? The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
doi:10.1093/fampra/cmm029Family Practice Advance Access published on 24 June 2007
Feasibility and acceptability of screening for eating
disorders in primary care
Johnston O, Fornai G, Cabrini S and Kendrick T. Feasibility and acceptability of screening for
eating disorders in primary care. Family Practice 2007; 24: 511–517.
Background. Earlier diagnosis of disordered eating is linked to improved prognosis, but
detection in primary care is poor.
Objectives. To assess the feasibility of screening for disordered eating within primary care, in
terms of the proportion of patients accepting screening, yield of cases, action taken by staff and
staff views on screening.
Methods. Data were collected in open GP surgeries, midwife (MW) antenatal clinics and health
visitor (HV) child health surveillance clinics in two GP practices, using face-to-face surveys and
semi-structured interviews. Female patients aged 16–35 were asked to complete the SCOFF
questionnaire, which was scored by researchers and taken by the patient into their consultation.
If the result indicated possible disturbed eating, the health professional (HP) running the surgery/
clinic was asked to complete a questionnaire and interview. One hundred and eleven women
were screened and 11 HPs (GPs, MWs, HVs) were interviewed.
Results. Forty-six percent of patients agreed to be screened. Of these, 16% produced a positive
result. The staff survey suggested that HPs found screening acceptable. However, concerns
arose in the interviews, principally over what action to take in response to positive results. Pos-
itive results were rarely recorded in medical notes, and treatment was rarely offered.
Conclusion. In order for a screening programme for eating disorders to be implemented in
primary care, HP concerns about options for dealing with positive results would need to be ad-
dressed. Feasibility of screening would be enhanced by production of a protocol to be followed
in the case of positive results.
Keywords. Acceptability, attitudes, eating disorders, feasibility, screening.
Disordered eating is one of the three most common
mental health difficulties (along with depression and
anxiety disorders).1Eating disorders are particularly
common in young women, and are a significant cause of
morbidity and mortality.2,3Luck et al.4note that ‘health
care workers in primary care are at the forefront of
screening and managing these disorders’ (p. 755). Ear-
lier diagnosis of eating disorders is linked to improved
prognosis,5but detection of eating disorders in primary
care is poor.6The National Institute for Clinical Excel-
lence (NICE) guidelines on the management of eating
disorders7point to the need for improved identification
and screening of eating disorders in primary care set-
tings. A survey by the Eating Disorders Association8in-
dicated that 42% of GPs did not make an early
diagnosis, suggesting that services are failing to meet
the NICE7recommendation that ‘People with eating
disorders seeking help should be assessed and receive
treatment at the earliest opportunity’.
A number of factors are likely to contribute to these
low rates of detection. Patients may be slow to present,
or may not present to services at all. Individuals with
diagnoses of disordered eating are renowned for their
high levels of secrecy and denial, and are often reluctant
to disclose information.9Patients with bulimic symptoms
are oftenof normal weight or slightly overweight, causing
Received 29 September 2006; Revised 9 April 2007; Accepted 30 April 2007.
aOJ is now at the Department of Psychology, Institute of Psychiatry, King’s College London, PO78, Addiction Sciences Building,
4 Windsor Walk, London SE5 8AF, UK.bCommunity Clinical Sciences Division, School of Medicine, University of Southampton,
Aldermoor Health Centre, Aldermoor Close, Southampton, Hampshire SO16 5ST, UK. Correspondence to: Tony Kendrick, Com-
munity Clinical Sciences Division, School of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close,
Southampton, Hampshire SO16 5ST, UK; Email: firstname.lastname@example.org
by guest on June 1, 2013
some patients in this group to be missed.10Screening for
disordered eating within primary care could be one way
of improving rates of detection. A short, reliable and
valid screening questionnaire for eating disorders has
been developed, and its acceptability to patients hasbeen
demonstrated.4,11However, previous research has not
investigated the feasibility of screening in terms of the
proportion of patients accepting screening or health
professional (HP) views on screening.
The finding that women who self-report eating disor-
dered behaviour, and those who go on to receive
diagnoses of eating disorders (including partial syn-
dromes), have higher levels of health care utilization in
primary care settings12,13suggests that primary care
workers may not be seizing the opportunity to ask
screening questions. Previous research has found varia-
tion among primary care physicians in their rates of
asking about disordered eating.14,15This points to the
need for exploration of primary care HP views on
screening for eating disorders. As well as exploring the
views of GPs, there is a need to explore the attitudes of
other primary care HPs such as midwives (MWs) and
health visitors (HVs). Such HPs also have opportunities
to detect eating disorders [e.g. when running antenatal
(AN) clinics or child health surveillance (CHS) clinics],
but there is less research on detection of mental ill
health by primary care practitioners other than GPs.6
The present study investigated the feasibility (in
terms of numbers of patients accepting screening,
yield and action taken by staff) of using the SCOFF
questionnaire4to screen for eating disorders within
primary care. The acceptability of screening to pri-
mary care HPs was also explored.
