Results of disseminating an online screen for eating disorders across the U.S.: Reach, respondent characteristics, and unmet treatment need

Self Cite

Objective The Internet‐based Healthy Body Image (HBI) Program, which uses online screening to identify individuals at low risk of, high risk of, or with an eating disorder (ED) and then directs users to tailored, evidence‐based online or in‐person interventions to address individuals' risk or clinical status, was deployed at 28 U.S. universities as part of a randomized controlled trial. The purpose of this study is to report on: (a) reach of HBI, (b) screen results, and (c) differences across ED status groups. Method All students on participating campuses ages 18 years or older were eligible, although recruitment primarily targeted undergraduate females. Results The screen was completed 4,894 times, with an average of 1.9% of the undergraduate female student body on each campus taking the screen. ED risk in participating students was high—nearly 60% of students screened were identified as being at high risk for ED onset or having an ED. Key differences emerged across ED status groups on demographics, recruitment method, ED pathology, psychiatric comorbidity, and ED risk factors, highlighting increasing pathology and impairment in the high‐risk group. Discussion Findings suggest efforts are needed to increase reach of programs like HBI. Results also highlight the increasing pathology and impairment in the high‐risk group and the importance of programs such as HBI, which provide access to timely screening and intervention to prevent onset of clinical EDs.

Section: Discussionsupporting

confidence: 83%

Screening and offering online programs for eating disorders: Reach, pathology, and differences across eating disorder status groups at 28 U.S. universities

Fitzsimmons‐Craft

Balantekin

Eichen

et al. 2019

Self Cite

“…From a population perspective, reach of the resource relative to the population of Australia was 0.01%. This is somewhat lower than the population reach of 0.02% reported in a U.S. study of an online screen for eating disorders conducted over a shorter period of time (Fitzsimmons‐Craft et al, ). More specifically, considering the size of the population of 18‐ to 60‐year olds in Victoria (Australian Bureau of Statitstics, ), where most promotion for ROAR took place, and estimates of point prevalence of eating disorders in Australian data (Hay et al, ), the reach of ROAR during the data collection period to those potentially in need of the resource was 0.9%.…”

Section: Methodsmentioning

confidence: 68%

Reach Out and Recover: Intentions to seek treatment in individuals using online support for eating disorders

McLean

Caldwell

Roberton

2019

Objective The aim of this study was to explore characteristics and treatment‐seeking intentions of consumers accessing an online resource for eating disorders support, Reach Out and Recover (ROAR). Factors associated with treatment‐seeking intent among visitors to ROAR were also examined. Method Participants were 200 visitors to the website aged 18 to 60 plus. The majority of participants (93.5%) identified as women. Responses to self‐report questions assessing treatment‐seeking intention, eating disorder symptoms and their impact on health, and attitudes to treatment were collected. Results Participants experienced a range of eating disorder symptoms, yet the majority (86.0%) was not receiving treatment. Importantly, of those not in treatment, the majority (82.6%) indicated that they planned to get treatment. In addition, more than half of participants (52.9%) downloaded a report to present to their health practitioner to facilitate communication with a health professional. Intention to seek treatment and download of the report were positively associated with motivation to change, confidence to achieve change, greater frequency of binge eating, and greater recognition of the impact of eating disorder symptoms on relationships and well‐being but not with stigma or ambivalence. Discussion Study findings indicated that the ROAR website was accessed by individuals for whom it was designed, namely those experiencing eating disorder symptoms who are not receiving treatment. Encouragingly, participants had strong intentions to seek treatment, and the majority downloaded a report that could be used to facilitate the first step toward treatment. Greater focus on enhancing motivation and confidence to change may further promote treatment‐seeking.

“…However, the emphasis should not be on improving the efficacy of only one type of intervention, but on considering population needs and interests, costs, and other factors from which to employ a suite of interventions and perhaps even sequencing strategies (e.g., stepped care models) to improve outcomes for the defined population of interest (Wilfley, Agras, & Taylor, ). As an example, data from NEDA suggest that there are large numbers of individuals with EDs in rural and remote areas who are unlikely to have access to ED (let alone evidence‐based) treatment (Fitzsimmons‐Craft, Balantekin, Graham, et al, ; figure 1). A defined population strategy might thus develop and evaluate ED teletherapy interventions for rural populations.…”

Section: Improving Intervention Outcomementioning

confidence: 99%

“…In recent years, online screens have been used to identify individuals at risk for or with subthreshold/threshold eating disorders (EDs), with the intention of motivating individuals with EDs to consider treatment (Fitzsimmons‐Craft, Balantekin, Graham, et al, ). Routine online screening through organizations such as the National Eating Disorders Association (NEDA), Mental Health America, and the Healthy Minds Network have identified hundreds of thousands of individuals at risk for or with EDs who are not receiving care (Eisenberg, Hunt, Speer, & Zivin, ; Fitzsimmons‐Craft, Balantekin, Graham, et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the successes in identifying individuals with EDs in need of intervention, gaps remain in optimizing outcomes for these individuals: (a) screens do not reach all of those in need; (b) there is a large treatment gap between the number of individuals in need of and who receive treatment for an ED (Hart, Granillo, Jorm, & Paxton, ); (c) the number of individuals who follow through on treatment recommendations after a screen is suboptimal (DeBar et al, ); and (d) among those who do receive treatment, many individuals fail to complete a full course of treatment or achieve a desired outcome within a set time frame (Bauer & Moessner, ; Eisenberg et al, ; Fitzsimmons‐Craft, Balantekin, Eichen, et al, ; Fitzsimmons‐Craft, Balantekin, Graham, et al, ; Fitzsimmons‐Craft, Eichen, et al, ; Fitzsimmons‐Craft, Firebaugh, et al, ; Kazdin, Fitzsimmons‐Craft, & Wilfley, ; Lindenberg, Moessner, Harney, McLaughlin, & Bauer, ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing eating disorder treatment outcomes for individuals identified via screening: An idea worth researching

Taylor

Graham

Fitzsimmons‐Craft

et al. 2019

Self Cite

In recent years, online screens have been commonly used to identify individuals who may have eating disorders (EDs), many of whom may be interested in treatment. We describe a new empirical approach that takes advantage of current evidence on empirically supported, effective treatments, while at the same time, uses modern statistical frameworks and experimental designs, data‐driven science, and user‐centered design methods to study ways to expand the reach of programs, enhance our understanding of what works for whom, and improve outcomes, overall and in subpopulations. The research would focus on individuals with EDs identified through screening and would use continuously monitored data, and interactions of interventions/approaches to optimize reach, uptake, engagement, and outcome. Outcome would be assessed at the population, rather than individual level. The idea worth researching is to determine if an optimization outcome model produces significantly higher rates of clinical improvement at a population level than do current approaches, in which traditional interventions are only offered to the few people who are interested in and able to access them.