Oregon Research Institute, Eugene, Oregon 97403, USA.
Int J Eat Disord. 2013 Jul;46(5):478-85. doi: 10.1002/eat.22105.
This narrative review sought to (a) characterize prevention programs that have produced reliable, reproducible, and clinically meaningful effects in efficacy trials, (b) discuss effectiveness trials that have tested whether prevention programs produce intervention effects under ecologically valid real-world conditions, (c) discuss dissemination efforts and research on dissemination, and (d) offer suggestions regarding directions for future research in this field.
A literature revealed that 6 prevention programs have produced significant reductions in eating disorder symptoms through at least 6-month follow-up and that 2 have significantly reduced future eating disorder onset. Effectiveness trials indicate that 2 prevention programs have produced effects under ecologically valid conditions that are only slightly attenuated. Although there have been few dissemination efforts, evidence suggests that a community participatory approach is most effective. Lastly, it would be useful to develop programs that produce larger and more persistent reductions in eating disorder symptoms and eating disorder onset, focus more on effectiveness trials that confirm that prevention programs produce clinically meaningful effects under real-world conditions, conduct meditational, mechanisms of action, and moderator research that provides stronger support for the intervention theory of prevention programs, and investigate the optimal methods of disseminating and implementing evidence-based prevention programs.
本叙述性评论旨在：(a) 描述在疗效试验中产生可靠、可重复且具有临床意义效果的预防计划；(b) 讨论有效性试验，以测试预防计划在生态有效现实环境下是否产生干预效果；(c) 讨论传播工作和传播研究；(d) 就该领域未来研究的方向提出建议。
文献表明，有 6 个预防计划通过至少 6 个月的随访显著减少了饮食障碍症状，有 2 个预防计划显著降低了未来饮食障碍的发病风险。有效性试验表明，在生态有效条件下，有 2 个预防计划产生的效果仅略有减弱。尽管传播工作很少，但有证据表明，社区参与方法最有效。最后，开发能更显著、更持久地减少饮食障碍症状和发病风险的计划将是有益的，更多地关注那些能证实预防计划在现实环境下产生临床意义效果的有效性试验，开展中介、作用机制和调节因素研究，为预防计划的干预理论提供更有力的支持，并研究传播和实施循证预防计划的最佳方法。
