Sarah Barakat1, Sarah Maguire2, Kathryn E Smith3,4, Tyler B Mason5, Ross D Crosby3,4, Stephen Touyz1. 1. School of Psychology, University of Sydney, Sydney, New South Wales, Australia. 2. InsideOut Institute for Eating Disorders, Boden Institute, University of Sydney, Sydney, New South Wales, Australia. 3. Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota. 4. Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota. 5. Department of Preventive Medicine, University of Southern California, Los Angeles, California.
Abstract
OBJECTIVE: Despite the existence of reviews which document the effectiveness of online therapies, there is little consensus regarding the exact components of online treatment delivery that are most effective in maintaining user engagement and reducing eating disorder (ED) symptomology. The current review and meta-analysis aimed to determine which components of web-based, ED self-help interventions are associated with lower attrition and improved therapeutic outcome. METHOD: A systematic search of electronic databases (PsycINFO, Medline, Web of Science, Scopus) was conducted for published studies of web-based interventions for EDs and a meta-analysis of the final included studies was performed. Each intervention was coded across four dimensions, including the multimedia channels employed (e.g., text, audio, videos), degree of user interactivity (e.g., online self-monitoring, skills exercises), level of automated feedback (e.g., reminders, personalized feedback), and technological device through which the program was accessed (e.g., smartphone, computer). RESULTS: A final 23 papers were included. The results of meta-regressions indicated that higher scores on the multimedia subscale were associated with greater ED symptom improvement in treatment groups. Conversely, a higher degree of feedback in the treatment group was associated with a group difference in ED psychopathology favoring the control group. Other intervention components were not associated with treatment outcome or dropout. DISCUSSION: The results are discussed in relation to limitations of the scale used to quantify digital intervention features, as well as the limited diversity and technological sophistication of available ED digital interventions. Such findings indicate the importance of understanding the digital components, which differentiate online therapeutic programs.
OBJECTIVE: Despite the existence of reviews which document the effectiveness of online therapies, there is little consensus regarding the exact components of online treatment delivery that are most effective in maintaining user engagement and reducing eating disorder (ED) symptomology. The current review and meta-analysis aimed to determine which components of web-based, ED self-help interventions are associated with lower attrition and improved therapeutic outcome. METHOD: A systematic search of electronic databases (PsycINFO, Medline, Web of Science, Scopus) was conducted for published studies of web-based interventions for EDs and a meta-analysis of the final included studies was performed. Each intervention was coded across four dimensions, including the multimedia channels employed (e.g., text, audio, videos), degree of user interactivity (e.g., online self-monitoring, skills exercises), level of automated feedback (e.g., reminders, personalized feedback), and technological device through which the program was accessed (e.g., smartphone, computer). RESULTS: A final 23 papers were included. The results of meta-regressions indicated that higher scores on the multimedia subscale were associated with greater ED symptom improvement in treatment groups. Conversely, a higher degree of feedback in the treatment group was associated with a group difference in ED psychopathology favoring the control group. Other intervention components were not associated with treatment outcome or dropout. DISCUSSION: The results are discussed in relation to limitations of the scale used to quantify digital intervention features, as well as the limited diversity and technological sophistication of available ED digital interventions. Such findings indicate the importance of understanding the digital components, which differentiate online therapeutic programs.
Authors: Claudia Stoeten; Hein Arnoud de Haan; Marloes Gerda Postel; Marjolein Brusse-Keizer; Elke Daniëlle Ter Huurne Journal: JMIR Form Res Date: 2022-06-30
Authors: Ewelina Smoktunowicz; Azy Barak; Gerhard Andersson; Rosa M Banos; Thomas Berger; Cristina Botella; Blake F Dear; Tara Donker; David D Ebert; Heather Hadjistavropoulos; David C Hodgins; Viktor Kaldo; David C Mohr; Tine Nordgreen; Mark B Powers; Heleen Riper; Lee M Ritterband; Alexander Rozental; Stephen M Schueller; Nickolai Titov; Cornelia Weise; Per Carlbring Journal: Internet Interv Date: 2020-06-02
Authors: Fernando Fernández-Aranda; Miquel Casas; Laurence Claes; Danielle Clark Bryan; Angela Favaro; Roser Granero; Carlota Gudiol; Susana Jiménez-Murcia; Andreas Karwautz; Daniel Le Grange; Jose M Menchón; Kate Tchanturia; Janet Treasure Journal: Eur Eat Disord Rev Date: 2020-05
Authors: William Bevens; Tracey Weiland; Kathleen Gray; George Jelinek; Sandra Neate; Steve Simpson-Yap Journal: J Med Internet Res Date: 2022-02-09 Impact factor: 5.428
Authors: Jessica A Lin; Sydney M Hartman-Munick; Meredith R Kells; Carly E Milliren; Wallis A Slater; Elizabeth R Woods; Sara F Forman; Tracy K Richmond Journal: J Adolesc Health Date: 2021-07-12 Impact factor: 5.012