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Online prevention of disordered eating in at-risk young-adult women: a two-country pragmatic randomized controlled trial

Published online by Cambridge University Press:  13 December 2017

Simon M. Wilksch
Affiliation:
School of Psychology, Flinders University, South Australia, Australia
Anne O'Shea
Affiliation:
School of Psychology, Flinders University, South Australia, Australia
C. Barr Taylor
Affiliation:
Department of Psychiatry, Stanford University Medical Center, Stanford, California, USA
Denise Wilfley
Affiliation:
Department of Psychology, Washington University in St. Louis, St. Louis, Missouri, USA Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
Corinna Jacobi
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Tracey D. Wade
Affiliation:
School of Psychology, Flinders University, South Australia, Australia
Corresponding

Abstract

Background

Disordered eating (DE) is a widespread, serious problem. Efficacious prevention programs that can be delivered at-scale are needed.

Methods

A pragmatic randomized controlled trial of two online programs was conducted. Participants were young-adult women from Australia and New Zealand seeking to improve their body image. Media Smart-Targeted (MS-T) and Student Bodies (SB) were both 9-module interventions released weekly, whilst control participants received positive body image information. Primary [Eating Disorder Examination–Questionnaire (EDE-Q) Global], secondary (DE risk factors) and tertiary (DE) outcome measures were completed at baseline, post-program, 6- and 12-month follow-up.

Results

Baseline was completed by 608 women (M age = 20.71 years); 33 were excluded leaving 575 randomized to: MS-T (N = 191); SB (N = 190) or control (N = 194). Only 66% of those randomized to MS-T or SB accessed the intervention and were included in analyses with controls; 78% of this sample completed measures subsequent to baseline. Primary intent-to-treat (ITT) analyses revealed no differences between groups, while measure completer analyses found MS-T had significantly lower EDE-Q Global than controls at 12-month follow-up. Secondary ITT analyses found MS-T participants reported significantly higher quality of life–mental relative to both SB and controls (6-month follow-up), while MS-T and controls had lower clinical impairment relative to SB (post-program). Amongst measure completers, MS-T scored significantly lower than controls and SB on 5 variables. Of those with baseline DE, MS-T participants were significantly less likely than controls to have DE at 12-month follow-up.

Conclusions

Given both programs were not therapist-moderated, MS-T has potential to achieve reductions in DE risk at low implementation costs.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

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