Predictors of treatment seeking and uptake among respondents to a widely disseminated online eating disorders screen in the United States

Abstract

Objective: To explore predictors of treatment seeking and uptake among individuals following an online eating disorders (EDs) screen in the U.S. disseminated by the National Eating Disorders Association. Method:Respondents who screened at risk or positive for a probable ED from 04/2019 to 05/2021 (N = 263,530) were eligible to complete a 2-month follow-up survey that assessed treatment seeking and uptake after being offered referral options following screening. Analyses were conducted using chi-square tests or logistic regressions.Results: Sixty thousand thirty-four respondents (22.8%) opted-in to the follow-up survey, of whom 2276 (3.8%) completed it. Of the final analytic sample (n = 1922), 35.7% of respondents reported seeking and 22.4% reported receiving treatment.Treatment seeking and uptake were more common among respondents who were female, White, or >24 years of age; uptake was more common among respondents who were non-Hispanic or higher income. Elevated shape/weight concerns were significantly, albeit modestly, associated with reduced likelihood to receive treatment.Discussion: Demographic differences in treatment seeking and uptake highlight the need to optimize ED screening tools/feedback to meet the needs of underserved groups and to address stereotypes and structural barriers that may interfere.Research is also needed to identify barriers to uptake among those with elevated shape/weight concerns.Public Significance: Relatively low rates of treatment seeking and uptake were observed, particularly among underserved groups, 2 months following a widely disseminated online eating disorders screen. Optimization of online eating disorder screening tools and delivery of feedback and referral information may be needed to increase health care utilization.

Barriers and facilitators affecting treatment uptake behaviours for patients with eating disorders: A systematic review synthesising patient, caregiver and clinician perspectives

“…Disagreements were settled by a third, independent rater. In total, 73 studies were deemed eligible to be included in the current review (Ali et al., 2020; Andersen et al., 2021; Becker et al., 2003; Becker et al., 2010; Bye et al., 2018; Byrom et al., 2022; Cachelin & Striegel‐Moore, 2006; Cachelin et al., 2001; Cavazos‐Rehg et al., 2020; Chowbey et al., 2012; Ciao et al., 2020; Coelho et al., 2021; Couturier et al., 2013; Dayal et al., 2015; Dearden & Mulgrew, 2013; Del Valle et al., 2017; Elran‐Barak et al., 2018; Escobar‐Koch et al., 2010; Evans et al., 2011; Fitzsimmons‐Craft, Balantekin, et al., 2020; Fitzsimmons‐Craft, Eichen, et al., 2020; Fitzsimmons‐Craft, Krauss, et al., 2020; Forrest et al., 2017; Goodwin & Fitzgibbon, 2002; Gorse et al., 2013; Grammer et al., 2022; Griffiths et al., 2015; Griffiths et al., 2018; Grillot & Keel, 2018; Gulliksen et al., 2015; Hamilton et al., 2022; Hartman‐Munick et al., 2021; Hepworth & Paxton, 2007; Herman et al., 2014; Javier & Belgrave, 2019; Kanakam, 2021; Kästner et al., 2021; Lazare et al., 2021; Leavey et al., 2011; Lebow et al., 2021; Linardon, Shatte, et al., 2020; Linardon, Rosato, et al., 2020; Linardon et al., 2021; Lipson et al., 2017; Liu et al., 2022; Ma et al., 2021; Maier et al., 2014; Malova & Dunleavy, 2021; Martin‐Wagar et al., 2021; McClay et al., 2016; Meyer, 2001; Moessner et al., 2016; Mond et al., 2009; Neyland & Bard...…”

“…Cachelin & Striegel-Moore, 2006;Cachelin et al, 2001;Cavazos-Rehg et al, 2020;Chowbey et al, 2012;Ciao et al, 2020;Coelho et al, 2021;Couturier et al, 2013;Dayal et al, 2015;Dearden & Mulgrew, 2013;Del Valle et al, 2017;Elran-Barak et al, 2018;Escobar-Koch et al, 2010;Evans et al, 2011;Fitzsimmons-Craft, Balantekin, et al, 2020;Fitzsimmons-Craft, Eichen, et al, 2020;Fitzsimmons-Craft, Krauss, et al, 2020;Forrest et al, 2017;Goodwin & Fitzgibbon, 2002;Gorse et al, 2013;Grammer et al, 2022;Griffiths et al, 2015;Griffiths et al, 2018;Grillot & Keel, 2018;Gulliksen et al, 2015;Hamilton et al, 2022;Hartman-Munick et al, 2021;Hepworth & Paxton, 2007;Herman et al, 2014;Javier & Belgrave, 2019;Kanakam, 2021;Kästner et al, 2021;Lazare et al, 2021;Leavey et al, 2011;Lebow et al, 2021;Linardon, Shatte, et al, 2020;Linardon, Rosato, et al, 2020;Linardon et al, 2021;Lipson et al, 2017;…”

Equitable access to evidence-based treatment for eating disorders for patients with low-income: identifying barriers and exploring solutions

“…Mis-diagnosis and under-diagnosis, well-described elsewhere (Fursland and Watson, 2014; Kornstein et al ., 2016; Strother et al ., 2013), are associated with low rates of treatment-seeking for individuals with EDs (Hart et al ., 2011). Reluctance to seek care may be fuelled by shame and stigma, poor mental health literacy (Grammer et al ., 2022; Hamilton et al ., 2022; Sonneville and Lipson, 2018), denial of the illness and the belief that others cannot help (Radunz et al ., 2023). Delays in diagnosis or treatment-seeking are especially prominent in historically marginalized ethnic/racial groups, men, and individuals in larger bodies (Becker et al ., 2003; Coffino et al ., 2019; Garb, 2021; Gewirtz O’Brien et al ., 2021; Harrop, 2020; Marques et al ., 2011; Sonneville and Lipson, 2018), which may be related to higher levels of stigma felt by these groups (Benuto et al ., 2019; Griffiths et al ., 2015).…”

Adaptations of an Online Cognitive-Behavioral Therapy Intervention for Binge-Purge Type Eating Disorders in Publicly-Insured and Uninsured Adults: A Pilot Study

“…EDs affect individuals across race, ethnicity, and socioeconomic status (SES), and do not typically differ by race or ethnicity, except for bulimia nervosa which is more prevalent among Latino and Black vs White individuals (1-3). Unfortunately, < 20% of individuals with EDs ever receive care, with treatment uptake being lowest amongst those who do not identify as female, White, non-Hispanic, or high income (4,5).…”