Considerations of Access and Inclusion in Adolescent Eating Disorder Care: A Custom Rapid Report

Abstract


 This custom rapid report provides insight into some challenges of equitable access to and inclusion in specialized eating disorder care for racialized, LGBTQ2S+, and male adolescents living with distress related to body image, eating, and food. To do this work, the author of this custom report engaged with empirical and conceptual literature around adolescent eating disorders and investigates how access and inclusion have been conceptualized in that literature.
 Equitable access to specialized and inclusive eating disorder care for racialized, LGBTQ2S+, and male adolescents can be hampered by reductive understandings of these adolescents’ needs and experiences of distress around eating and body image. Similarly, diagnostic categories, diagnostic assessment tools, and treatments designed with and for the archetype of the young, white, cisgender woman living with an eating disorder, reduce the understanding of adolescents not fitting this archetype. Cultural competency training and practising cultural humility were both described as supportive elements in working toward providing equitable access to inclusive eating disorder care.
 A series of sensitizing questions are provided at the end of this report and are meant to support the CADTH team in remaining attentive to considerations of equity of access and inclusivity as they assess early intervention programs for adolescents living with eating disorders in an upcoming health technology assessment.

Short- and long-term effects of Covid-19 pandemic on health care system for individuals with eating disorders

“…One significant hindrance is the impact of socioeconomic status, particularly for individuals belonging to lower social classes, who face challenges in accessing ED units due to perceived treatment costs and inaccurate stereotypes associating EDs mainly with higher social classes. Cultural barriers, such as stigma, shame, and guilt, contribute to the reluctance of seeking specialized care, as well as personal factors, including denial, ambivalence, and poor health literacy, further impede access ( 38 ). Moreover, as suggested in the report by Herington and colleagues ( 38 ) structural challenges, like dismissive attitudes from primary care providers and disparities in referral patterns, affecting ethnic minorities, LGBTQ2S+ individuals, and non-binary individuals, add complexity to the issue.…”

“…Cultural barriers, such as stigma, shame, and guilt, contribute to the reluctance of seeking specialized care, as well as personal factors, including denial, ambivalence, and poor health literacy, further impede access ( 38 ). Moreover, as suggested in the report by Herington and colleagues ( 38 ) structural challenges, like dismissive attitudes from primary care providers and disparities in referral patterns, affecting ethnic minorities, LGBTQ2S+ individuals, and non-binary individuals, add complexity to the issue. The role of others in prompting individuals to seek care is nuanced, with prompting from friends and workmates associated with delayed access to ED units, while prompting from family members and partners shortens access time.…”