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Bauer S, Bilić S, Ozer F, Moessner M. Dissemination of an Internet-Based Program for the Prevention and Early Intervention in Eating Disorders. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 48:25-32. [PMID: 31050585 DOI: 10.1024/1422-4917/a000662] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Research on the dissemination of e-mental health interventions is in an early stage, so that little is known about the reach, costs, participant characteristics, and patterns of program utilization associated with different recruitment strategies and access paths. This study investigated differences between user groups informed about an Internet-based program for the prevention and early intervention in eating disorders via different recruitment channels. Method: Participant characteristics and user behavior of 3548 participants in the Internet-based program ProYouth were analyzed. Participants were informed about ProYouth via different channels (e. g., print materials, high school, Internet). Results: Results indicate significant relationships between access paths and both user characteristics and program utilization. Participants who were informed about ProYouth at their high schools were more likely to be male, younger, and at lower risk of developing eating disorders. In contrast, other recruitment channels (e. g., Internet, print materials) resulted in participants with significantly higher risk and symptom levels who used the program more frequently and with higher intensity. Conclusion: Efforts aimed at the dissemination of Internet-based interventions should consider the effects that different recruitment channels and access paths may have on sample composition and utilization of the intervention.
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Affiliation(s)
- Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
| | - Sally Bilić
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
| | - Fikret Ozer
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
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2
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Forrest LN, Smith AR, Swanson SA. Characteristics of seeking treatment among U.S. adolescents with eating disorders. Int J Eat Disord 2017; 50:826-833. [PMID: 28323350 DOI: 10.1002/eat.22702] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/20/2017] [Accepted: 02/26/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The majority of persons with eating disorders (EDs) do not seek ED treatment, yet little is known about treatment-seeking barriers or facilitators. The aim of the study is to describe the characteristics associated with seeking ED treatment among U.S. adolescents with EDs. METHOD Data from a nationally representative cross-sectional study of U.S. adolescents ages 13-18 years were used for these analyses. Specifically, adolescents who met criteria for lifetime EDs (N = 281) were included. Sociodemographic information, characteristics of EDs, psychiatric comorbidities, and other mental health service use were assessed via interview. RESULTS Only 20% of adolescents sought ED treatment. Females were 2.2 (95% CI 0.8, 6.4) times more likely to seek treatment than males (19.9% vs. 8.9%). Adolescents who met criteria for anorexia nervosa or bulimia nervosa were 2.4 (95% CI 0.9, 6.3) and 1.9 (95% CI 1.0, 3.8) times more likely to seek treatment than adolescents who met criteria for binge-eating disorder (27.5% and 22.3% vs. 11.6%). Specific ED behaviors (restriction and purging), ED-related impairment, and any mental health service use were also associated with adolescent treatment seeking. DISCUSSION Adolescent treatment seeking was infrequent overall, with individuals with counter-stereotypic ED presentations least likely to have sought treatment. Adolescent treatment seeking could be promoted through increasing awareness among the public and healthcare professionals that EDs affect a heterogeneous group of people. More generally, research involving both treatment-seeking and non-treatment-seeking individuals holds great potential to refine the field's knowledge of ED etiology, prevalence, treatment, and prevention.
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Affiliation(s)
| | - April R Smith
- Department of Psychology, Miami University, Oxford, Ohio
| | - Sonja A Swanson
- Erasmus MC, Rotterdam, The Netherlands.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Kass AE, Jones M, Kolko RP, Altman M, Fitzsimmons-Craft EE, Eichen DM, Balantekin KN, Trockel M, Taylor CB, Wilfley DE. Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses. Eat Behav 2017; 25:74-80. [PMID: 27090854 PMCID: PMC5042805 DOI: 10.1016/j.eatbeh.2016.03.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/16/2016] [Accepted: 03/22/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. METHODS 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. RESULTS Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. CONCLUSIONS Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students.
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Affiliation(s)
- Andrea E. Kass
- Department of Medicine, The University of Chicago, Chicago, IL, USA,Corresponding author at: Department of Medicine, The University of Chicago, 5841 S. Maryland Avenue, MC 1000, Chicago, IL 60637, USA. (A.E. Kass)
| | - Megan Jones
- Lantern, San Francisco, CA, USA,Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Rachel P. Kolko
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Myra Altman
- Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Dawn M. Eichen
- Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | | | - Mickey Trockel
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - C. Barr Taylor
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA,Center for mHealth, Palo Alto University, Palo Alto, CA, USA
| | - Denise E. Wilfley
- Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Bauer S, Kindermann SS, Moessner M. [Prevention of eating disorder: a review]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2016; 45:403-413. [PMID: 27951744 DOI: 10.1024/1422-4917/a000506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Eating disorders are severe mental illnesses that are challenging to treat and often follow a chronic course. They are associated with
immense impairment on the psychological, physical, interpersonal, and social level as well as signifi cant direct and indirect cost. Therefore,
prevention and early intervention are of utmost importance. Based on a qualitative literature review, we summarized the empirical evidence for
the effi cacy of universal and selective prevention of eating disorders. Programs available in German and/or English were included in the review.
In addition to research on effi cacy and effectiveness, the areas of implementation, dissemination, and reach were identifi ed as key issues for
future studies. Furthermore, more research is needed on the relationship of cost, benefi t, and risks of eating disorder prevention.
