Assessing program sustainability in an eating disorder prevention effectiveness trial delivered by college clinicians

Abstract

Sustainability of the Body Project, a dissonance-based selective eating disorder prevention program supported by efficacy and effectiveness trials, has not previously been examined. This mixed-methods study collected qualitative and quantitative data on training, supervision, and the intervention from 27 mental health clinicians from eight US universities who participated in an effectiveness trial and quantitative data on 2-year sustainability of program delivery. Clinicians, who were primarily masters-level mental health providers, had limited experience delivering manualized interventions. They rated the training and manual favorably, noting that they particularly liked the role-plays of session activities and intervention rationale, but requested more discussion of processes and group management issues. Clinicians were satisfied receiving emailed supervision based on videotape review. They reported enjoying delivering the Body Project but reported some challenges with the manualized format and time constraints. Most clinicians anticipated running more groups after the study ended but only four universities (50%) reported providing additional Body Project groups at the 1-year follow-up assessment and sustained delivery of the groups decreased substantially two years after study completion, with only one university (12%) continuing to deliver groups. The most commonly reported barriers for conducting additional groups were limited time and high staff turnover.

Práticas grupais de promoção e prevenção em saúde mental: revisão da literatura

“…Um estudo avaliou a sustentabilidade do grupo (Rohde et al, 2015), compreendida pelos autores como o acompanhamento do desenvolvimento e das possibilidades de continuidade de uma prática grupal, a partir da perspectiva dos coordenadores. Eles utilizaram método misto, que abrangeu entrevistas estruturadas por telefone que avaliavam a satisfação dos coordenadores com o treinamento e supervisão recebidos, além da coleta de informações após um e dois anos, sobre a continuidade do programa grupal nos locais de trabalho dos coordenadores, avaliando as barreiras percebidas pelos mesmos.…”

“…Os estudos que se dedicaram à abordagem destes outros elementos concentraram maior heterogeneidade metodológica. Foi neste conjunto de estudos, por exemplo, que se abriu espaço para a inclusão da perspectiva de outros protagonistas das práticas grupais, como é o caso dos coordenadores, no estudo deRohde et al (2015); ou, para o relato da criação de determinados protocolos de grupo, que transparece os processos que o originaram, como os estudosde Maatouk et al (2016) e que reportaram como operacionalizaram a inclusão das necessidades e do conhecimento advindo das populações-alvo -preocupação central à prevenção e à promoção -podendo inspirar a criação de outras práticas grupais no campo. É…”

Feasibility and Acceptability of a Guided Self-Help, Text-Messaging Intervention to Promote Positive Body Image of Emerging Adult Women

“…Issues of feasibility and acceptability should also be considered in designing interventions with high utility for impacting risk and protective factors (12). Although several prevention programs for eating disorders exist for the emerging adult population and have been demonstrated as efficacious, there are concerns about ongoing availability and the sustainability of these efforts (13,14). One specific concern with maintaining longevity involves a lack of providers trained to perform these services (15).…”

“…Moreover, for the emerging adult population, there are also other perceived barriers to treatment to consider such as financial limitations and time constraints (16,17). For example, although the Body Project has been quite successful in preventing later eating disorder development, several universities in which it was tested discontinued use of the program for reasons such as staff turnover and time limitations for students and staff (14). As a result, there is a need to utilize innovative intervention designs that are both acceptable by this population and have the potential to be efficacious.…”