The overarching goal of our work is to identify neuropsychological and behavioral economic processes that influence health behavior, and leverage this knowledge to prevent obesity-related disease. Current projects examine behavioral mechanisms underlying socioeconomic differences in obesity risk, and test whether recreational activity is a potential substitute for unhealthy behaviors. Our work relies on several methodologies that allow us to probe relevant influences on health behavior, including ecological momentary assessment, lab-based and ambulatory cognitive assessments, behavioral economic measures of demand and discounting, and RCT designs.
Principal Investigator:
Brad Appelhans, PhD
Associate Professor
Current Projects
Activity and Recreation in Communities for Health (ARCH)
ARCH evaluates a novel intervention aimed at reducing the burden of depression and cardiometabolic disease in underresourced communities. Grounded in Behavioral Activation and Reinforcer Pathology models, ARCH is designed to promote engagement in recreational and social activities offered through our partnering community-based organizations, as well as activities done independently at home. ARCH is delivered in participants’ homes and community venues by a health outreach workforce, which addresses barriers to accessing treatment. The trial compares ARCH to a traditional health outreach program on the outcomes of change in depressive symptoms, adiposity, and physical activity. In addition to clinical outcomes, key metrics of program uptake, cost, and feasibility will be collected.
Recruiting status: Open to enrollment (by invitation)
Responses to Behavioral Obesity Treatment (REBOOT)
Behavioral weight loss interventions focused on dietary modification, physical activity, and behavior change strategies are the first-line treatment for obesity. These interventions can produce clinically meaningful weight loss, and reduce risk for heart disease, diabetes, and other health problems. But, a significant proportion of participants do not respond to these programs. The REBOOT study tests several mechanisms that may account for the variability in weight loss outcomes among adults enrolled in a 6-month, standard-of-care weight loss intervention, including the impact of daily experiences of stress, cognitive challenges, and scarcity on the thinking abilities needed to adhere to weight loss recommendations.
Recruiting status: Open to enrollment
Contact information: EatingLab@rush.edu or call 312-942-8260
Past Projects
Creating Healthy Environments for Chicago Kids (CHECK)
Children from low-income families are more than twice as likely to become obese than those from higher-income households, which places them at increased risk for obesity-related chronic diseases throughout their adult lives. Family-based pediatric obesity interventions, particularly those designed for low-income populations, are increasingly delivered in children’s homes. This randomized trial directly tests whether delivering family-based behavioral interventions for pediatric overweight/obesity in the home setting improves weight loss outcomes in low-income children relative to medical center-based treatment. The trial will also quantify the cost-effectiveness of home visitation, and explore the mechanisms accounting for observed treatment effects.
A National Trial of the ELM Lifestyle Program and Remission of the Metabolic Syndrome
This is a multi-site randomized controlled trial of a lifestyle intervention designed to reverse the metabolic syndrome. The trial is led by Dr. Lynda Powell, and funded by the William G. McGowan Charitable Fund. The project will enroll up to 600 patients with metabolic syndrome at 5 sites in different regions of the U.S. The primary outcomes are reversal of the metabolic syndrome at 2 years, and cost-effectiveness of the group-based lifestyle intervention relative to a self-directed intervention.
Circadian and Sleep Pathways to Cardiometabolic Disease Risk: Role of Neurobehavioral Processes
This project, which is led by a colleague at University of Utah, investigates how disruptions in the body’s internal 24-hour sleep wake rhythms affects obesity and diabetes risk. We are interested in understanding how disrupted rhythms along with short sleep duration affects eating behavior behaviors (e.g. decreased ability to withstand temptation), metabolism and weight gain over a 12-month period.
Delays to Influence Snack Choice (DISC)
This project tested whether applying a brief time delay to the sale of less healthy vending machine snacks can nudge people to choose healthier options. We designed a patented vending machine system that selectively delayed unhealthy vending machine sales by 25 seconds. Healthy snacks vended immediately, with no delay. Our analysis of over 32,000 vending machine sales showed a small but reliable increase in healthy snack purchasing when less healthy snacks were delayed. Importantly, time delays did not harm overall vending sales or revenue, which is relevant to the real-world feasibility of this intervention.
Study of Household Purchasing Patterns, Eating, and Recreation (SHoPPER)
In this project, we used a novel protocol that involved home visitation, receipt collection, and photographic documentation to quantify the nutritional content of household food purchases in over 200 Chicago households. We found that food purchases do in fact provide a valid estimate of the nutritional content of individuals’ diets. We observed meaningful socioeconomic differences in food purchasing patterns, with lower-income households purchasing less healthful items. Finally, we found that individual differences in the ability to delay gratification were related to the nutritional content and energy density of food purchases, which has implications for obesity risk and cardiometabolic health.