Binge eating disorder (BED) is a condition associated with significant emotional distress. It is characterized by episodes of eating unusually large amounts of food where the individual experiences a loss of control. These episodes are accompanied by negative emotions such as shame or guilt. BED is frequently associated with obesity, which is a stigmatized state in society. As a newer official diagnosis in the DSM-V, BED is rarely screened for in routine healthcare practice. As the most prevalent eating disorder in the United States and the only one affecting similar proportions of men and women, the lack of screening presents a large gap in healthcare services. Currently, screening for eating disorders, in general, is not standardized and education of healthcare professionals on eating disorders is minimal. This educational intervention study aims to evaluate the effect of providing education on BED to primary care clinicians along with recommendations for using a standardized screening tool in their practice. Investigators provide an hour-long educational intervention and will track provider practices over three months. At the conclusion of the study, we will compare the proportion of patients screened for BED before and after the intervention. We hypothesize that after the intervention, more providers will be screening for BED. At a minimum, positive findings become a starting point for further research to identify the educational needs for primary care clinicians on eating disorder diagnoses.

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Objective. The purpose of these studies was to examine the influence of the SPIN (Strength and Power in Nutrition) nutrition education intervention on the food and beverage purchasing decision-making processes and behaviors of 11-14 year old low-income tweens in "hot" (high emotional stimulation) and "cold" (low emotional stimulation) situations. Methods. Participants were taken to the grocery store and given two dollars to spend on three consecutive weeks before and three consecutive weeks after the intervention. Each participant was given a tape recorder, instructed to think aloud while making their purchase selections, and to write down the reason for their purchases after shopping. Participants returned receipts for their purchases. Tweens shopped alone on weeks one and three and with a friend on week two. They also completed questionnaires on nutrition knowledge and perceived influences on food decision-making both pre- and post-intervention. Setting. The study took place at an after-school program at a Western Massachusetts Boys and Girls Club and a grocery store across the street. Participants. Participants included seventeen ethnically diverse, low-income tweens. However, only twelve out of seventeen completed both qualitative and quantitative assessments. Analysis. Food and beverage decision-making themes and outcomes were compared during various levels of "cold" and "hot" situations using scores on questionnaires (quantitative), nutritional quality of purchases (quantitative) and thematic analysis (qualitative). Results. There were significant differences in NNR (Naturally Nutrient Rich) scores post intervention compared to baseline. There were significant differences in NNR scores between tweens who scored high and those who scored low or did not answer the nutrition attitudes section of the nutrition knowledge survey post-intervention. Certain themes, including cost, health, mood, and taste were similar in both "cold" and "hot" situations, but external influences on purchases, such as peer influence were only present in "hot" situations. Conclusions and Implications. The SPIN intervention resulted in decision-making and behavior change in "hot" situations. There are minor differences in decision-making processes and purchasing behaviors in "hot" and "cold" situations among tweens. Additional studies with larger sample sizes assessing food and beverage purchase decision-making behavior in "hot" versus "cold" situations are needed.

For decades, infant and maternal mortality rates have presented concern within healthcare. Even more alarmingly, infant and maternal mortality rates among African American women are significantly higher than those of non-Hispanic White origin. There are numerous factors that contribute to this disparity including disease and environmental factors. Additionally, lack of intervention prior to conception also contributes to poor birth outcomes and mortality rates. Preconception care identifies and diminishes risk factors that contribute to complications of childbirth and promotes a healthy lifestyle to increase the likelihood of a healthy pregnancy. A useful technological tool that expands access to preconception care is The Gabby Preconception Care System. The Gabby System (TGS) is an online tool that screens African American women for preconception risks through a risk assessment and provides health education and information on behavior changes that could aid in improving outcomes for mother and baby. Eligibility criteria for patients to use the Gabby System includes identifying as Black or African American, female, 18-39 years old, English-speaking, and they are not pregnant at the time of enrollment. After ten years of development, including a pilot and two Randomized Control Trials, The Gabby System was implemented at Healthy Start programs and Community Health Centers across the country. The advantages and disadvantages of the implementation of The Gabby System in community-based sites were evaluated using qualitative data collected from pre-implementation interviews with implementation site staff. The pre-implementation barriers of The Gabby System include the requirement of internet access and maintaining enthusiasm and engagement with the system among participants and staff. The advantages of The Gabby System include feasibility of implementation, ability to provide educational content, and the expansion of educational resources at the sites. Overall, the general sentiment demonstrated by organizational staff is The Gabby System possesses numerous benefits and its implementation at organizational sites has the potential to be advantageous in encouraging comprehensive preconception care as one strategy to address disproportionate infant and maternal mortality in African American communities.

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