An Internet-based intervention for eating disorders consisting of automated computer-tailored feedback with or without supplemented frequent or infrequent support from a coach: study protocol for a randomized controlled trial

Trials

Eric F Van Furth²  Leona Hakkaart-van Roijen¹  Philip Spinhoven²  Alexandra E Dingemans³  Jiska J Aardoom³ 

[1] Institute of Health Policy and Management (iBMG) and institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Postbus 1738, 3000 DR, Rotterdam, the Netherlands;Department of Psychiatry, Leiden University Medical Center, Postbox 9600, 2300 RC, Leiden, the Netherlands;Center for Eating Disorders Ursula, Postbox 422, 2260 AK, Leidschendam, The Netherlands

关键词: Treatment;    Therapist support;    Self-help;    Prevention;    Predictors;    Intervention;    Internet;    Eating disorders;    Computer-tailored;   

Others  :  1092880
DOI  :  10.1186/1745-6215-14-340

 received in 2013-04-03, accepted in 2013-10-10,  发布年份 2013

【 摘 要 】

Background

Several Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static ‘one-size-fits-all’ approach. ‘Featback’, an Internet-based intervention for symptoms of eating disorders provides a more individualized approach. It consists of several components (psychoeducation, a fully automated monitoring and feedback system, and support from a coach), which can be matched to participants’ needs and preferences. Until now, it is unclear whether online self-help interventions for eating disorders with support are more effective than those without. The aims of the current study are i) to examine the relative effectiveness of (the different components of) Featback; ii) to examine predictors, moderators and mediators of intervention responses; iii) to report on practical experiences with Featback; and iv) to examine the cost-effectiveness of Featback.

Methods/design

Individuals aged 16 years or older, with mild to severe eating disorder symptoms will be randomized to one of the four study conditions. In condition one, participants receive the basic version of Featback, consisting of psychoeducation and a fully automated monitoring and feedback system. In conditions two and three, participants receive the basic version of Featback supplemented with the possibility of infrequent (weekly) or frequent (three times a week) e-mail, chat, or Skype support from a coach, respectively. The fourth condition is a waiting list control condition. Participants are assessed at baseline, post-intervention (8 weeks), and at 3- and 6-month follow-up (the latter except for participants in the waiting list control condition). Primary outcome measures are disordered eating behaviors and attitudes. Secondary outcome measures are (eating disorder-related) quality of life, self-stigma of seeking help, self-esteem, mastery and support, symptoms of depression and anxiety, repetitive negative thinking, motivation to change, user satisfaction, compliance, and help-seeking attitudes and behaviors.

Discussion

This study aims to provide more insight into the (cost-) effectiveness of Internet-based interventions for eating disorders, particularly those with and without professional support, as well as different levels of support.

