George Mason University, Fairfax, Virginia, USA.
Brown University, Butler Hospital, Providence, Rhode Island, USA.
Pediatr Diabetes. 2022 Nov;23(7):1122-1132. doi: 10.1111/pedi.13395. Epub 2022 Aug 12.
Adolescents with type 1 diabetes are at significantly increased risk for eating disorders and few interventions exist.
This study examined the feasibility, acceptability, and preliminary effects of an internet-based eating disorders prevention program adapted specifically for adolescent girls with type 1 diabetes.
Thirty-five girls (16.2 ± 1.1 years) participated Body Project (T1D Style), a 4-week program consisting of four adolescent sessions focused on promoting illness acceptance, challenging sociocultural body image pressures, increasing social support, and teaching assertive communication. Caregivers participated in one session focused on fostering body image positivity and a healthy relationship with food. Pre-intervention, post-intervention, and 3-month follow-up surveys assessed disordered eating, body dissatisfaction, thin-ideal internalization, diabetes acceptance, diabetes distress, and quality of life. Cohen's d effect sizes were calculated at post-intervention and follow-up. Program acceptability was assessed at post-intervention. Manual fidelity and homework completion were monitored.
High manual fidelity, retention, and homework completion were achieved. Quantitative and qualitative feedback from teens and caregivers suggested high acceptability. Large effects (d = 1.35-0.83) were observed for dieting, body dissatisfaction, diabetes distress, diabetes acceptance, and diabetes-related quality of life at post-intervention, with large-medium effects (d = 1.16-0.58) at follow-up. Medium-small effects (d = 0.49-0.78) at post-intervention were observed for diabetes-specific disordered eating and thin-ideal internalization, with effects maintained at follow-up.
Results support the acceptability and feasibility of this targeted eating disorders prevention program for adolescent girls with type 1 diabetes. Future clinical trials are warranted to determine its effectiveness compared to a control condition.
患有 1 型糖尿病的青少年患饮食失调症的风险显著增加，但目前干预措施较少。
本研究旨在检验专门为 1 型糖尿病少女设计的基于互联网的饮食失调预防计划的可行性、可接受性和初步效果。
35 名女孩（16.2±1.1 岁）参加了 Body Project（T1D Style），这是一个为期 4 周的计划，包括 4 个针对青少年的课程，重点是促进疾病接受度、挑战社会文化身体形象压力、增加社会支持和教授自信沟通。照顾者参加了一个专注于培养身体形象积极性和健康食物关系的课程。在干预前、干预后和 3 个月随访调查中，评估了饮食失调、身体不满、瘦理想内化、糖尿病接受度、糖尿病困扰和生活质量。在干预后和随访中计算了 Cohen's d 效应大小。在干预后评估了项目的可接受性。监测了手册的忠实度和家庭作业的完成情况。
实现了高手册忠实度、保留率和家庭作业完成率。青少年和照顾者的定量和定性反馈表明，该项目的可接受性很高。在干预后，节食、身体不满、糖尿病困扰、糖尿病接受度和糖尿病相关生活质量方面观察到较大的效应（d=1.35-0.83），在随访中观察到较大-中等效应（d=1.16-0.58）。在干预后观察到糖尿病特异性饮食失调和瘦理想内化方面的中等-小效应（d=0.49-0.78），随访中效应仍然存在。
结果支持针对 1 型糖尿病少女的这种有针对性的饮食失调预防计划的可接受性和可行性。未来需要进行临床试验，以确定与对照组相比的有效性。
