A clinical trial protocol of a single-session self-guided acceptance-based online intervention targeting food cravings as predictors of disordered eating in pregnant people

BACKGROUND

Pregnancy is a time of heightened risk for disordered eating behaviors, which are linked to adverse health outcomes in gestation, delivery, and the postpartum. These adverse outcomes may be partially mediated by greater rates of deviation from recommended weight gain trajectories, especially in those who engage in binge and loss of control (LOC) eating. Food cravings are powerful and highly modifiable triggers of binge and LOC eating in non-pregnant populations with preliminary evidence linking cravings to disordered eating behaviors in pregnancy as well. Acceptance-based approaches have been shown to be feasible and effective in reducing the adverse impact of cravings on behavior.

PURPOSE

To test the feasibility, acceptability, and preliminary efficacy of a single-session, self-guided, acceptance-based online workshop targeting food cravings as predictors of binge and LOC eating in pregnancy.

METHODS

We will conduct a pilot randomized controlled trial of a single-session, self-guided online acceptance-based workshop targeting food cravings in pregnancy. Pregnant individuals in the second trimester (n ≥ 74) endorsing current food cravings will be randomly assigned to the intervention or an untreated control group. The intervention group will participate in a one-hour workshop that imparts skills grounded in Acceptance and Commitment Therapy, including acceptance, defusion, and present-moment awareness. Both groups will complete comprehensive self-report assessments of primary outcomes and hypothesized mediators and moderators of intervention efficacy at baseline, one-month follow-up, and at full-term.

CONCLUSION

Results will inform integration of acceptance-based skills targeting food cravings into routine prenatal care to prevent adverse outcomes associated with disordered eating behaviors in pregnancy.

TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT06129461; registered on November 10, 2023.

Randomized evaluation of an online single-session intervention for minority stress in LGBTQ+ adolescents

Background

LGBTQ+ youth face myriad adverse health outcomes due to minority stress, creating a need for accessible, mechanism-targeted interventions to mitigate these minority stress-related risk factors. We tested the effectiveness and acceptability of Project RISE, an online single-session intervention designed to ameliorate internalized stigma and improve other outcomes among LGBTQ+ youth. We hypothesized that youth assigned to RISE (versus a control) would report significantly reduced internalized stigma and increased identity pride at post-intervention and at two-week follow-up and would find RISE acceptable.

Methods

We recruited adolescents nationally through Instagram advertisements in May 2022 (N = 538; M age = 15.06, SD age = 0.97). Participants were randomly assigned to RISE or an information-only control and completed questionnaires pre-intervention, immediately post-intervention, and two weeks post-intervention. Inclusion criteria included endorsing: (1) LGBTQ+ identity, (2) age 13-16, (3) English fluency (4) Internet access, and (5) subjective negative impact of LGBTQ+ stigma.

Results

Relative to participants in the control condition, participants who completed RISE reported significant decreases in internalized stigma (d = -0.49) and increases in identity pride (d = 0.25) from pre- to immediately post-intervention, along with decreased internalized stigma (d = -0.26) from baseline to two-week follow-up. Participants rated both RISE and the information-only control as highly, equivalently acceptable.

Conclusions

RISE appears to be an acceptable and useful online SSI for LGBTQ+ adolescents, with potential to reduce internalized stigma in both the short- and longer-term. Future directions include evaluating effects of Project RISE over longer follow-ups and in conjunction with other mental health supports.

Linguistic distancing predicts response to a digital single-session intervention for adolescent depression

Examining the linguistic characteristics of youths' writing may be a promising method for detecting youth who are struggling. In this study, we examined linguistic patterns of adolescent responses to writing prompts in a large, well-powered trial of an evidence-based, digital single-session intervention teaching malleability beliefs about personal traits and symptoms ("growth mindset"). Participants who completed the intervention as part of a larger randomized control trial were included in this preregistered study (n = 638, https://osf.io/zqmxt). Participants' responses were processed using Linguistic Inquiry and Word Count. We tested correlations between linguistic variables (i.e., linguistic distancing, positive affect, negative affect, insight, certainty), baseline outcome variables, post-intervention outcome variables, and 3-month post-intervention outcome variables. We also used Least Absolute Shrinkage and Selection Operator (LASSO) regression models to identify key predictors of treatment outcomes. As hypothesized, greater use of linguistic distancing was associated with lower levels of baseline hopelessness and higher levels of perceived agency. Additionally, per LASSO models including all linguistic variables, greater use of linguistic distancing predicted larger reductions in depressive symptoms from baseline to three-month follow-up. Linguistic distancing appeared to account for 27% of the variance in depression trajectories when also accounting for baseline depression. CLINICAL REGISTRATION NO: NCT04634903.

