# Clinical Trial of the Fit Families Multicomponent Obesity Intervention for African American Adolescents and Their Caregivers: Next Step from the ORBIT Initiative

> **NIH NIH R33** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2022 · $215,800

## Abstract

PROJECT SUMMARY/ABSTRACT. Obesity is a significant public health concern among all racial/ethnic
groups, ages, gender, and geographic areas, but some groups are more disproportionately affected than others.
Ethnic minority adolescents, especially AAs, are disproportionately likely to be obese relative to non-Hispanic
White adolescents.29,30 The proposed study is designed to improve a comprehensive multicomponent family-
based behavioral intervention (FIT Families) delivered by Community Health Workers (CHWs; therapists) for
African American (AA) adolescents with obesity (AAAO). This application expands a program of research that
has followed the Obesity Related Behavioral Intervention Trials (ORBIT) for developing behavioral treatments,31
by capitalizing on our recent work using innovative artificial intelligence technologies to thoroughly examine
within-session therapy processes (i.e., mechanisms of action), specifically the role of CHW empathy in the
development and maintenance of the therapeutic alliance (TA) while treating AAAO and their primary caregivers.
TA is considered an essential element of therapy.32 The TA is composed of three features: 1. Emotional bond
between therapist and client; 2. Agreement between the client and therapist on the goals of treatment; and 3.
Agreement on the tasks of therapy.33 TA is a dynamic, bidirectional, and synergistic element of therapy with
implications across differences in race, age, and gender of the client and therapist. Therapist empathy is critical
in establishing and maintaining a strong TA, with outcomes mediated by the therapeutic alliance. Empathy
accounts for more variance in therapy outcome than specific interventions34 and consistently predicts client
change.35 Unfortunately, analysis of crucial facilitative interpersonal skills such as therapist empathy is
technically challenging as the intent of another's behavior is nuanced, contextual (e.g., therapists and client differ
in personality, background, cultural values, etc.), and interactive (bidirectional and synergistic); and can be
expressed in multiple ways (voice tone, physiology]). To better understand empathy, requires empirical
approaches and analytical tools that can discern empathetic behaviors in actual clinical encounters that produce
behavior change. We will operationalize empathy through two measures that are each associated with empathy
and treatment outcomes: 1) Empathic accuracy, defined as the CHW's accurate understanding of the client's
state; and 2) Interpersonal physiological synchrony (IPS), defined as the correlation between therapist and client
IPS over time (i.e., heart rate [HR], HR variability, galvanic skin response, voice features). This study uses these
two empathy measures to understand the relationship between empathy, therapeutic alliance, and treatment
outcomes. Further, the study will explore how empathy effects change based on the race and gender
concordance/discordance of therapist-client dyads. Toward futu...

## Key facts

- **NIH application ID:** 10666990
- **Project number:** 3R33HL155793-02S1
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** PHILLIPPE Belton CUNNINGHAM
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $215,800
- **Award type:** 3
- **Project period:** 2022-09-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10666990

## Citation

> US National Institutes of Health, RePORTER application 10666990, Clinical Trial of the Fit Families Multicomponent Obesity Intervention for African American Adolescents and Their Caregivers: Next Step from the ORBIT Initiative (3R33HL155793-02S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10666990. Licensed CC0.

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