Accurso Erin C, Drury Catherine R, Yu Kimberly, Vendlinski Siena, Pérez-Flores Nancy Jacquelyn, Howe Carli P, Wilfley Denise E, Fitzsimmons-Craft Ellen E
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA.
Int J Eat Disord. 2025 Aug;58(8):1535-1546. doi: 10.1002/eat.24459. Epub 2025 May 12.
This study evaluated the feasibility, acceptability, and preliminary effectiveness of the first digital intervention tailored for lower-income adults with eating disorders, who are poorly served by the public health care system.
Adults (N = 30) with public insurance or without insurance coverage who endorsed ≥ 6 binge eating episodes, ≥ 6 vomiting episodes, and/or ≥ 6 laxative/diuretic episodes in the past three months with a body mass index ≥ 18.5 kg/m were enrolled in this open pilot trial. Participants received access to the coached digital CBT-based intervention, which included individualized guidance and twice-weekly SMS feedback from a program coach over three months.
Almost all participants (93.3%, n = 28) accessed the program after enrollment, completing about half (M = 4.15, SD = 2.68) of the 8 sessions and sending an average of 32.5 (SD = 35.2) texts to their coach over three months. From pre- to post-intervention, there were large improvements in eating disorder psychopathology (d = 0.79, p < 0.001) and moderate decreases in binge eating (d = 0.62, p = 0.003) and self-induced vomiting episodes (d = 0.43, p = 0.031). There were also large improvements in clinical impairment (d = 0.83, p < 0.001) and moderate to large reductions in anxiety (d = 0.47, p = 0.019) and depression (d = 0.84, p < 0.001). Most participants indicated that they were somewhat to very satisfied with the program (67.9%, n = 19).
The results from this pilot trial testing a brief online guided self-help intervention are promising, with relatively high treatment engagement, indicating good feasibility and acceptability and signals of preliminary effectiveness. Future research is needed to examine longer-term effectiveness relative to other active treatments or waitlist control.
本研究评估了首款为患有饮食失调症的低收入成年人量身定制的数字干预措施的可行性、可接受性和初步效果，这些成年人在公共医疗保健系统中未得到充分服务。
在过去三个月中出现≥6次暴饮暴食发作、≥6次呕吐发作和/或≥6次使用泻药/利尿剂发作且体重指数≥18.5kg/m²的有公共保险或无保险的成年人（N = 30）参加了这项开放试点试验。参与者可以使用基于认知行为疗法的有指导的数字干预措施，其中包括个性化指导以及在三个月内由项目教练提供的每周两次的短信反馈。
几乎所有参与者（93.3%，n = 28）在注册后都使用了该项目，完成了8次课程中的约一半（M = 4.15，SD = 2.68），并在三个月内向他们的教练平均发送了32.5条（SD = 35.2）短信。从干预前到干预后，饮食失调心理病理学有了很大改善（d = 0.79，p < 0.001），暴饮暴食（d = 0.62，p = 0.003）和自我诱导呕吐发作（d = 0.43，p = 0.031）有中度下降。临床损伤也有很大改善（d = 0.83，p < 0.001），焦虑（d = 0.47，p = 0.019）和抑郁（d = 0.84，p < 0.001）有中度至大幅降低。大多数参与者表示他们对该项目有些满意到非常满意（67.9%，n = 19）。
这项测试简短在线指导自助干预措施的试点试验结果很有前景，治疗参与度相对较高，表明具有良好的可行性和可接受性以及初步效果的信号。需要进一步的研究来检验相对于其他积极治疗或等待名单对照的长期效果。
