Abstract
BackgroundE-mental health has become increasingly popular in interventions for individuals with eating disorders (EDs). It has the potential to offer low-threshold interventions and guide individuals to the needed care more promptly. Featback is such an Internet-based intervention and consists of psychoeducation and a fully automated monitoring and feedback system. Preliminary findings suggest Featback to be (cost-)effective in reducing ED symptomatology. Additionally, e-mail or chat support by a psychologist did not enhance the effectiveness of Featback. Support by an expert patient (someone with a lived experience of an ED) might be more effective, since that person can effectively model healthy behavior and enhance self-efficacy in individuals struggling with an ED. The present study aims to replicate and build on earlier findings by further investigating the (cost-)effectiveness of Featback and the added value of expert-patient support.MethodsThe study will be a randomized controlled trial with a two-by-two factorial design with repeated measures. The four conditions will be (1) Featback, in which participants receive automated feedback on a short monitoring questionnaire weekly, (2) Featback with weekly e-mail or chat support from an expert patient, (3) weekly support from an expert patient, and (4) a waiting list. Participants who are 16 years or older and have at least mild self-reported ED symptoms receive a baseline measure. Subsequently, they are randomized to one of the four conditions for 8 weeks. Participants will be assessed again post-intervention and at 3, 6, 9, and 12 months follow-up. The primary outcome measure will be ED psychopathology. Secondary outcome measures are experienced social support, self-efficacy, symptoms of anxiety and depression, user satisfaction, intervention usage, and help-seeking attitudes and behaviors.DiscussionThe current study is the first to investigate e-mental health in combination with expert-patient support for EDs and will add to the optimization of the delivery of Internet-based interventions and expert-patient support.Trial registrationNetherlands Trial Register, NTR7065. Registered on 7 June 2018.
Highlights
E-mental health has become increasingly popular in interventions for individuals with eating disorders (EDs)
It is highly similar to a previous Randomized controlled trial (RCT) from the same research group
Findings regarding the effectiveness of Featback can be replicated, and limitations of the previous study can be overcome
Summary
Design Since the present study is a continuation of previous work of this research group, the methodology described here will be similar and in some parts identical to the previous design [19]. If a participant indicates a BMI of 15 or lower or reports compensatory behavior or bingeing at least every day during a week in the screening or Featback monitoring assessment, an alarm signal will be sent to the main researcher. Satisfaction and intervention usage analyses (H5)To examine the fifth hypothesis that Featback with weekly expert-patient support results in an increased satisfaction and intervention usage, an ANOVA will be conducted to compare mean scores of satisfaction and intervention usage at T1 (i.e., directly after the intervention) between the three active intervention conditions. Cost-effectiveness analyses The effects and costs of Featback and/or online support from an expert patient will be compared to those of usual care (i.e., participants in the waiting list condition) from a societal perspective, including healthcare costs and nonhealthcare costs. No official data monitoring committee will be formed, since no difficulties in data management are anticipated, but use of a data log, making back-ups of the anonymized data file, and regularly checking data completeness are several methods that will be employed to promote data quality
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