D'Adamo Laura, Laboe Agatha A, Goldberg Jake, Howe Carli P, Steinhoff Molly Fennig, DePietro Bianca, Firebaugh Marie-Laure, Cooper Zafra, Wilfley Denise E, Fitzsimmons-Craft Ellen E
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Center for Weight, Eating, and Lifestyle Science and Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA.
BMC Digit Health. 2025;3(1). doi: 10.1186/s44247-024-00140-6. Epub 2025 Jan 7.
Most individuals with eating disorders (EDs) do not receive treatment, and those who do receive care typically do not receive evidence-based treatment, partly due to lack of accessible provider training. This study developed a novel "all-in-one" online platform for disseminating training for mental health providers in cognitive-behavioral therapy guided self-help (CBTgsh) for EDs and supporting its implementation. The aim of the study was to obtain usability data from the online platform prior to evaluating its effects on provider training outcomes and patient ED symptom outcomes in an open pilot trial.
Nine mental health provider participants ( = 4 in Cycle 1; = 5 in Cycle 2) and 9 patient participants ( = 4 in Cycle 1; = 5 in Cycle 2) were enrolled over two cycles of usability testing. In Cycle 1, we recruited providers and patients separately to complete brief platform testing sessions. In Cycle 2, we recruited provider-patient dyads; providers completed training using the platform and subsequently delivered CBTgsh to a patient for three weeks. Usability was assessed using the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), and semi-structured interviews.
Interview feedback converged on two themes for providers (applicability of program for real-world use, platform structure and function) and two themes for patients (barriers and facilitators to engagement, perceived treatment effects). SUS and USE scores were in the "average" to "good" ranges across cycles.
Findings from this study demonstrate preliminary feasibility and acceptability of the online platform. Data collected in this study will inform further refinements to the online platform. The platform's effects on provider training outcomes and patient ED symptom outcomes will be evaluated in an open pilot trial. Given the wide treatment gap for EDs and barriers to dissemination and implementation of evidence-based treatments, the online platform represents a scalable solution that could improve access to evidence-based care for EDs.
大多数饮食失调（ED）患者未接受治疗，而那些接受治疗的患者通常也未接受循证治疗，部分原因是缺乏可获得的提供者培训。本研究开发了一个新颖的“一体化”在线平台，用于向心理健康提供者传播针对饮食失调的认知行为疗法指导自助（CBTgsh）培训并支持其实施。本研究的目的是在一项开放性试点试验中评估该在线平台对提供者培训结果和患者饮食失调症状结果的影响之前，从该在线平台获取可用性数据。
在两个可用性测试周期中招募了9名心理健康提供者参与者（第1周期4名；第2周期5名）和9名患者参与者（第1周期4名；第2周期5名）。在第1周期，我们分别招募提供者和患者来完成简短的平台测试环节。在第2周期，我们招募提供者 - 患者二元组；提供者使用该平台完成培训，随后为一名患者提供为期三周的CBTgsh。使用系统可用性量表（SUS）、有用性、满意度和易用性问卷（USE）以及半结构化访谈来评估可用性。
访谈反馈集中在提供者的两个主题（该项目在现实世界中的适用性、平台结构和功能）和患者的两个主题（参与的障碍和促进因素、感知到的治疗效果）上。各周期的SUS和USE分数处于“平均”到“良好”范围。
本研究结果证明了该在线平台的初步可行性和可接受性。本研究收集的数据将为在线平台的进一步改进提供信息。该平台对提供者培训结果和患者饮食失调症状结果的影响将在一项开放性试点试验中进行评估。鉴于饮食失调的治疗差距巨大以及循证治疗的传播和实施存在障碍，该在线平台代表了一种可扩展的解决方案，有望改善饮食失调患者获得循证护理的机会。
