Examining the feasibility of a parental self‐help intervention for families awaiting pediatric eating disorder services

Abstract

Objective Waitlists for eating disorder (ED) services grew immensely during the COVID‐19 pandemic. To address this, we studied the feasibility of a novel parental self‐help waitlist intervention. Method Parents of a child/adolescent (7–17 years) awaiting pediatric ED services were provided with our intervention, adapted from the family‐based treatment model, and consisting of videos and reading material with no therapist involvement. Parent‐reported child/adolescent weight was collected weekly 6 weeks pre‐intervention, 2 weeks during the intervention, and 6‐week post‐intervention. Recruitment and retention rates were calculated. Regression‐based interrupted time series analyses were completed to measure changes in the rate of weight gain. Results Ninety‐seven parents were approached, and 30 agreed to participate (31% recruitment rate). All but one completed end‐of‐study measures (97% retention rate). The average rate of weight gain was 0.24 lbs/week pre‐intervention, which increased significantly to 0.78 lbs/week post‐intervention (p < .034). Discussion Our findings provide preliminary evidence that this intervention is feasible. Future research is needed to confirm the efficacy of this intervention on a larger scale. Public Significance The COVID‐19 pandemic has resulted in several challenges in providing care for children and adolescents with eating disorders, including long waiting lists and delays in treatment. This study suggests that providing parents on a waitlist with educational videos and reading material is acceptable to parents, and may even help in improving the child's symptoms of an eating disorder.

Waiting-list interventions for children and young people using child and adolescent mental health services: a systematic review

“…Behavioural changes were assessed in three of the four eating disorders studies in terms of child weight and eating disorder symptoms. A positive impact was noted in two studies,17 26 with significant weight gains reported in both studies; one study26 additionally noted a decrease in eating disorder behaviours. No impact on eating disorder symptoms was found in another 24…”

“…There were contradictory findings on whether the waiting list interventions improved parental stress14 23 and parental depression and anxiety 15 18 21 27 29. Improvements were noted in quality of life and parent self-efficacy,17 as well as a reduction in the proportion of families with unhealthy family functioning 18…”

“…Some children and young people reported difficulties in attending the intervention because it was held during the school day 21. Low recruitment rate was noted as a barrier in some studies,17 21 with authors postulating that this may be because of parental disempowerment and fear of losing their place on the waiting list or that support may be delayed because of their participation 26. However, once participants were recruited, waiting list interventions generally had low drop-out rates 13 21 22…”

“…Given the exploratory nature of many of the studies, few studies reported on clinical outcomes, and these presented mixed results. Nevertheless, several interventions had some supporting evidence for their clinical effectiveness 13 15 17 18 21 22 24 26 27 29…”

“…The limitations of the underpinning research limit our ability to draw definitive conclusions through this review, particularly as most of the primary studies are small in nature, and feasibility rather than definitive trials. Several studies reported difficulties in terms of recruitment, this could have led to selection bias in that parents/children and young people who participated were more likely to believe that the intervention would work and consequently more likely to benefit 13 17. Some studies reported that recruitment was limited by the exploratory nature of the study 14.…”