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

• Published in: Psychological medicine Vol. 48; no. 12; pp. 2034 - 2044
• Main Authors: Wilksch, Simon M., O'Shea, Anne, Taylor, C. Barr, Wilfley, Denise, Jacobi, Corinna, Wade, Tracey D.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.09.2018
• Subjects: Adolescent; Adult; Adults; Body image; Body Image - psychology; Child development; Clinical trials; Eating disorders; Feeding and Eating Disorders - prevention & control; Female; Humans; Internet; Intervention; Mobile Applications; Original Articles; Outcome Assessment, Health Care; Pathology; Prevention; Prevention programs; Psychotherapy - methods; Quality of life; Questionnaires; Risk factors; Self help; Self image; Telemedicine - methods; Therapists; Women; Young Adult; Young adults; targeted; online; risk factors; prevention; Eating disorders
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291717003567

Disordered eating (DE) is a widespread, serious problem. Efficacious prevention programs that can be delivered at-scale are needed. 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. 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. Given both programs were not therapist-moderated, MS-T has potential to achieve reductions in DE risk at low implementation costs.