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，寻求治疗的肥胖症成年人中高达30%的人会暴饮暴食 吃东西。凭借我的K01研究科学家发展奖，我正在设计和试验食品步骤，以及 同时解决肥胖和暴饮暴食的干预措施，通过移动设备提供，以提高可扩展性。 我这个研究项目的最终目标是将FoodSteps建立为一种循证干预， 可在常规临床实践中广泛应用。为了实现这一目标，我需要设计干预措施 (我的K01的重点)，了解如何在实践中实施(本R03提案的重点)，并验证其 混合试验的有效性和实施(未来R01提案)。因此，我对这款R03的总体目标 小额赠款计划是应用服务设计方法来了解如何在 不同的诊所。由于在现有工作流程中嵌入新的干预措施具有挑战性，因此服务设计 专注于改善患者和临床医生如何相互接触和使用技术的过程 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，创建不是针对用户和实施这些干预措施的环境而设计的干预措施。 为了确保食品步骤最大限度地发挥临床效果，我必须注意服务设计，以便目标用户 定位于并将在实践中实施干预时使用干预。我将与三家诊所合作 这是肥胖和暴饮暴食的人接受治疗的典型环境，也是计划中的 未来R01试验的地点：一家初级保健诊所，一项生活方式药物体重管理计划，以及 门诊饮食失调计划。使用四阶段双钻石模型设计过程，我将应用 创建两个设计产品的服务设计方法，这两个产品描述了FoodSteps将如何嵌入到每个产品中 背景：服务蓝图(目标1)和实施路线图(目标2)。服务蓝图是 个人对个人和个人对技术交易发生时的接触点 干预交付过程。实施路线图将具体说明实施战略和 适应支持食品步骤传递所需的干预和设置。专心关注 在R01试验之前进行服务设计将：(A)加强与诊所的伙伴关系，以提高准备程度 为了更长期的协作；(B)加快向患者提供干预的时间表，因为 在开始收集数据之前完成必要的执行准备活动；和(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，以便 以后就避免了。考虑到我在K01学习和应用设计方法方面的进展，我非常适合领导这项研究， 包括服务设计。综上所述，旨在提供移动肥胖干预和 暴饮暴食将把我的科学从K01试验加速到R01试验，并推动数字干预研究走向 通过使数字工具与其实施环境保持一致，提高参与度和影响力。

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.