Trial registration

NTR3646

【 授权许可】

   
2013 Aardoom et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Kohn R, Saxena S, Levav I, Saraceno B: The treatment gap in mental health care. Bull World Health Organ 2004, 82:858-866.
• [2]Gulliver A, Griffiths K, Christensen H: Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 2010, 10:113. BioMed Central Full Text
• [3]Sareen J, Jagdeo A, Cox BJ, Clara I, ten Have M, Belik SL, de Graaf R, Stein MB: Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatr Serv 2007, 58:357-364.
• [4]Spek V, Cuijpers P, Nyklícek N, Riper H, Keyzer J, Pop V: Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 2007, 37:319-328.
• [5]Cuijpers P, Marks IM, van Straten A, Cavanagh K, Gega L, Andersson G: Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther 2009, 38:66-82.
• [6]Andersson G, Cuijpers P: Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cogn Behav Ther 2009, 38:196-205.
• [7]Aardoom J, Dingemans AE, Spinhoven S, van Furth EF: Treating eating disorders over the internet: a systematic review and future research directions. Int J Eat Disord 2013, 46(6):539-552.
• [8]Winzelberg AJ, Eppstein D, Eldredge KL, Wilfley D, Dasmahapatra R, Dev P, Taylor CB: Effectiveness of an internet-based program for reducing risk factors for eating disorders. J Consult Clin Psychol 2000, 68:346-350.
• [9]Celio AA, Winzelberg AJ, Wilfley DE, Eppstein-Herald D, Springer EA, Dev P, Taylor CB: Reducing risk factors for eating disorders: comparison of an internet- and a classroom-delivered psychoeducational program. J Consult Clin Psychol 2000, 68:650-657.
• [10]Bruning Brown J, Winzelberg AJ, Abascal LB, Taylor CB: An evaluation of an internet-delivered eating disorder prevention program for adolescents and their parents. J Adolescent Health 2004, 35:290-296.
• [11]Winzelberg AJ, Taylor CB: Evaluation of a computer-mediated eating disorder intervention program. Int J Eat Disord 1998, 24:339-349.
• [12]Zabinski MF, Pung MA, Wilfley DE, Eppstein DL, Winzelberg AJ, Celio A, Taylor CB: Reducing risk factors for eating disorders: targeting at-risk women with a computerized psychoeducational program. Int J Eat Disord 2001, 29:401-408.
• [13]Jacobi C, Morris L, Beckers C, Bronisch-Holtze J, Winter J, Winzelberg AJ, Taylor CB: Maintenance of internet-based prevention: a randomized controlled trial. Int J Eat Disord 2007, 40:114-119.
• [14]Taylor CB, Bryson S, Luce KH, Cunning D, Doyle AC, Abascal LB, Rockwell R, Dev P, Winzelberg AJ, Wilfley DE: Prevention of eating disorders in at-risk college-age women. Arch Gen Psychiatry 2006, 63:881-888.
• [15]Graff Low K, Charanasomboon S, Lesser J, Reinhalter K, Martin R, Jones H, Winzelberg A, Abascal L, Taylor CB: Effectiveness of a computer-based interactive eating disorders prevention program at long-term follow-up. Eat Disord 2006, 14:17-30.
• [16]Beintner I, Jacobi C, Taylor CB: Effects of an internet-based prevention programme for eating disorders in the USA and Germany: a meta-analytic review. Eur Eat Disord Rev 2011, 20:1-8.
• [17]Bauer S, Moessner M, Wolf M, Haug S, Kordy H: ES[S]PRIT - an Internet-based programme for the prevention and early intervention of eating disorders in college students. Br J Guid Couns 2009, 37:327-336.
• [18]Lindenberg K, Moessner M, Harney J, McLaughlin O, Bauer S: E-Health for individualized prevention of eating disorders. Clin Pract Epidemol Ment Health 2011, 7:74-83.
• [19]Gulec H, Moessner M, Mezei A, Kohls E, Túry F, Bauer S: Internet-based maintenance treatment for patients with eating disorders. Prof Psychol Res Pr 2011, 42:479-486.
• [20]Berger T, Caspar F, Richardson R, Kneubühler B, Sutter D, Andersson G: Internet-based treatment of social phobia: a randomized controlled trial comparing unguided with two types of guided self-help. Behav Res Ther 2011, 49:158-169.
• [21]Klein B, Austin D, Pier C, Kiropoulos L, Shandley K, Mitchell J, Gilson K, Ciechomski L: Internet-based treatment for panic disorder: does frequency of therapist contact make a difference? Cogn Behav Ther 2009, 38:100-113.
• [22]Tate DF, Jackvony EH, Wing RR: A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an internet weight loss program. Arch Intern Med 2006, 166:1620-1625.
• [23]Bauer S, Winn S, Schmidt U, Kordy H: Construction, scoring and validation of the short evaluation of eating disorders (SEED). Eur Eat Disord Rev 2005, 13:191-200.
