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Email UsPrimary and Secondary Prevention of Eating Disorders
In this initiative, sponsored by the Harvard Catalyst Community Engagement Program, Harvard-affiliated faculty were invited to submit applications for pilot grants to support novel research partnerships with the potential to:
- Generate new evidence or methodologies that foster deeper understanding of the primary or secondary prevention of eating disorders or disordered eating, and/or
- Evaluate promising interventions that address the primary and secondary prevention of eating disorders or disordered eating.
The specific research priority areas represented topics covered during the Harvard Catalyst/ STRIPED Symposium entitled Reimagine the Frontier of Public Health Approaches to Eating Disorders Prevention, held on April 30, 2018 and included:
- Effectiveness and Dissemination Studies of Primary and Secondary Preventive Interventions
- Studies Focused on Macroenvironmental Factors
- Translational Research
- Economic and Decision Sciences Research
While proposals that addressed an area of particular interest were encouraged, this was an opportunity to conduct research in all areas of primary and secondary prevention of eating disorders and/ or disordered eating. Three pilots grants were awarded in the amount of up to $50,000 for a one-year period. Funding decisions were announced in December 2018.
Sponsoring Program
Awardees
Principal Investigator: Allegra Gordon, ScD, Boston Children’s Hospital
Co-Investigators: Sari Reisner, ScD, Boston Children’s Hospital Jerel Calzo, PhD, San Diego State University Graduate School of Public Health
Transgender and other gender minority (GM) adolescents and young adults face 2-4 times greater risk of eating disorder symptoms than their cisgender (non-transgender) peers. These health disparities have been linked to appearance ideals, lack of access to gender affirming medical care, and social stressors such as transphobia, racism, and sexism. To mitigate these severe but understudied disparities, it is critical to identify effective primary preventive interventions for eating disorders for GM young people. Cognitive dissonancebased (DB) body image interventions are effective in reducing eating disorder symptoms in cisgender female college students and cisgender gay men but little is known about how DB interventions should be adapted and disseminated to help prevent eating disorders for diverse GM young people. Guided by an Intervention Mapping approach to adapting evidence-based interventions, this formative study will address three specific aims: (1) Identify evidence-based DB interventions and assess fit for GM young people through a literature review and key informant interviews (n=15); (2) Explore relationships between appearance ideals, stigma/resilience, and body image concerns, as well as opportunities for intervention, among GM young adults (ages 18-30 years) using an asynchronous online focus group methodology (n=12 groups) to maximize sample diversity; (3) Informed by Aims 1 and 2 and an expert panel of GM community members, develop tailored materials for a positive body image development intervention for GM young people. Findings from this study will lay the groundwork for future pilot testing, evaluation, and dissemination of intervention materials tailored to the needs of this underserved population.
Principal Investigator: Erica Kenney, ScD, Harvard T.H. Chan School of Public Health
Co-Investigators: Rebekka Lee, ScD, Harvard T.H. Chan School of Public Health
Allegra Gordon, ScD, Boston Children’s Hospital
Gretchen Brion-Meisels, PhD, Harvard Graduate School of Education
This study aims to increase understanding of how youth experience weight stigma in schools. Experiencing weight stigma increases the risk of binge eating disorder and disordered weight control behaviors. Reducing youth weight stigma in school settings could be a crucial population strategy for preventing eating disorders, given how prevalent experiences of weight stigma currently are and given the importance of early intervention. However, in order to research potential population strategies, it is essential to examine lived experiences of weight stigma in schools to inform the conceptualization of youth weight stigma as a construct and develop valid measurement tools. Schools are particularly important for youth prevention efforts given that they reach nearly all youth, that there is epidemiologic evidence that students may be subjected to teacher bias in grading and peer-to-peer bullying, and that many schools have been found to be implementing weight loss programs in the name of public health, potentially exacerbating weight stigma and disordered eating. Using a mixed methods approach, this grant will support us in furthering the research by allowing us to: (1) Explore how school administrators understand weight stigma in schools and how they select obesity prevention programs, by conducting interviews with 12 school administrators; (2) Examine student perspectives of how the school environment, including school-based wellness efforts, impacts weight stigma experiences and interacts with other forms of stigma (e.g., racism, sexism) by conducting 36 key informant interviews with students; and (3) Develop a quantitative measure of weight stigma in school settings based on these formative findings.
Principal Investigator: Fatima Stanford, MD, Massachusetts General Hospital
Co-Investigators: Iyiola Solanke, PhD, Leeds University (UK), School of Law
Allegra Gordon, ScD, Boston Children’s Hospital
Suman Ambwani, PhD, Dickinson College
Erica Kenney, ScD, Harvard T.H. Chan School of Public Health
Josiemer Mattei, PhD, Harvard T.H. Chan School of Public Health
Despite growing evidence of weight discrimination and the impact of weight stigma on eating disorder risk, only Michigan currently targets macro-environmental change with a legal prohibition of weight discrimination. Research suggests that many U.S. adults would support anti-weight discrimination legislation, but the pathways to enacting such legislation remains unclear. Possible implementation barriers may include the political opportunity structure or because anti-discrimination law is premised upon immutability and body management is seen as personal responsibility. This research-to-policy study focuses on anti-weight discrimination law such as the proposed ‘Rushing Bill’ (H.952) in Massachusetts. It employs mixed methods (interviews and surveys) to explore this legislative effort. We posit that state anti-weight discrimination law efforts can be improved by three things: knowledge of the evolution of the Elliot Larsen Act in Michigan; deeper understanding amongst legislators of weight discrimination and its consequences for individual and public health; and a stronger social coalition supporting legislative efforts. To explore these hypotheses, we examine with key stakeholders the evolution of anti-weight discrimination legislation in Michigan and Massachusetts; apply the anti-stigma principle to ascertain perceptions and knowledge amongst legislators in Massachusetts of the experiences of people living in larger bodies; and through these activities support generation of a coalition to facilitate legislative efforts in Massachusetts. We argue that a macro-level tool will help alleviate weight stigma at a societal level and thereby serve as an important tool for preventing eating disorders and promoting health at an individual level.