'Dove Confident Me Indonesia: Single Session': study protocol for a randomised controlled trial to evaluate a school-based body image intervention among Indonesian adolescents

Background

Due to the prevalence and associated adverse health consequences of negative body image among adolescents globally, there is a need to develop acceptable, effective, and scalable interventions. School-based body image interventions delivered by trained teachers show promise in reducing negative body image in adolescents. However, there is currently a lack of evidenced-based body image interventions for use in low- and middle-income countries (LMICs). This paper outlines a protocol for the development and evaluation of Dove Confident Me Indonesia: Single Session, a single-session, teacher-led body image intervention for Indonesian adolescents.

Method

The effectiveness of the intervention will be evaluated using a cluster randomised controlled trial design. Due to the COVID-19 pandemic, the trial will be conducted online. Trained teachers or school guidance counsellors will deliver the intervention. Self-report questionnaires will be collected at three time points: baseline, post-intervention, and two-month follow-up. The primary outcome is body esteem. Secondary outcomes are internalisation of appearance ideals, mood, engagement in life activities, tendency to engage in appearance comparisons, and skin shade satisfaction. A minimum of 1000 participants will provide 95% power to detect small-to-medium intervention effects. To account for attrition and potential internet issues, the sample will comprise of 2000 Indonesian adolescents in grades 7–9, attending state junior high schools in Surabaya, East Java. Quantitative and qualitative data on acceptability of the intervention will also be collected from teachers and students. Additionally, fidelity of lesson implementation will be assessed. This project received ethical approval from the Universitas Indonesia and the University of the West of England. The intervention will be disseminated in junior high schools throughout Indonesia via UNICEF’s Life Skills Education (LSE) programme, which will be freely available for teachers to download.

Discussion

This paper presents Dove Confident Me Indonesia: Single Session, a culturally adapted school-based intervention designed to improve Indonesian adolescents’ body image. It details the plan for evaluation, highlighting the strengths and limitations of the proposed study design. It will be informative for others aiming to adapt evidence-based school curricula to promote well-being among adolescents in LMICs.

Trial registration

NCT04665557. Registered 11th December 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11770-0.

Comparative efficacy of a single-session "Empowered Relief" videoconference-delivered group intervention for chronic pain: study protocol for a randomized controlled trial

BACKGROUND

Chronic pain is naturally aversive and often distressing for patients. Pain coping and self-regulatory skills have been shown to effectively reduce pain-related distress and other symptoms. In this trial, the primary goal is to pilot test the comparative efficacy of a single-session videoconference-delivered group pain education class to a waitlist control among patients with chronic pain.

METHODS

Our study is a randomized clinical trial pilot testing the superiority of our 2-h single-session videoconference-delivered group pain education class against a waitlist control. We will enroll 120 adult patients with mixed etiology chronic pain and randomize 1:1 to one of the two study arms. We hypothesize superiority for the pain education class for bolstering pain and symptom management. Team researchers masked to treatment assignment will assess the outcomes up to 3 months post-treatment.

DISCUSSION

This study aims to test the utility of a single-session videoconference-delivered group pain education class to improve self-regulation of pain and pain-related outcomes. Findings from our project have the potential to significantly reduce barriers to effective psychological treatment for pain, optimizing the delivery of increasingly vital online and remote-delivered intervention options.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04546685 . Registered on 04 September 2020.

Do Immediate Gains Predict Long-Term Symptom Change? Findings from a Randomized Trial of a Single-Session Intervention for Youth Anxiety and Depression

Single-session interventions (SSIs) can help reduce youth psychopathology, but SSIs may benefit some youths more than others. Identifying predictors of SSIs' effectiveness may clarify youths' likelihoods of benefitting from an SSI alone, versus requiring further treatment. We tested whether pre-to-post-SSI shifts in hypothesized symptom change mechanisms predicted subsequent reductions in youth internalizing symptoms. Data were from a trial evaluating whether an SSI teaching growth mindset (the belief that personality is malleable) reduced youth anxiety and depression. Youths (N = 96, ages 12-15) self-reported growth mindsets, perceived primary control, and perceived secondary control pre- and immediately post-intervention. They self-reported depression and anxiety symptoms at pre-intervention and 3, 6, and 9-month follow-ups. Larger immediate increases in primary control predicted steeper depressive symptoms declines across the follow-up; larger immediate increases in secondary control predicted steeper anxiety symptoms declines. Immediate shifts in proximal intervention "targets" may predict longer-term response to an SSI for youth internalizing distress. CLINICAL TRIALS: Clinicaltrials.gov registration: NCT03132298.