Implementation of a Waitlist Intervention and Clinical Care Pathway for Families Awaiting at Eating Disorders Program
Condition: Eating Disorders
MeSH terms: Feeding and Eating Disorders
Study type: Interventional

Summary: 
      The COVID-19 pandemic has resulted in several challenges in service delivery for the eating
      disorders program at McMaster Children's Hospital. Long waiting lists prior to the pandemic
      (6-9 month wait time) have been made worse by an interruption in service during the initial
      stages of the pandemic. New routine assessments were placed on hold for many months, while
      only the most urgently ill children were seen. This, in combination with a dramatic increase
      in new referrals has resulted in a long waitlist. Now families are waiting 12-18 months for
      service. The resulting waitlist is now unmanageable and unsafe. Investigators wish to study
      the implementation of a waitlist intervention which will educate parents on how to start to
      renourish their children and interrupt eating disordered behaviors. The intervention will
      consist of a series of educational videos and a book on how to help their children. It is
      hoped that this intervention can lessen the need for hospitalization and can change the
      trajectory of symptoms while waiting for service. A clinical care pathway will also be
      developed to ensure those waiting receive the most appropriate treatment.
    

Detailed description: 
      Investigators would like to study the implementation of an adapted FBT model in which there
      is no therapist involvement and the intervention is delivered to families on the waitlist of
      Eating Disorder program at McMaster Children's Hospital. The intervention would involve a
      series of prerecorded videos and reading material. This, in combination with the development
      of a clinical care pathway, would help to manage the extraordinary volumes of referrals
      recently been received. The need to social distance brought on by the pandemic presents the
      opportunity to consider the value of this waitlist intervention as a structured program for
      parents who have a child waiting for service. A model such as this could dramatically improve
      parental abilities to begin to re-feed their children, thereby reducing acuity and time spent
      in treatment. Similarly, some parents on the waitlist may decide that the proposed treatment
      model is not suitable after they have received the proposed waitlist intervention, and may
      wish to seek treatment elsewhere. Alternatively, parents may be able to shift the pattern of
      weight loss and/or binge purge behavior in children so that the severity of illness is
      decreased by the time of assessment. If successful, this intervention and clinical care
      pathway for waitlisted patients and their families could be disseminated to other tertiary
      care centers, thereby reducing mounting pressures on these centers.
    

Intervention name(s): Parental guided self-help version of FBT-pre-recorded videos and readings from the book
Intervention type(s): Behavioral
Intervention description(s): Each participant will receive a series of pre-recorded videos of parental guided self help version FBT. There will be10 videos of about 10 minutes each. The videos will include content on empowering parents to renourish their child and interrupt binge/purge behaviors. Readings will be assigned to each participant from the book "Help Your Teenager Beat and Eating Disorder". There will be psychoeducational content on the dangers and medical complications of eating disorders. The readings will also contain content on coping skills for young people including relaxation, mindfulness strategies, and distress tolerance skills.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: eating disorders; waitlist intervention; pandemic; children; clinical care pathway