National Implementation of Highly Efficient Evidence-Informed Treatment for Youth With Eating Disorders
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Implementation success at participating sites, as measured by fidelity to GSH FBT model
研究概览
简要总结
Eating disorders are amongst the most understudied illnesses affecting young women in Canada. Further, mortality rates are amongst the highest of all psychiatric illnesses. Despite their high prevalence and mortality rates, research into adolescent eating disorders is underfunded in Canada. In addition to the problem of research underfunding, healthcare system underfunding exists - creating long waiting lists and fragmented care for children and youth with eating disorders. More efficient treatments are urgently needed to reduce wait times and provide expedited care to adolescents on eating disorder waitlists. The current study aims to assess whether implementing a virtual parent-lead therapy, Guided Self Help Family-Based Therapy (GSH FBT) might alleviate wait times for eating disorder services and also reduce eating disorder symptomatology in young people with anorexia nervosa. This study also aims to determine the experiences of both families and medical teams of GSH FBT implementation as an intervention.
详细描述
The most widely used evidence-based treatment for children and adolescents with eating disorders is Family-Based Treatment (FBT). Similarly, Guided Self-Help FBT (GSH FBT) is a virtual treatment, adapted using FBT principles, that involves a therapist "coach" and a video platform for parents. Therapeutic challenges such as treatment fidelity could be partially mitigated with a model, such as GSH FBT, in which essential material is delivered by video or written material, standardizing the treatment and ensuring that key components are delivered. Given the surging wait list times for adolescent eating disorder treatment, GSH FBT is emerging as a promising, more efficient alternative to longer-term FBT and FBT-V. This study is aimed at examining the implementation of GSH FBT for pediatric patients with eating disorders across nine provinces in Canada using a mixed methods design. To implement this new model of care, the investigators will use implementation teams at each site along with GSH FBT provider training and consultation. The investigators will evaluate the implementation approach using qualitative and quantitative methods including fidelity assessments, examination of wait times, patient, family, and provider outcomes, as well as the overall experience of the implementation of the intervention. Experience of implementation will be assessed using qualitative measures such as semi-structured interviews and focus groups.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 12 Years 至 100 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Family including an adolescent with a confirmed diagnosis of Anorexia nervosa according to DSM-5-TR criteria.
- •Access to computer and internet connection
- •Have the capacity to speak, write, and understand English or French
- •Therapist/coaches are licensed mental health clinician with experience in eating disorder treatment
排除标准
- •Adolescent has a current physical or mental disorder that requires hospitalization and/or prohibits the use of psychotherapy
- •Adolescent has a current dependence on drugs or alcohol
- •Adolescent has a current physical condition known to influence weight or eating (pregnancy, diabetes mellitus)
- •Adolescent has expected body weight of less than 75%
- •Adolescent/family has undergone four or more sessions of FBT for anorexia nervosa at any time
- •Does not have the capacity to speak, write, and understand English or French
- •Does not have access to computer and internet connection
- •Professionals are not licensed mental health professionals with experience in eating disorder treatment.
研究组 & 干预措施
Parents who have a child with anorexia nervosa
Each participant will receive a series of pre-recorded videos, an electric scale, and a therapy manual ("Help Your Teenager Beat an Eating Disorder"). This will include content on empowering parents to renourish their child and interrupt binge/purge behaviors.
干预措施: Guided Self Help Family Based Therapy (GSH FBT) (Behavioral)
结局指标
主要结局
Implementation success at participating sites, as measured by fidelity to GSH FBT model
时间窗: Immediately after each session throughout the 10-week protocol
Fidelity of therapists will be measured via administration of a self-reporting fidelity questionnaire piloted in a previous GSH FBT feasibility study. This questionnaire includes nine yes/no questions that gauge whether the therapist was adherent to GSH FBT principles: 1) ensuring only parents are present; 2) ensuring the adolescent is not present; 3) asking parents questions/comments about course materials; 4) avoiding direct orchestration of behavioural change; 5) referencing course materials during the session; 6) focusing the session on treatment; 7) assigning homework appropriately; and 8) \& 9) verifying session length. Videos will also be monitored regularly for fidelity via expert review.
次要结局
- Changes in wait times as result of implementation approach(at the baseline (week 0) and at the end of treatment (24 weeks))
- Provider's readiness for change(at the baseline (week 0) and at the end of treatment (24 weeks))
- Changes in severity of eating disorder symptoms(at the baseline (week 0) and at the end of treatment (24 weeks))
- Changes in severity of depressive symptoms(at the baseline (week 0) and at the end of treatment (24 weeks))
- Changes in anxiety symptoms(at the baseline (week 0) and at the end of treatment (24 weeks))
- Changes in obsessional thinking and compulsive behaviours(at the baseline (week 0) and at the end of treatment (24 weeks))
- Changes in parental self-efficacy(at the baseline (week 0) and at the end of treatment (24 weeks))
- Providers' attitudes towards evidence-based practice(at the baseline (week 0) and at the end of treatment (24 weeks))
- Changes in obsessional thinking and compulsive behaviours (linked to eating disorder symptomatology)(at the baseline (week 0) and at the end of treatment (24 weeks))
- Provider's confidence in ability to deliver intervention(at the baseline (week 0) and at the end of treatment (24 weeks))
研究者
Jennifer Couturier
Principal Investigator
McMaster University