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

项目概要/摘要-项目2 肥胖是美国许多可预防的慢性疾病的主要危险因素，也是导致 医疗保健成本上升。特别值得关注的是年轻人过渡到大学，因为他们更容易 与没有上大学的同龄人相比，体重增加了。这种体重增加是由于营养不良 减少体力活动。此外，参加少数民族服务机构（MSI）/历史上 黑人学院或大学（HBCU）经历了几个独特的障碍和促进健康 努力解决大学环境中的健康行为是一个机会， 并在青年期的关键时期提高健康素养。必须采取综合办法， 研究社会环境，一个人生活和工作的社区， 个人的个人信仰，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，程序报告了更显著的效应量（即，定制反馈，自我- 与仅基于互联网的教育干预措施相比，因此，为了提高购买力和可持续性， 有必要为非洲裔美国人/黑人（AA/B）年轻人制定和评估减肥干预措施 利用适合文化的和基于社区的战略。解决与体重控制相关的障碍 在高危人群中，研究已经调整了密集的糖尿病预防计划（DPP），包括一项试验， AA/黑人产后妇女。BeFAB是一种新型的数字化产后体重管理干预措施， 以前测试过。旗舰BeFAB计划为超重和肥胖的AA女性提供服务， 具体、量身定制、易于使用、吸引人，并作为值得信赖的来源。在国际社会的支持和咨询下， 原始BeFAB MPI，拟议的研究建立在支持BeFAB可行性的证据基础上，并寻求 使其适应年轻的成年人群体并进行功效试验。本疗效试验将1）整合BeFAB-HBCU 对于在北卡罗来纳州达勒姆参加MSI的年轻人，2）评估其对身体活动相关的影响， 营养相关的行为变化，体重减轻，生物标志物和压力管理结果超过12个月。 该项目的第一阶段包括适应和发展阶段。第二阶段包括实施 干预效果试验。这项研究将设立一个社区咨询委员会，并进行一项 在北卡罗来纳州达勒姆研究地点及其周围进行社区环境评估，包括资产地理测绘 和风险因素。在北卡罗来纳州达勒姆的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/延迟等待列表控制组相比， 一般营养和体力活动含量，对4个时间点的体重和生物标志物的影响。

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.