Midcareer award in patient-oriented research: Ambulatory Study of Stress, Eating, and Reactivity in Teens (Project ASSERT)

About This Grant

PROJECT SUMMARY ABSTRACT Overweight and obesity are complex, multifactorial health conditions that affect >30% of adolescents and are associated with severe adverse physical and psychosocial health consequences, including markers of cardiovascular disease (CVD) and elevated risk for eating disorders. Advancing understanding of the complex associations between eating, weight, and cardiometabolic health requires interdisciplinary team-based science, cutting edge methodology, and new cohorts of well-trained early career scholars who can bring fresh approaches and perspectives to the field. This application for a NHLBI Midcareer Award in Patient-Oriented Research is led by Andrea Goldschmidt, Ph.D., a clinical psychologist whose research lies at the intersection of obesity and eating disorders and whose mentorship history reflects a sustained commitment to training the next generation of clinical researchers studying eating and weight. The proposal leverages her expertise in ambulatory assessment of maladaptive eating behaviors in youth with overweight/obesity to broaden her conceptualization of the inter- and intra-personal context in which these behaviors occur. The career development goals will allow her to: 1) deepen her understanding of the pathophysiology and assessment of stress, particularly negative weight-based interpersonal and environmental stressors and associated cognitions, which have been poorly integrated into existing etiological models of maladaptive eating and weight gain in youth; 2) translate her mechanistic findings to the development of personalized intervention approaches with high potential for scale; and 3) enhance the quality and scope of her mentorship activities by supporting protected time to provide trainees with more hands-on experiential training, and mentor scholars whose research backgrounds less directly align with hers, but whose unique skills and perspective could enrich her research program and advance translational research on eating and weight. The training environment offers exceptional resources for early- and mid-career scholars and is home to internationally recognized experts in health psychology and personalized medicine. The research project directly aligns with the career development goals and will serve as a vehicle for Dr. Goldschmidt and her trainees to apply new learning in ambulatory measurement of stress and trial emulation to inform future just-in-time adaptive interventions (JITAIs) targeting maladaptive eating. Aims are to assess variability in negative weight-based experiences (NWEs, reflected in both interpersonal/environmental events and internal, self-directed cognitions) naturalistically and in real-time among adolescents with overweight/obesity; evaluate the impact of NWEs on acute physiological, behavioral, and affective stress response and on weight change and cardiometabolic health outcomes over one year; and estimate the effects a JITAI would have had on weight and cardiometabolic health if it had included strategies targeting NWEs and their physiological, behavioral, and affective consequences. Overall, the K24 project will help build capacity for emerging scholars who will carry out the mission of NHLBI over the coming decades.