Disseminating Eating Disorders Education and Treatment Across Multiple Levels of Care: Improving Access in the Rhode Island Medicaid Population
试验速览
- 阶段
- 1 期
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- BMI percentile
研究概览
简要总结
The goals of this project are to 1) develop training opportunities for master's-level and pre-doctoral psychology students in evidence-based assessment and treatment of adolescent EDs; 2) to provide the healthcare workforce, including licensed health professionals such as primary care physicians and behavioral health interventionists, with knowledge and competence to recognize early symptoms of and intervention strategies for EDs; and 3) to test the efficacy of delivering two evidence-based treatments for adolescent eating disorders, Family Based Treatment (FBT) and Enhanced Cognitive Behavioral Therapy (CBT-E), in the home-based setting.
详细描述
The complete project will incorporate three phases. Phase I is designed to gather information from existing licensed health professionals in the community who serve Medicaid populations on their knowledge needs and priorities related to screening and intervening with patients with eating disorders. Phase I will comprise eating disorder psycho-education, implementation of workshops, and supervision among primary care professionals and mental health workers. Responses will inform the content of in-services and program development (e.g., monthly consultation services, ongoing multi-family support groups) provided in Phase II.
During Phase II, families containing a child with a restrictive-type eating disorder will be recruited to receive treatment from the clinicians assessed and trained during Phase I. Families will be assigned to receive either Family Based Treatment (FBT) or Enhanced Cognitive Behavioral Therapy (CBT-E) to treat their adolescent's eating disorder. Treatment will occur over 10-16 weeks, depending on the family's needs and availability. Families will be assessed at pre-treatment, post-treatment, and 1-year follow-up.
Phase III will consist of follow-up with the families and clinicians, and further development of training/education approaches for the Rhode Island healthcare workforce.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 12 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •meets criteria for AN, atypical AN, or BN according to DSM-5 diagnostic criteria
- •is currently living at home
- •is medically stable for outpatient treatment according to the recommended thresholds of the American Academy of Pediatrics and the Society of Adolescent Medicine (e.g., ≥75% of expected body weight, heartrate ≥50 beats per minute)
- •if on a psychotropic medication, meets all eligibility criteria while on stable dose of psychotropic medication (8 weeks) for a co-morbid condition
- •speaks English
- •be available for long-term follow-up.
排除标准
- •associated physical illness that necessitates hospitalization
- •psychotic illness/other mental illness requiring hospitalization
- •current dependence on drugs or alcohol
- •physical conditions (e.g. diabetes mellitus, pregnancy) known to influence eating or weight
- •concurrent involvement in other psychological treatment for an eating disorder
- •developmental delay that would preclude participation in the intervention.
研究组 & 干预措施
FBT
10 families will be randomized to receive 10 - 16 weeks of eating disorder treatment for their adolescent.
干预措施: Family Based Treatment (Behavioral)
CBT-E
10 families will be randomized to receive 10 - 16 weeks of eating disorder treatment for their adolescent.
干预措施: Enhanced Cognitive Behavioral Therapy (Behavioral)
结局指标
主要结局
BMI percentile
时间窗: 1 year follow up
Eating disorder symptomology, as assessed by the ED-15.
时间窗: post treatment (week 17)
Patient will complete the Eating Disorder 15 (ED-15) to assess the frequency and severity of specific eating disorder behaviors and cognitions. Average scores from the 15-item measure range from 1 - 5, with higher scores indicating higher eating disorder symptomology.
Eating disorder symptomology, as assessed by ED-15.
时间窗: 1 year follow-up
Patient will complete the Eating Disorder 15 (ED-15) to assess the frequency and severity of specific eating disorder behaviors and cognitions. Average scores from the 15-item measure range from 1 - 5, with higher scores indicating higher eating disorder symptomology.
Perceived efficacy of treatment, as assessed by the CSQ
时间窗: 1 year follow-up
The Client Satisfaction Questionnaire (CSQ) is an 8-item measure that assesses how successful the patient perceived treatment to be. Average scores range from 1 - 4, with higher scores indicating higher satisfaction and perceived efficacy.
Perceived efficacy of treatment, as assessed by the TSPE.
时间窗: 1 year follow-up
One item from the Treatment Suitability and Patient Expectancy (TSPE) survey will assess how successful the patient perceived treatment to be. This item ranges from 0 - 10, with higher scores indicating higher perceived efficacy.
Perceived feasibility of treatment, as assessed by the TSPE.
时间窗: post treatment (week 17)
One item from the Treatment Suitability and Patient Expectancy (TSPE) survey will assess how feasible the patient perceived treatment to be. This item ranges from 0 - 10, with higher scores indicating higher feasibility.
Perceived feasibility of treatment, as assessed by the CSQ.
时间窗: post treatment (week 17)
Two items from the 8-item Client Satisfaction Questionnaire (CSQ) will assess how suitable/feasible treatment was based on the patient's needs, family dynamics, schedule constraints, etc. Average scores range from 1 - 4, with higher scores indicating higher feasibility.
Eating disorder symptomology, as assessed by the EDE-Q.
时间窗: post treatment (week 17)
Patient will complete the Eating Disorder Examination Questionnaire (EDE-Q) to assess the frequency and severity of specific eating disorder behaviors and cognitions. Averages of the 28-item measure range from 0 to 6, with higher score indicating higher eating disorder symptomology.
Perceived efficacy of treatment, as assessed by the TSPE
时间窗: post treatment (week 17)
One item from the Treatment Suitability and Patient Expectancy (TSPE) survey will assess how successful the patient perceived treatment to be. This item ranges from 0 - 10, with higher scores indicating higher perceived efficacy.
Eating disorder symptomology, as assessed by EDE-Q
时间窗: 1 year follow-up
Patient will complete the Eating Disorder Examination Questionnaire (EDE-Q) to assess the frequency and severity of specific eating disorder behaviors and cognitions. Average scores of the 28-item measure range from 0 to 6, with higher score indicating higher eating disorder symptomology.
BMI percentile
时间窗: post treatment (week 17)
Perceived efficacy of treatment, as assessed by the CSQ
时间窗: post treatment (week 17)
The Client Satisfaction Questionnaire (CSQ) is an 8-item measure that assesses how successful the patient perceived treatment to be. Average scores range from 1 - 4, with higher scores indicating higher satisfaction and perceived efficacy.
次要结局
未报告次要终点