Dissonance Eating Disorder Prevention: Clinician Led, Peer Led vs Web Delivered
Condition: Eating Disorder Prevention
MeSH terms: Feeding and Eating Disorders
Study type: Interventional

Summary: 
      Five percent of young women meet criteria for anorexia nervosa, bulimia nervosa, or binge
      eating disorder, with another 5% meeting criteria for Eating Disorder Not Otherwise Specified
      (ED-NOS), which includes subthreshold variants of these disorders. Over half of those
      presenting for eating disorder treatment meet criteria for ED-NOS and both threshold cases
      and ED-NOS are marked by chronicity, relapse, distress, functional impairment, and increased
      risk for future obesity, depression, suicide attempts, anxiety disorders, substance abuse,
      morbidity, and mortality. Anorexia and bulimia nervosa show stronger relations to suicide
      attempts, outpatient/inpatient treatment, and functional impairment than most other
      psychiatric disorders. Treatment of eating disorders is very expensive, similar to the cost
      for schizophrenia treatment, and is effective for only 40-60% of patients. Thus, a public
      health priority is to develop and disseminate effective eating disorder prevention programs.
    

Detailed description: 
      Although dozens of eating disorder prevention programs have been evaluated, only a
      dissonance-based program (the Body Project) has significantly reduced future onset of
      threshold and subthreshold eating disorders through long-term follow-up. An effectiveness
      trial found that the Body Project produced significant reductions in risk factors, eating
      disorder symptoms, and functional impairment relative to educational brochure controls, with
      some effects persisting through 3-yr follow-up when high school clinicians recruited students
      and delivered the program. These trials confirm the efficacy and effectiveness of the Body
      Project, but revealed a key dissemination barrier; it can be difficult to identify and
      recruit clinicians at high schools and colleges with the time and expertise to competently
      deliver the program.

      One solution to this key dissemination barrier is to train students in established peer
      leader programs at colleges to recruit high-risk students and deliver the program. Another
      solution to this dissemination barrier would be to deliver the Body Project via the Internet.

      Because peer-led groups and Internet delivery of the Body Project could markedly extend the
      reach and sustainability of this evidence-based program, we propose to conduct the first
      large multi-site effectiveness trial that directly compares the effects and cost
      effectiveness of peer-led Body Project groups, the eBody Project intervention, and
      clinician-led Body Project groups to an educational video control condition.
    

Intervention name(s): Peer-Led Group Intervention; Internet-Based Intervention; Clinician-Led Group Intervention; Education Video
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: body image; body dissatisfaction