U.S. adults have obesity, and up to 30% of treatment-seeking adults with obesity engage in binge eating. With my K01 Research Scientist Development Award, I am designing and pilot testing FoodSteps, an intervention that addresses both obesity and binge eating, delivered via mobile device to increase scalability. My ultimate goal for this program of research is to establish FoodSteps as an evidence-based intervention that can be broadly implemented in routine clinical practice. To achieve this goal, I need to design the intervention (focus of my K01), understand how to implement it in practice (focus of this R03 proposal), and validate its effectiveness and implementation in a hybrid trial (future R01 proposal). Thus, my overarching aim for this R03 small grant program is to apply service design methods to understand how to implement the intervention in diverse clinics. Because embedding a new intervention into existing workflows is challenging, service design focuses on improving the process of how patients and clinicians engage with each other and technologies when delivering an intervention in practice. However, digital intervention research has largely ignored service design, creating interventions that are not designed for the users and contexts in which they are implemented. To ensure FoodSteps is maximized for clinical impact, I must attend to service design so the intended users are positioned to and will use the intervention when it is delivered in practice. I will partner with three clinics that are typical settings where people with obesity and binge eating present for treatment, and are the planned sites of the future R01 trial: a primary care clinic, a lifestyle medicine weight management program, and an outpatient eating disorders program. Using the 4-phase Double Diamond Model design process, I will apply service design methods to create two design products that describe how FoodSteps will be embedded in each setting: service blueprints (Aim 1) and implementation roadmaps (Aim 2). Service blueprints are diagrams of the touchpoints when person-to-person and person-to-technology transactions occur throughout the intervention delivery process. Implementation roadmaps will specify the implementation strategies and adaptations to the intervention and settings that are needed to support FoodSteps delivery. Dedicated attention to service design in advance of a R01 trial will (a) strengthen partnerships with the clinics to enhance readiness for longer-term collaboration; (b) accelerate the timeline to deliver the intervention to patients due to already completing implementation-preparation activities that are necessary before initiating data collection; and (c) address potential challenges that could occur when conducting research in real-world settings so they are avoided later. I am well suited to lead this study given my K01 progress learning and applying design methods, including service design. Taken together, designing for the delivery of a mobile intervention for obesity and binge eating will accelerate my science from a K01 to R01 trial, and propel digital intervention research toward improved engagement and impact by aligning digital tools with their implementation contexts.