An evaluation of an Internet-delivered eating disorder prevention program for adolescents and their parents

Brown, Jennifer Bruning; Winzelberg, Andrew J.; Abascal, Liana; Taylor, C. Barr

doi:10.1016/j.jadohealth.2003.10.010

Cited by 78 publications

(50 citation statements)

References 30 publications

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“…One study contained 2 interventions, which are designated as a and b [62]. Across these studies, 17,524 participants were allocated to 30 interventions, with 14,895 participants completing postintervention surveys.…”

Section: Resultsmentioning

confidence: 99%

Online Interventions for Social Marketing Health Behavior Change Campaigns: A Meta-Analysis of Psychological Architectures and Adherence Factors

Cugelman¹,

Thelwall²,

Dawes³

2011

J Med Internet Res

278

242

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BackgroundResearchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet’s reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change.ObjectivesThis meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes.MethodsDrawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence and behavioral outcomes.ResultsThe overall impact of online interventions across all studies was small but statistically significant (standardized mean difference effect size d = 0.19, 95% confidence interval [CI] = 0.11 - 0.28, P < .001, number of interventions k = 30). The largest impact with a moderate level of efficacy was exerted from online interventions when compared with waitlists and placebos (d = 0.28, 95% CI = 0.17 - 0.39, P < .001, k = 18), followed by comparison with lower-tech online interventions (d = 0.16, 95% CI = 0.00 - 0.32, P = .04, k = 8); no significant difference was found when compared with sophisticated print interventions (d = –0.11, 95% CI = –0.34 to 0.12, P = .35, k = 4), though online interventions offer a small effect with the advantage of lower costs and larger reach. Time proved to be a critical factor, with shorter interventions generally achieving larger impacts and greater adherence. For psychological design, most interventions drew from the transtheoretical approach and were goal orientated, deploying numerous influence compon...

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Section: Resultsmentioning

confidence: 99%

Online Interventions for Social Marketing Health Behavior Change Campaigns: A Meta-Analysis of Psychological Architectures and Adherence Factors

Cugelman¹,

Thelwall²,

Dawes³

2011

J Med Internet Res

278

242

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“…In a pilot study, we randomly assigned 69 parents of adolescents to a program that combined online instruction and a pamphlet to reduce parental criticism about weight, shape, and eating. 28 The pamphlet included a self-quiz in which parents self-assessed the type of messages they might be sending their daughter about weight and shape, discussed the negative consequences of these messages, and provided examples of how to communicate without being critical. There was a significant reduction on a measure of parental negative attitudes and behaviors to others and, surprisingly, a significant increase on the parents' outlook about themselves.…”

Section: Discussionmentioning

confidence: 99%

The Adverse Effect of Negative Comments About Weight and Shape From Family and Siblings on Women at High Risk for Eating Disorders

et al. 2006

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“…SB has been evaluated in eleven RCTs, seven in the USA (Bruning Brown et al , 2004, Celio et al , 2000, Kass et al , 2014, Low et al , 2006, Taylor et al , 2006, Taylor et al , 2016, Winzelberg et al , 2000, Winzelberg et al , 1998) and four in Germany (Jacobi et al , 2005, 2007, Jacobi et al , 2012). These samples have included young-adult or late adolescent females from college and high-school settings.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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Background: Disordered eating (DE) is a widespread, serious problem. Efficacious prevention programs that can be delivered at-scale are needed. Methods: A pragmatic randomized-controlled trial of 2 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. Results: 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 intention-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. Conclusions: Given both programs were not therapist-moderated, MS-T has potential to achieve reductions in DE risk at low implementation costs.

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An evaluation of an Internet-delivered eating disorder prevention program for adolescents and their parents

Abstract: The program demonstrates the feasibility of providing an integrated program for students and their parents with short-term positive changes in parental attitudes toward weight and shape.

Cited by 78 publications

References 30 publications

Online Interventions for Social Marketing Health Behavior Change Campaigns: A Meta-Analysis of Psychological Architectures and Adherence Factors

Online Interventions for Social Marketing Health Behavior Change Campaigns: A Meta-Analysis of Psychological Architectures and Adherence Factors

The Adverse Effect of Negative Comments About Weight and Shape From Family and Siblings on Women at High Risk for Eating Disorders

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

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