Targeting Binge Eating to Prevent Weight Gain in College Students

描述(申请人提供)：肥胖是一个主要的公共卫生问题。由于肥胖症广泛流行，导致无数的个人和社会负担，一旦发展起来很难治疗，专家强调预防的必要性。在NIH肥胖研究战略计划中列举的建议战略包括针对高风险发育期的干预措施，并寻求改变肥胖发展的已知风险因素。青壮年是体重增加和肥胖风险特别高的发育期。暴饮暴食(暴饮暴食并失控)是肥胖发展的一个重要的可改变的风险因素。暴饮暴食在不同性别和种族/民族的年轻人中很常见：约10%的人报告每周至少暴饮暴食1次。在全国范围内，18至24岁的年轻人中约有40%(1200万英镑)在上大学，这使得大学成为接触高危人群的好环境。与R15机制的目标一致，本应用程序建议a)收集关于以证据为基础的、同行指导的自助(PGSH)计划的可行性、可接受性和有效性的试点数据，以防止学生体重增加；b)开发适合大学生活方式的内容和交付的研究和干预材料；以及c)为本科生提供有意义的研究参与。为了实现这些目标，我们建议进行一项随机临床试验，测试针对暴饮暴食的八个疗程的PGSH计划的有效性，包括两个主要结果(停止暴饮暴食和随机化后体重指数的变化)和治疗后和六个月随访的几个次要结果。我们计划从一所社区大学(50%)和一所四年制大学招募男性和女性，随机选择132名报告反复暴食PGSH或纯自助治疗的学生。主要结果将通过严格的面谈(暴饮暴食)和客观(BMI)措施来衡量。将对计划材料进行调整，以反映肥胖和饮食失调领域关于健康饮食的战略的整合。上流社会的本科生将接受严格的研究培训，并担任这项研究的同行评价员或指导。作为我们对传播/实施研究的长期兴趣的第一步，这项概念验证研究还将检查同行管理干预的保真度和参与者对PGSH的满意度。这项创新来自于将一种经过验证的暴饮暴食疗法应用于预防体重增加的新目标；根据同伴指导调整治疗方法，这是一种有利于在校园内吸收和广泛实施的提供方式；调整计划内容，以解决大学生中常见的不健康饮食模式；并将社区大学生包括在内，此前的肥胖预防研究基本上忽略了这一群体。我们的研究将通过创建一个循证的、有针对性的、可扩展的、高度可传播的肥胖预防计划，并通过教育本科生进行健康行为研究和循证干预来促进公共健康。 公共卫生相关性：这项研究为同伴指导的自助项目提供了可行性、可接受性和有效性数据，旨在防止大学生体重增加。暴饮暴食是肥胖发展的一个可改变的风险因素。年轻人是超重的高危人群，暴饮暴食在这个年龄段很常见(约10%)。每年有超过1200万18至24岁的年轻人上大学，这使大学成为接触大量高危人群的理想环境。这项拟议的工作通过开发和评估一种新的战略，有针对性地预防暴饮暴食的年轻人肥胖，从而促进公共健康。暴饮暴食的年轻人特别有可能经历快速而显著的体重增加。

DESCRIPTION (provided by applicant): Obesity is a major public health concern. Because obesity is widely prevalent, leads to a myriad of personal and social burdens and, once developed, is difficult to treat, experts emphasize the need for prevention. Among the recommended strategies enumerated in the NIH Strategic Plan for Obesity Research are interventions that target developmental periods of high risk and seek to modify known risk factors for obesity development. Young adulthood represents a developmental period of special risk for weight gain and obesity. Binge eating (overeating with loss of control) is an important modifiable risk factor for obesity development. Binge eating is common in young adults across gender and race/ethnicity groups: about 10% report binge eating at least 1/week. Nationally, about 40% (> 12 million) of 18- to 24- years-olds attend college, making colleges an opportune environment for reaching at-risk individuals. Consistent with the goals of the R15 mechanism, this application proposes to a) gather pilot data about the feasibility, acceptability, and efficac of an evidence-based, peer-guided self-help (PGSH) program targeting binge eating to prevent student weight gain; b) develop research and intervention materials that are suited in content and delivery to the college lifestyle; and c) provide meaningful research involvement for undergraduates. To achieve these aims, we propose a randomized clinical trial testing the efficacy of an eight-session PGSH program targeting binge eating regarding two primary outcomes (cessation of binge eating and change in BMI since randomization) and several secondary outcomes at post-treatment and a six- month follow-up. We plan to recruit men and women from a community college (50%) and a four-year college for randomizing 132 students who report recurrent binge eating into PGSH or pure self-help treatment. Primary outcomes will be measured with rigorous interview (binge eating) and objective (BMI) measures. Program materials will be adapted to reflect an integration of strategies from the obesity and eating disorder fields regarding healthy eating. Upper-class undergraduates will undergo rigorous research training and serve as peer assessors or guides on the study. As an initial step toward our longer-term interest in dissemination/implementation research, this proof of concept study also will examine fidelity of the peer-administered intervention and participants' satisfaction wit PGSH. The innovation derives from applying a proven binge eating treatment to a new target, weight gain prevention; adapting the treatment to peer guidance, a mode of delivery conducive to uptake and broad implementation across campuses; tailoring program content to address unhealthy eating patterns common among college students; and including community college students, a population largely ignored in prior obesity prevention research. Our study will advance public health by creating an evidence-based, targeted, and scalable, highly disseminable obesity prevention program and by educating undergraduate students in health behavior research and evidence based interventions. PUBLIC HEALTH RELEVANCE: This research generates feasibility, acceptability and efficacy data for a peer-guided self-help program targeting binge eating, a modifiable risk factor for obesity development, to prevent weight gain in college students. Young adults are a high risk group for excess weight gain and binge eating is common in this age group (~10%). Annually, over 12 million 18 to 24-year-olds attend college, making colleges an ideal environment for reaching large numbers of at-risk individuals. The proposed work advances public health by developing and evaluating a new strategy for targeted prevention of obesity in young adults who binge eat, a group especially likely to experience rapid and significant weight gain.