The efficacy of an eHealth prevention and early intervention program targeting eating disorder symptoms in adults.

Web- and app-based Interventions for Reducing Eating Disorders (WIRED) project are developing a 10-week individual intervention, delivered via our smartphone app. The 10-week app-based intervention (titled SEED) includes text, audio, and visual content adapted from the research team’s prior trials: (i) cognitive behavioural techniques (including dissonance techniques) to challenge disordered eating thought patterns and encourage healthy lifestyle choices to supplant eating disorder (ED) behaviours; (ii) psycho-education about healthy eating and exercise habits and dangers of EDs; (iii) media literacy development to reduce social media influence on ED symptoms; and (iv) acceptance and mindfulness relaxation to disrupt the influence of negative mood on binge eating. In total, there will be 8 modules of content, each expected to take about 1-2 hours per week to complete. Our study is an RCT with three arms: waitlist control, WIRED-matched, and WIRED self-guided. Our study involves three phases: Phase 1 involves self-report measures via a web-based survey (hosted by Qualtrics) and a phone interview to confirm level of eating disorder symptoms. The phone interview will be conducted by a research assistant who has been trained by clinical staff within the team to use the screening interview tool. The initial interview will last approximately 15-30 minutes. Phase 2 is the 10-week intervention with three arms: (1) waitlist control, (2) self-guided use of the app intervention, and (3) matched / guided app use based on symptom profile at baseline. Adherence to the app will be monitored automatically through the app. If participants have not used the app within a specific time period (e.g., 1-week), the app will send a notification to the participant to prompt them to use the app. Phase 3 involves completing the baseline survey again immediately post-intervention, and at 6- and 12-months post-intervention to observe maintenance and continued improvement in symptom reduction. At each of these timepoints, participants will also receive a phone call check-in with a research assistant on the project to see how they are going, and to remind them to complete the current survey. At the immediate post-intervention point, this phone call will also involve reassessment of ED symptom levels. The immediate post-intervention phone interview will be shorter than the baseline interview, taking approximately 10-15 minutes. The check-in phone calls at 6- and 12-month follow-up will likely be very brief as they’re primarily used to remind the participant to complete the online survey. The intervention content is the same for both the WIRED-matched and WIRED-self-guided arms, though the order and prioritisation of content will be different as WIRED-matched tailors the content delivery to most pressing needs based on symptoms at baseline.