Acceptability, Feasibility, and Preliminary Effectiveness of a Mobile App for Teens With or at High Risk for Eating Disorders: A Three-Arm Pilot Randomized Controlled Trial Comparing Self-Help, Guided Self-Help, and Guided Self-Help With a Social Networking Component.

内容摘要

Given the wide treatment gap for eating disorders (EDs) and that these problems often emerge in adolescence, novel tools, such as app-based interventions, are needed to prevent and treat EDs in teens. However, questions remain about the optimal level of human support and features within these programs that could enhance outcomes (e.g., social networking). We conducted a pilot randomized controlled trial of a mobile app for teens with or at high risk for EDs, comparing self-help (control) to guided self-help (GSH) and GSH+ social networking (GSH+). N&#x2009;=&#x2009;148 teens with or at high risk for EDs recruited from social media and an online EDs screen were randomized. Participants had access to their assigned intervention for 3&#x2009;months and completed surveys at baseline, 6&#x2009;weeks, 3&#x2009;months, and 6&#x2009;months. Teen qualitative feedback illustrated positive perceptions about acceptability and feasibility of the tool and its impact on ED-related thoughts and behaviors. There were no significant differences across groups for the main outcome, global ED psychopathology, but there was a significant reduction for all groups over time (ps&#x2009;<&#x2009;0.01; d&#x2009;=&#x2009;-0.93 from baseline to 6&#x2009;months). While all intervention conditions had significant reductions in binge eating behaviors over time, the rate of reduction was greatest in the GSH condition (p&#x2009;<&#x2009;0.001). Overall, our preliminary findings suggest that digital self-help interventions (both unguided and guided) may represent scalable interventions for teens with or at high risk for EDs, with coaching possibly augmenting outcomes for some subgroups. Teens with eating disorders represent an important population to target for early, accessible interventions. The mobile app in the current study showed preliminary effectiveness in reducing eating disorder symptoms among teens. Larger trials will be needed to determine whether coaching may especially benefit those with high levels of binge eating or other subgroups, such as teens with higher co&#x2010;morbid mental health concerns or those identifying as sexual and/or gender minorities.