Eating Disorders
Conditions
Brief summary
The purpose is to evaluate a technologically-enhanced, guided self-help program to reduce eating disorder outcomes in college-age women.
Detailed description
Colleges are faced with an elevated prevalence of eating disorders, yet less than 20% of students report receiving treatment. Inadequacies in mental health care delivery result in prolonged illness, disease progression, poorer prognosis, and greater likelihood of relapse, highlighting the need for improved modalities for screening and intervention. Over the past 20 years, we have developed a comprehensive, online platform through which we identify and offer tailored evidence-based interventions to individuals across the eating disorder risk and diagnostic spectrum, using minimal person-based resources. The newest intervention in our suite of programs, Student Bodies-Eating Disorders (SB-ED), has not yet been tested in a large-scale trial or via platform delivery. The aim of this study is to conduct the first national deployment of our comprehensive platform and demonstrate that our transdiagnostic guided self-help program, SB-ED, yields measurable and significant improvements in access, costs, and outcomes for eating disorder treatment over referral to usual care (i.e., treatment per protocol at students' corresponding college's mental health services center). Twenty-eight colleges will be randomly assigned to receive either SB-ED or referral to usual care. We will enroll at least 650 students from these campuses who screen positive for a DSM-5 clinical or subclinical eating disorder (excluding anorexia nervosa, which warrants more intensive medical monitoring). Outcomes will be measured at 6-months, 1-year, and 2-years following the completion of the online screen.
Interventions
BEHAVIORALStudentBodies - Eating Disorders
The intervention is a structured, cognitive-behavioral guided self-help program, derived from manual-based cognitive-behavioral therapy. The intervention targets the core eating disorder pathology (e.g., extreme dietary restraint, overvaluation of shape and weight, binge eating, compensatory behaviors), focusing on helping users develop regular eating patterns, self-control strategies, problem-solving skills, and relapse prevention tools for maintenance of behavior change. The program includes daily symptom checklists, journal exercises and activities, and an asynchronous moderated online discussion group.
Sponsors
National Institute of Mental Health (NIMH)
Stanford University
Washington University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* Student at a participating college or university ages 18-30 * Screen positive for DSM-5 bulimia nervosa, binge eating disorder, or a subclinical eating disorder
Exclusion criteria
* Screen positive for DSM-5 anorexia nervosa * No access to the internet * Acutely suicidal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in eating disorder symptoms | Measured at baseline, 6-months, 1-year, and 2-years | Eating disorder outcomes will be measured using the Eating Disorder Examination Questionnaire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Realized treatment access | 2 years | Realized treatment access is defined as receipt of eating disorder treatment and will be measured using medical records (when available) and a Health Care Utilization Questionnaire |
| Eating disorder behavior abstinence rates | 2 years | Rates of bingeing and purging will be measured using the Eating Disorder Examination Questionnaire |
| Comorbid symptom severity and impairment | 2 years | Symptom Severity includes depression, anxiety, alcohol use, eating disorder associated clinical impairment, and academic impairment. These symptoms will be measured using the Patient Health Questionnaire, the PROMIS anxiety questionnaire, an assessment of binge drinking, the Counseling Center Assessment of Psychological Symptoms, the Clinical Impairment Assessment, and academic transcripts (when available). |
| Service and implementation costs | up to 5 years | Service and implementation costs will be assessed based on published rates. |
Outcome results
None listed