Effectiveness of a Digital Cognitive Behavior Therapy-Guided Self-Help Intervention for Eating Disorders in College Women: A Cluster Randomized Clinical Trial

Eating disorders (EDs) are common, serious psychiatric disorders on college campuses, yet most affected individuals do not receive treatment. Digital interventions have the potential to bridge this gap. To determine whether a coached, digital, cognitive behavior therapy (CBT) intervention improves o...

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Bibliographic Details
Published in:JAMA network open 2020-08, Vol.3 (8), p.e2015633-e2015633
Main Authors: Fitzsimmons-Craft, Ellen E, Taylor, C Barr, Graham, Andrea K, Sadeh-Sharvit, Shiri, Balantekin, Katherine N, Eichen, Dawn M, Monterubio, Grace E, Goel, Neha J, Flatt, Rachael E, Karam, Anna M, Firebaugh, Marie-Laure, Jacobi, Corinna, Jo, Booil, Trockel, Mickey T, Wilfley, Denise E
Format: Article
Language:English
Subjects:
Adolescent
Adult
Behavior modification
Clinical trials
Cognition & reasoning
Cognitive behavioral therapy
Cognitive Behavioral Therapy - methods
Colleges & universities
Eating disorders
Feeding and Eating Disorders - therapy
Female
Humans
Internet
Intervention
Online Only
Original Investigation
Psychiatry
Psychopathology
Self Care
Self help
Treatment Outcome
United States
Young Adult
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Summary:Eating disorders (EDs) are common, serious psychiatric disorders on college campuses, yet most affected individuals do not receive treatment. Digital interventions have the potential to bridge this gap. To determine whether a coached, digital, cognitive behavior therapy (CBT) intervention improves outcomes for college women with EDs compared with referral to usual care. This cluster randomized trial was conducted from 2014 to 2018 at 27 US universities. Women with binge-purge EDs (with both threshold and subthreshold presentations) were recruited from enrolled universities. The 690 participants were followed up for up to 2 years after the intervention. Data analysis was performed from February to September 2019. Universities were randomized to the intervention, Student Bodies-Eating Disorders, a digital CBT-guided self-help program, or to referral to usual care. The main outcome was change in overall ED psychopathology. Secondary outcomes were abstinence from binge eating and compensatory behaviors, as well as ED behavior frequencies, depression, anxiety, clinical impairment, academic impairment, and realized treatment access. A total of 690 women with EDs (mean [SD] age, 22.12 [4.85] years; 414 [60.0%] White; 120 [17.4%] Hispanic; 512 [74.2%] undergraduates) were included in the analyses. For ED psychopathology, there was a significantly greater reduction in the intervention group compared with the control group at the postintervention assessment (β [SE], -0.44 [0.10]; d = -0.40; t1387 = -4.23; P 
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2020.15633