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Psychol Med. 2018 Sep;48(12):2034-2044. doi: 10.1017/S0033291717003567. Epub 2017 Dec 13.

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

Author information

1
School of Psychology,Flinders University,South Australia,Australia.
2
Department of Psychiatry,Stanford University Medical Center,Stanford,California,USA.
3
Department of Psychology,Washington University in St. Louis,St. Louis,Missouri,USA.
4
Institute of Clinical Psychology and Psychotherapy,Technische Universit├Ąt Dresden,Dresden,Germany.

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.

KEYWORDS:

Eating disorders; online; prevention; risk factors; targeted

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