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Affiliation(s)
- Stephanie Bauer
- 1 Forschungsstelle für Psychotherapie, Universitätsklinikum Heidelberg
| | | | - Markus Moessner
- 1 Forschungsstelle für Psychotherapie, Universitätsklinikum Heidelberg
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McInroy LB. Pitfalls, Potentials, and Ethics of Online Survey Research: LGBTQ and Other Marginalized and Hard-to-Access Youths. SOCIAL WORK RESEARCH 2016; 40:83-94. [PMID: 27257362 PMCID: PMC4886272 DOI: 10.1093/swr/svw005] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 08/30/2015] [Accepted: 09/08/2015] [Indexed: 05/08/2023]
Abstract
Online research methodologies may serve as an important mechanism for population-focused data collection in social work research. Online surveys have become increasingly prevalent in research inquiries with young people and have been acknowledged for their potential in investigating understudied and marginalized populations and subpopulations, permitting increased access to communities that tend to be less visible-and thus often less studied-in offline contexts. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) young people are a socially stigmatized, yet digitally active, youth population whose participation in online surveys has been previously addressed in the literature. Many of the opportunities and challenges of online survey research identified with LGBTQ youths may be highly relevant to other populations of marginalized and hard-to-access young people, who are likely present in significant numbers in the online environment (for example, ethnoracialized youths and low-income youths). In this article, the utility of online survey methods with marginalized young people is discussed, and recommendations for social work research are provided.
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Affiliation(s)
- Lauren B McInroy
- is a PhD candidate, Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4 Canada
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Brownlow RS, Maguire S, O'Dell A, Dias-da-Costa C, Touyz S, Russell J. Evaluation of an online training program in eating disorders for health professionals in Australia. J Eat Disord 2015; 3:37. [PMID: 26550477 PMCID: PMC4636783 DOI: 10.1186/s40337-015-0078-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/02/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Early detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals-representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery. METHODS One-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants' levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders. RESULTS Significant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about eating disorders. DISCUSSION The results of this study demonstrated that the online training program was an effective tool in increasing health professionals' level of knowledge, skill and confidence to treat people with eating disorders. The results also demonstrated that online training reduced health professionals' personal bias towards people with eating disorders. Limitations of this study include the use of self-report measures rather than observation of the health professional in clinical practice. As a result, it is not possible to make determinations regarding the translation of these results to clinical settings. CONCLUSIONS The findings of this study suggest that online training programs may present an innovative solution to the considerable workforce development challenges faced by clinicians needing training in eating disorders.
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Affiliation(s)
| | | | - Adrienne O'Dell
- The Centre for Eating and Dieting Disorders, Sydney, NSW Australia
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Kass AE, Trockel M, Safer DL, Sinton MM, Cunning D, Rizk MT, Genkin BH, Weisman HL, Bailey JO, Jacobi C, Wilfley DE, Taylor CB. Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help. Behav Res Ther 2014; 63:90-8. [PMID: 25461783 DOI: 10.1016/j.brat.2014.09.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 09/02/2014] [Accepted: 09/23/2014] [Indexed: 02/06/2023]
Abstract
Student Bodies, an internet-based intervention, has successfully reduced weight/shape concerns and prevented eating disorders in a subset of college-age women at highest risk for an eating disorder. Student Bodies includes an online, guided discussion group; however, the clinical utility of this component is unclear. This study investigated whether the guided discussion group improves program efficacy in reducing weight/shape concerns in women at high risk for an eating disorder. Exploratory analyses examined whether baseline variables predicted who benefitted most. Women with high weight/shape concerns (N = 151) were randomized to Student Bodies with a guided discussion group (n = 74) or no discussion group (n = 77). Regression analyses showed weight/shape concerns were reduced significantly more among guided discussion group than no discussion group participants (p = 0.002; d = 0.52); guided discussion group participants had 67% lower odds of having high-risk weight/shape concerns post-intervention (p = 0.02). There were no differences in binge eating at post-intervention between the two groups, and no moderators emerged as significant. Results suggest the guided discussion group improves the efficacy of Student Bodies in reducing weight/shape concerns in college students at high risk for an eating disorder.
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Affiliation(s)
- Andrea E Kass
- Department of Psychology, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA
| | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC 5722, Stanford, CA 94305, USA
| | - Debra L Safer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC 5722, Stanford, CA 94305, USA
| | - Meghan M Sinton
- Department of Psychology, The College of William and Mary, Integrated Science Center, Room 1223, P.O. Box 8795, Williamsburg, VA 23187, USA
| | - Darby Cunning
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC 5722, Stanford, CA 94305, USA
| | - Marianne T Rizk
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA
| | - Brooke H Genkin
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA
| | - Hannah L Weisman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC 5722, Stanford, CA 94305, USA
| | - Jakki O Bailey
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC 5722, Stanford, CA 94305, USA
| | - Corinna Jacobi
- Technische Universität Dresden, Klinische Psychologie und Psychotherapie, Chemnitzer Str. 46, D-01187 Dresden, Germany
| | - Denise E Wilfley
- Department of Psychology, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA; Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA.
| | - C Barr Taylor
- Department of Psychology, The College of William and Mary, Integrated Science Center, Room 1223, P.O. Box 8795, Williamsburg, VA 23187, USA
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