Cross-sectional face-to-face surveys, semi-structured
Open GP surgeries, MW AN clinics and HV CHS
clinics in two GP practices.
Only female patients aged 16–35 were approached.
Patients with currently diagnosed mental health diffi-
culties, or those who were taking psychotropic medica-
tion, as well as those with severe or terminal illness
and those who did not speak English well enough to
complete the questionnaire were excluded by the HP
before the session commenced. Eleven HPs (seven
GPs, two MWs and two HVs) were interviewed.
The medical students (GF and SC) were present in
the waiting rooms of general practice clinics/surgeries
(AN clinics, CHS clinics or open GP surgeries) at
a time previously agreed with the attending HP. The
HP checked his or her appointment list to ensure
that any patients he or she deemed unsuitable would
not be approached. As each patient arrived, they
were handed a slip by the receptionist, asking them
to indicate their willingness to be approached by the
students. If a patient was willing to be approached,
the study was discussed with them in a quiet area off
the waiting room. Patients who were prepared to
take part signed a consent form and then completed
the written questionnaire. Patients were asked to
take the completed SCOFF questionnaire into their
If a positive screening result was produced, the at-
tending MW/HV (where applicable) and the patient’s
GP completed a brief questionnaire on their reaction
and planned response, and their rating of the accept-
ability of screening. In the case of AN/CHS clinics,
a copy of each screening questionnaire was forwarded
to the patient’s GP (with a blank staff survey form at-
tached for completion by the GP in the case of posi-
tive screening results). GPs were asked to note the
patient’s involvement and screening result in their
medical notes. Medical notes were accessed by the stu-
dents at a later date (with informed consent from the
patient) to determine what (if any) action was taken
following screening. Interviews were undertaken at
the end of the study with those HPs who had received
a positive screening result for one of their patients.
While 16 HPs had offered to take part (10 GPs,
3 MWs and 3 HVs), only 10 received a positive screen-
ing result for one of their patients. These HPs (seven
GPs, two MWs and one HV) were interviewed, along
with an additional HV who had not received a positive
screening result but wished to participate in an inter-
view due to her interest in the topic. Interviews took
approximately 30 minutes and explored in more detail
the HPs’ brief survey responses. Questions covered
four main topics: responses to specific positive screen-
ing results in patients the HP had seen during the
study, general responses to suspected disordered eat-
ing, views on screening and responses to results of the
overall screening results from the study (e.g. propor-
tion of patients accepting screening, proportion pro-
ducing positive results).
The SCOFF questionnaire4was used to screen for dis-
ordered eating. This questionnaire is a short and effec-
tive screening tool in general practice. It has shown
excellent validity in a clinical population11and reli-
ability in a student population.16The SCOFF tool also
performed well against 10 questions set by Green-
halgh17to assess screening tests. It has been found to
be reliable and replicable when administered as a writ-
ten questionnaire rather than when undertaken as
Family Practice—an international journal
by guest on June 1, 2013
an oral interview, and may even provide enhanced dis-
closure of symptoms due to the less intimidating ap-
proach.16The use of this questionnaire, both the
questions and the term ‘SCOFF’, has been found to
be acceptable to patients, and its use by HPs in pri-
mary care is recommended.4,11It is intended to raise
suspicion of likely cases of disturbed eating, rather
than acting as a diagnostic tool. A positive result is
produced if a ‘yes’ response is provided to two or
more of the five questions. Luck et al.4report sensitiv-
ity of 84.6% and specificity of 89.6%. A brief staff sur-
vey form was produced to collect information on HP
responses to positive screening results, and a semi-
structured topic guide was used to collect data during
staff interviews (see Appendix).
A framework approach18was used to analyse the in-
terview findings. Framework analysis was developed
for use in applied qualitative research with pre-
specified objectives, and so employs deductively de-
rived categories.19However, this method also allows
for inductive exploration of participant accounts and
so enables exploration of emergent themes not antici-
pated at the outset of the study. Ritchie and Spencer18
note that the method is grounded or generative
(‘heavily based in, and driven by, the original accounts
and observations of the people it is about’, p. 176) and
dynamic (‘open to change, addition and amendment
throughout the analytic process’, p. 176), but also
that the analysis will draw upon a priori issues. The
five stages of analysis have much in common with
other methods of qualitative analysis, but are more
strongly informed by a priori reasoning. The stages of
analysis consist of familiarization with the data (read-
ing through the transcripts in detail and making notes
on any emerging ideas or themes), identifying the the-
matic framework (drawing up a list of themes using
a priori issues and issues emerging from the data), in-
dexing/applying the thematic framework to the data
(labelling transcript data with codes from the thematic
framework), charting (abstraction and synthesis, e.g.
drawing up tables summarizing what each participant
said about each theme in order to identify possible
patterns) and finally mapping and interpretation (sum-
marizing and interpreting overall patterns).
Results from the staff interviews were triangulated
with findings from the staff survey to improve the
comprehensiveness of the study. An audit trail was
maintained in the form of notes from the process of
framework analysis to increase the transparency of
this process. Also, the medical students kept notes re-
flecting on the possible impact of factors such as their
student status upon data collection and analysis.
