Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
Center for m2Health, Palo Alto University, Palo Alto, California, USA.
Int J Eat Disord. 2022 Mar;55(3):382-387. doi: 10.1002/eat.23652. Epub 2021 Dec 14.
Eating disorders (EDs) contribute considerably to the global burden of disease. However, most affected individuals do not receive treatment. Mobile apps present an enormous opportunity to increase access to mental healthcare services. This study examined whether the degree of usage of a self-help app for EDs mediated the app's effects on the clinical response by individuals with EDs.
App usage measures included the total number of cognitive-behavioral meal logs, total number of days spent using the app, and the last day the app was used during the study period. Mediation analysis was performed using the MacArthur framework.
All usage variables met the analytic requirements for testing mediation (group means (sd) for app and standard app, respectively: logs = 74 (108) vs. 51.4 (88.1), days spent = 14.3 (17.5) vs. 10.6 (15.0), p-values from Wilcox rank sum tests p < .01). Regression coefficients indicated mediation effects. The mediation effects demonstrated support that increased engagement (as measured by logs and time spent on the app) was related to an increased likelihood of achieving a significant clinical change by the end of the trial.
Greater and longer engagement in an ED app mediates its efficacy in terms of ED remission.
饮食失调（ED）对全球疾病负担有重大影响。然而，大多数受影响的个体并未接受治疗。移动应用程序为增加获得精神保健服务的机会提供了巨大的机会。本研究检查了 ED 自我帮助应用程序的使用程度是否在 ED 个体的临床反应中调节了该应用程序的效果。
应用程序使用措施包括认知行为膳食日志的总数、使用应用程序的总天数以及研究期间最后一次使用应用程序的日期。使用麦克阿瑟框架进行中介分析。
所有使用变量都满足测试中介的分析要求（分别为应用程序和标准应用程序的组平均值（sd）：日志= 74（108）与 51.4（88.1），使用天数= 14.3（17.5）与 10.6（15.0），Wilcox 等级和检验的 p 值<0.01）。回归系数表明存在中介效应。中介效应表明，参与度的增加（通过日志和在应用程序上花费的时间来衡量）与在试验结束时实现显著临床变化的可能性增加有关。
ED 应用程序的更大和更长时间的参与度调节了其在 ED 缓解方面的疗效。
