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

解决年轻人体重过重和糖尿病前期健康差异的多维方法

• 批准号: 10556582
• 负责人: Cherise Baldwin Harrington
• 金额: $ 47.42万
• 依托单位: NORTH CAROLINA CENTRAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-20 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10556582
• 关键词: Address; Adult; African American; African American population; Age; Amputation; Behavior; Behavioral; Belief; Biological Markers; Black American; Black race; Body Weight; Body Weight decreased; Body mass index; COVID-19 pandemic; Calories; Cardiovascular Diseases; Chronic Disease; Communities; Consultations; Control Groups; Data; Development; Diabetes Mellitus; Education; Effectiveness; Environment; Environmental Risk Factor; Face; Feedback; Grant; Health; Health Care Costs; Health Disparities Research; Health Promotion; Health behavior; Healthy Eating; Historically Black Colleges and Universities; Individual; Intervention; Intervention Trial; Kidney Diseases; Lead; Life; Life Style; Link; Longevity; Measures; Mediating; Metabolic; Minority-Serving Institution; Monitor; Non-Insulin-Dependent Diabetes Mellitus; North Carolina; Not Hispanic or Latino; Obesity; Online Systems; Outcome; Overweight; Persons; Phase; Physical activity; Physiological; Population; Postpartum Women; Prediabetes syndrome; Process; Randomized Controlled Trials; Reporting; Research; Resources; Risk; Risk Behaviors; Risk Factors; Site; Sleep Deprivation; Social Environment; Social support; Source; Stress; Students; Support Groups; Techniques; Technology; Testing; Text Messaging; Time; Trust; Universities; Visual impairment; Waiting Lists; Weight; Weight Gain; Weight maintenance regimen; Woman; Work; active lifestyle; aged; allostatic load; attentional control; base; behavior change; college; comparison intervention; critical period; density; design; diabetes prevention program; digital; disability; dosage; efficacy testing; efficacy trial; ethnic diversity; evidence base; experience; group intervention; health disparity; health literacy; healthy weight; implementation trial; improved; indexing; innovation; intergenerational; lifetime risk; mHealth; moderate-to-vigorous physical activity; mortality; novel; nutrition; nutrition related behavior; obesity risk; peer; postpartum weight; programs; psychosocial; racial diversity; resilience; social; social cohesion; social factors; social media; sociodemographics; stress management; success; theories; university student; web-based intervention; weight loss intervention; young adult

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.

项目摘要 /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，并且是领先的驱动力 医疗保健费用上涨。特别关心的是年轻人过渡到大学，因为他们更容易 与不上大学的同龄人相比，体重增加。这种体重增加归因于营养不良 并减少体育锻炼。此外，参加少数派服务机构（MSI）/历史上的年轻人 黑人学院或大学（HBCU）经历了一些独特的障碍和促进者，以促进健康促进 努力。解决大学环境中的健康行为是建立弹性，能力的机会 并在成年期的关键时期提高健康素养。全面的方法对于 研究社会环境之间的关系，一个人生活和工作的社区， 个人的个人信念和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措施方面已经成功。 程序在使用行为技术时报告了更明显的效果大小（即量身定制的反馈，自我 与仅基于互联网的干预措施相比，监视）。因此，为了增加买入和可持续性， 有必要开发和评估非裔美国人/黑色（AA/B）年轻人的减肥干预措施 使用以文化量身定制和基于社区的策略。解决与体重控制相关的障碍 在高危人群中，研究改编了强化糖尿病预防计划（DPP），包括一项试验 AA/黑人产后妇女。 Befab是一种新颖的数字产后体重管理干预措施，设计了 并以前已测试。旗舰Befab计划为超重和肥胖的AA女性服务，并且在文化上是 特定，量身定制，易于使用，参与并将其作为值得信赖的来源。在支持和咨询 拟议的研究基于支持Befab可行性的证据，并试图寻求原始的研究。 适应年轻人人口并进行疗效试验。该功效试验将1）整合Befab-HBCU 对于参加北卡罗来纳州达勒姆市MSI的年轻人，2）评估其对体育活动相关的影响 在12个月内，与营养相关的行为改变，体重减轻，生物标志物和压力管理结果。 该项目的第1阶段包括适应和发展阶段。第2阶段包括实施 和干预的功效试验。这项研究将建立社区顾问委员会（CAB）并进行 北卡罗来纳州达勒姆市及其周边地区的社区环境评估包括资产地理图 和风险因素。在北卡罗来纳州达勒姆市HBCU进行的试验将检查BEFAB-HBCU处理的效果 （MHealth综合干预措施，包括基于网络的社交媒体，SMS/文本消息，社区 与注意力控制/延迟候补列表对照组相比，支持和小组活动）包括 一般营养和体育锻炼含量，关于体重和生物标志物在4时间点上。