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

项目摘要/摘要-项目2 肥胖是美国许多可预防的慢性病的主要风险因素，也是导致 不断上涨的医疗成本。尤其值得关注的是正在过渡到大学的年轻人，因为他们更容易 与没有上过大学的同龄人相比，体重增加了。这种体重增加归因于营养不良。 并减少了体力活动。此外，参加少数群体服务机构(MSI)/历史上的年轻人 黑人学院或大学(HBCU)在健康促进方面遇到了几个独特的障碍和促进者 努力。解决大学环境中的健康行为是建立弹性、能力的机会 在青壮年的关键时期提高健康素养。全面的方法对于以下方面至关重要 考察社会环境、一个人生活和工作的社区、 个人的个人信念，以及可能影响任何努力有效性的生理因素。 此外，利用数字技术在提供体重管理干预方面取得了成功。 当使用行为技术时，程序报告更显著的效果大小(例如，量身定制的反馈、自我 监测)，而不是仅以教育为基础的互联网干预。因此，为了增加买入和可持续性， 有必要开发和评估针对非裔美国人/黑人(AA/B)年轻人的减肥干预措施 使用文化定制和以社区为基础的战略。解决与体重控制相关的障碍 在高危人群中，研究已经调整了强化糖尿病预防计划(DPP)，包括一项针对 AA/黑人产后妇女。设计了一种新型的数字化产后体重管理干预工具BeFAB 而且之前已经测试过了。BeFAB的旗舰项目服务于超重和肥胖的AA女性，并在文化上 具体、量身定做、易于使用、引人入胜，并被视为值得信赖的来源。在以下机构的支持和咨询下 最初的BeFAB MPIs，拟议的研究建立在支持BeFAB可行性的证据基础上，并寻求 使其适应青年人群，并进行疗效试验。这项疗效试验将1)整合BeFAB-HBCU 对于在北卡罗来纳州达勒姆参加MSI的年轻人，和2)评估其对与身体活动相关的影响和 12个月内与营养相关的行为变化、体重减轻、生物标记物和压力管理结果。 该项目的第一阶段包括适应和开发阶段。阶段2包括实现 并进行干预的疗效试验。这项研究将成立社区咨询委员会(CAB)，并进行 社区-北卡罗来纳州达勒姆研究地点内和周围的环境评估，包括资产的地理测绘 和风险因素。这项在北卡罗来纳州达勒姆HBCU进行的试验将检查BeFAB-HBCU治疗的效果 (移动健康综合干预，包括基于网络、社交媒体、短信/短信、社区 支持和小组活动)与注意力控制/延迟等待名单控制组相比，后者包括 一般营养和体力活动含量，4个时间点的体重和生物标志物。

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.