Screening and offering online programs for eating disorders: Reach, pathology, and differences across eating disorder status groups at 28 U.S. universities

Abstract

Objective The Internet‐based Healthy Body Image (HBI) Program, which uses online screening to identify individuals at low risk of, high risk of, or with an eating disorder (ED) and then directs users to tailored, evidence‐based online or in‐person interventions to address individuals' risk or clinical status, was deployed at 28 U.S. universities as part of a randomized controlled trial. The purpose of this study is to report on: (a) reach of HBI, (b) screen results, and (c) differences across ED status groups. Method All students on participating campuses ages 18 years or older were eligible, although recruitment primarily targeted undergraduate females. Results The screen was completed 4,894 times, with an average of 1.9% of the undergraduate female student body on each campus taking the screen. ED risk in participating students was high—nearly 60% of students screened were identified as being at high risk for ED onset or having an ED. Key differences emerged across ED status groups on demographics, recruitment method, ED pathology, psychiatric comorbidity, and ED risk factors, highlighting increasing pathology and impairment in the high‐risk group. Discussion Findings suggest efforts are needed to increase reach of programs like HBI. Results also highlight the increasing pathology and impairment in the high‐risk group and the importance of programs such as HBI, which provide access to timely screening and intervention to prevent onset of clinical EDs.

Introduction to the special issue on advancing assessment of, and interventions for, eating disorders via innovative uses of technology

“…Results with respect to help‐seeking intentions were promising and may inform future research that should assess actual help‐seeking behavior as an outcome variable. However, similar to Fitzsimmons‐Craft et al (), the authors report substantial challenges related to the reach and dissemination of the online resource.…”

“…Fitzsimmons‐Craft et al () invited students from 28 universities in the U.S. to participate in an online screening and subsequent intervention for preventing or treating eating disorders. Participants were assigned to one of four interventions depending on their individual risk profile and level of eating disorder‐related impairment.…”

User‐centered design for technology‐enabled services for eating disorders

“…Reach is defined as the number of people who are offered a service relative to the number of people eligible to receive it, and engagement is defined as uptake and/or adherence to a service. For example, in two initiatives we conducted to implement online screening and intervention for eating disorders on university campuses in the U.S., <3% of the student body completed screening (Fitzsimmons‐Craft et al, ; Fitzsimmons‐Craft et al, ). Similar results were observed for an Internet‐based eating disorder intervention delivered in an Irish university setting (Lindenberg, Moessner, Harney, McLaughlin, & Bauer, ).…”

Introduction to a special issue on eating disorders and related symptomatology in male populations

“…As such, the application of clinical interventions with male populations rests on inferences drawn from research conducted with largely female samples. However, in the largest prospective study to date of treatment outcomes in males with eating disorders, Strobel, Quadflieg, Naab, Voderholzer, and Fichter (2019) and Quadflieg, Strobel, Naab, Voderholzer, and Fichter (2019) describe a series of important outcomes in a large sample of male inpatients with eating disorders over an average follow-up period ranging from~5 to 9 years across the diagnostic groups.…”