3 - (SYM 118) Identifying the Social Determinants of Intuitive Eating: Using Qualitative Data to Inform Intervention Development

Accumulating evidence demonstrates that intuitive eating (IE; eating guided by hunger and fullness cues) is associated with favorable psychological and physical health outcomes and health-promoting behaviors. Therefore, there is increasing interest in IE as a promising behavioral intervention to address eating-related concerns. However, despite abundant evidence that IE predicts positive outcomes, there is comparatively little research on what factors predict IE. Further, the generalizability of existing data is severely limited by the reliance on overwhelmingly White, cisgender female samples. Therefore, our recent quantitative work sought to identify social determinants of IE in a diverse, population-based sample. We found that lower socioeconomic status and experiencing food insecurity were short- and long-term barriers to IE, further underscoring the need for greater representation within this research base. To build on our work, we conducted a mixed-methods study to identify how social, cultural, and environmental factors intersect with aspects of identity to promote and obstruct the practice of IE. Young adults (N=32; M=27.6 years) from the longitudinal Project EAT (Eating and Activity Over Time) 2010-2018 studies were recruited. The sample identified as 34.4% East Asian (n=11), 15.7% Black (n=5), 6.3% Latinx (n=2), 12.5% Multiracial (n=4) and 31.3% White (n=10). Half were cisgender women (n=16), 21.9% cisgender men (n=7), 3.1% transgender men (n=1), and 15.7% were gender fluid/expansive/non-binary (n=5). A quarter of participants were food insecure in the last year (n=8). Most were employed (96.9%; n=30) and earned less than $50,000 annually (78.1%; n=25); 15.6% (n=5) reported earning below $15,000 annually. All participants completed an individual interview and online surveys assessing IE, appearance ideal internalization, social media use, racial/weight discrimination, internalized weight stigma, and race-related stress. Qualitative data are being analyzed by a research team diverse in age and race (n=3) using reflexive thematic analysis (RTA). Established guidelines for RTA are being followed, which includes a six-phase iterative approach to identify patterns in the data. Descriptive quantitative data will be integrated to enrich qualitative findings. Analyses will be completed prior to the ABCT 2023 meeting. Findings will directly inform the development of a multi-level intervention designed to reduce barriers to practicing IE at the social and structural levels and promote IE at the individual level.