• [24]Killen JD, Taylor CB, Hammer LD, Litt I, Wilson DM, Rich T, Hayward C, Simmonds B, Kraemer H, Varady A: An attempt to modify unhealthful eating attitudes and weight regulation practices of young adolescent girls. Int J Eat Disord 1993, 13:369-384.
• [25]Percevic R: Computer-supported monitoring of patient treatment response. J Clin Psychol 2004, 60:285-299.
• [26]Schalken F, Wolters W, Tilanus M, Gemert M, Hoogenhuyze C, Meijer E, Kraefft E, Brenninkmeijer M, Postel M: Handboek online hulpverlening. Houten: Bohn Stafleu van Loghum; 2010.
• [27]Fairburn CG, Beglin SJ: Eating Disorder Examination Questionnaire (EDE-Q 6.0). In Cognitive Behavior Therapy and Eating Disorders. Edited by Fairburn CG. New York: Guilford Press; 2008:309-313.
• [28]Engel SG, Wittrock DA, Crosby RD, Wonderlich SA, Mitchell JE, Kolotkin RL: Development and psychometric validation of an eating disorder-specific health-related quality of life instrument. Int J Eat Disord 2006, 39:62-71.
• [29]Vogel DL, Wade NG, Haake S: Measuring the self-stigma associated with seeking psychological help. J Couns Psychol 2006, 53:325-337.
• [30]Bovier PA, Chamot E, Perneger TV: Brief scales for measurement of functional social support and psychological resources in French-speaking adults. Social Prev Med 2002, 47:298-306.
• [31]Kroenke K, Spitzer RL, Williams JBW, Löwe B: An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics 2009, 50:613-621.
• [32]Ehring T, Raes F, Weidacker K, Emmelkamp PMG: Validation of the Dutch version of the perseverative thinking questionnaire (PTQ-NL). Eur J Psychol Assess 2012, 28:102-108.
• [33]Genders R, Tchanturia K: Cognitive remediation therapy (CRT) for anorexia in group format: a pilot study. Eat Weight Disord 2010, 15:e234-e239.
• [34]Bewell CV, Carter JC: Readiness to change mediates the impact of eating disorder symptomatology on treatment outcome in anorexia nervosa. Int J Eat Disord 2008, 41:368-371.
• [35]Group EQ: EuroQol-a new facility for the measurement of health-related quality of life. Health Policy 1990, 16:199-208.
• [36]Hakkaart-van Roijen L, Donker M, Tiemens B: Trimbos/iMTA Questionnaire for Costs Associated with Psychiatric Illness (TiC-P): Handleiding. Rotterdam: Institute for Medical Technology Assessment; 2002.
• [37]Fairburn CG, Beglin SJ: Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 1994, 16:363-370.
• [38]Duncan BL, Miller SD, Sparks JA, Claud DA, Reynolds LR, Brown J, Johnson LD: The session rating scale: preliminary psychometric properties of a “working” alliance measure. J Brief Ther 2003, 3:3-12.
• [39]Killen JD, Taylor CB, Hayward C, Wilson DM, Haydel KF, Hammer LD, Simmonds B, Robinson TN, Litt I, Varady A, Kraemer H: Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis. Int J Eat Disord 1994, 16:227-238.
• [40]Jacobi C, Abascal L, Taylor CB: Screening for eating disorders and high-risk behavior: caution. Int J Eat Disord 2004, 36:280-295.
• [41]Cooper Z, Cooper P, Fairburn CG: The validity of the eating disorder examination and its subscales. Br J Psychiat 1989, 154:807-812.
• [42]Berg KC, Peterson CB, Frazier P, Crow SJ: Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 2011, 45:428-438.
• [43]Eysenbach G: The law of attrition. J Med Internet Res 2005, 7:e11.
• [44]Hakkaart-van Roijen L, Tan SS, Bouwmans CAM: Handleiding voor kostenonderzoek: Methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. Rotterdam: College voor zorgverzekeringen; 2010.
• [45]Cohen J: Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Mahwah, NJ: Lawrence Erlbaum Associates; 1988.
• [46]Melville KM, Casey LM, Kavanagh DJ: Dropout from internet-based treatment for psychological disorders. Br J Clin Psychol 2010, 49:455-471.
• [47]Hollis S, Campbell F: What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ 1999, 319:670-674.
• [48]Cohen J: A power primer. Psychol Bull 1992, 112:155-159.
• [49]Frazier PA, Tix AP, Barron KE: Testing moderator and mediator effects in counseling psychology research. J Couns Psychol 2004, 51:115-134.
• [50]Burns JW, Kubilus A, Bruehl S, Harden N, Lofland K: Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? A crossed-lagged panel analysis. J Consult Clin Psychol 2003, 71:81-91.
• [51]Braun DL, Sunday SR, Halmi KA: Psychiatric comorbidity in patients with eating disorders. Psychol Med 1994, 24:859-867.
• [52]Rosenvinge JH, Martinussen M, Ostensen E: The comorbidity of eating disorders and personality disorders: a meta-analytic review of studies published between 1983 and 1998. Eat Weight Disord 2000, 5:52-61.