Bulimia nervosa (BN) onsets in adolescence, impacts adolescent girls at increased rates relative to boys, and is associated with significant mental health comorbidities and increased risk for medical complications and mortality. BN occurs at equivalent rates across all demographic groups in the United States, and sexual minority adolescents are at increased risk relative to heterosexual peers. The significant barriers to evidence based treatment for BN are increased for historically marginalized adolescents. Restrictions related to the COVID-19 pandemic exacerbated risk for BN in adolescent girls. The goals of this project are to improve the detection of BN, intervention for BN, and implement sustainable strategies for detection and intervention in Fairfax County VA following increased need after the pandemic restrictions. Our research team has expertise in the etiology and treatment of BN (Dr. Fischer), in adolescent treatment development and implementation (Dr. Esposito-Smythers), and in culturally responsive assessment, treatment engagement, and implementation (Dr. Sanchez). We have already established a strong, collaborative community partnership with our stakeholders (Healthy Minds Fairfax, (including administrators and clinicians at our community mental health centers) the Fairfax Consortium for Evidence Based Practice, Project Echo, and Fairfax County Public Schools) over the past five years and thus are poised to begin work on providing evidence based assessment and intervention for BN to the underserved adolescents in our community. Our approach is consistent with a deployment focused intervention development model, in which we will collaborate with our community partners to develop and implement our detection, assessment, and intervention strategies directly within their systems of care serving historically marginalized adolescent girls. Our primary intervention for risk factors and symptoms of BN is a cognitive behavioral transdiagnos
tic treatment adapted for use in community mental health centers. After further developing outreach, assessment, and intervention materials with our partners, we will compare the effectiveness of the intervention to usual care within our community mental health centers. In the final phase of the project, we will work with partners to create a plan for sustainable implementation.