Granted by Southampton and South West Hampshire
The majority were white (96.2%) and in paid employ-
ment (62.9%). Patients’ ages ranged from 16 to 35
years, and the mean age was 26 years.
Proportion of patients accepting screening
A total of 510 patients were identified from appoint-
ment lists. After exclusion of patients for reasons out-
lined in Table 1, 300 women were eligible for
participation in the study. Of these, 138 (46%) agreed
to complete the SCOFF. Twenty-seven were interrup-
ted by being called into their appointments, and so, in
total, the SCOFF was completed by 111 women.
Yield of cases
Of the 111 women who completed the SCOFF, 18
(16%) produced positive results. This finding is in line
with the findings of Luck et al.4who found that 13%
of participants produced a positive result.
Action taken by HPs
An intention to offer treatment or referral was re-
corded on a staff survey form for only 2 of the 18 posi-
tive screening results produced. Comments on positive
screening results were only recorded in the patients’
medical notes for four of the patients. This excludes
one patient who declined permission for her notes to
be accessed by the researchers. The comments made
in patients’ notes are provided in Box 1.
Of the 16 participating HPs, 10 received a positive pa-
tient screening questionnaire (seven GPs, two MWs
TABLE 1Pathways of patients following identification from
Pathways of patients following identification
from appointment lists
HP deemed inappropriate to approach
Already seen by HP before students arrived
Did not attend or cancelled appointment
Did not receive a recruitment slip due to
receptionists’ time constraints
Called into appointment before could decide if
wanted to participate
Chose not to participate
Agreed to complete SCOFF but interrupted
(called into appointment)
Screening for eating disorders
by guest on June 1, 2013
and one HV), and one HV who had not received a pos-
itive result was also interviewed. They were asked how
acceptable they found screening for eating disorders.
For those who saw more than one patient with a posi-
tive screening result and so completed more than one
staff survey form, their average acceptability score
was calculated. A score of 7 denoted ‘completely ac-
ceptable’ and a score of 1 ‘completely unacceptable’.
Overall, the mean acceptability score was 5.9, the me-
dian 6.5 and the mode 7, indicating that the HPs found
screening for eating disorders to be highly acceptable.
Nine of the 11 participants produced mean acceptabil-
ity scores above the midpoint of 4 on the scale, sug-
gesting that overall they found screening to be
acceptable. One HP produced a mean acceptability
score, which fell at the midpoint on the scale (partici-
pant F), suggesting neutrality. One HP (participant A)
produced a mean acceptability score of 3, slightly below
the midpoint, suggesting some reservations about the
acceptability of screening.
The general consensus was that screening for eating
disorders was acceptable and could be useful, and
would fit with participants’ roles as primary health
care workers. The SCOFF questionnaire was found to
be an acceptable instrument (Box 2).
However, participants noted that they did not rou-
tinely screen for eating disorders as part of consulta-
tions, and there was wide variation in the extent to
which HPs felt comfortable approaching the topic with
patients (Box 3).
It was pointed out that the cultural emphasis on
slimness and dieting could make it difficult to deter-
mine pathological cases from the norm. There were
concerns about the accuracy and effectiveness of
screening, time, administration and financial con-
straints, as well as uncertainty surrounding the benefit
of early diagnosis and treatment (Box 4).
The overwhelming issue arising among HPs was
what action to take once a patient had screened
positively. Possibilities such as referral to an in-
practice counsellor, generic mental health service, spe-
cialist eating disorders service or a dietician were
mentioned, but available options were often seen as
being inappropriate or unavailable. Although a num-
ber of participants reported positive experiences with
the local specialist eating disorders service, it was
noted that many patients would not meet the referral
criteria for the service (age 18–65 years and meeting
diagnostic criteria for anorexia nervosa, bulimia nerv-
osa or eating disorders not otherwise specified/atypical
Participants noted that they did not have sufficient
time or expertise to manage possible disordered eating
alone, and a general uncertainty about the available
options was often expressed (Box 5).
Reference was also made to the issue of patient’s
denial of disordered eating or lack of motivation to
address their disturbed eating (Box 6).
In terms of suggestions for implementation, HPs sug-
gested that screening would be best carried out face to
face during a general patient health check, first ap-
pointment or AN booking visit. It was suggested that
BOX 4: Uncertainty about the benefits of early detection
‘I don’t know whether there is any advantage in picking them up
early’. (Participant D, GP)
‘I think you need to kind of ask yourself at the end of the day, if
you, if you, if you want to sort of screen for cardiovascular risk
factors and you treat them, then you, you’re reducing cardiovas-
cular disease so therefore you’ve got an outcome. The problem
with this is that if you, if you screen for eating disorders and,
and say you’ve got two positives, and you were missing it, but
what would matter if you didn’t treat it, if you see what I mean?
Is there, is there any harm in not treating it and what are the
benefits of treating it? Um, are you going to do it, if the
patient’s quite happy, are you going to do any harm leaving it?’
(Participant G, GP)
BOX 1:Comments on positive screening results made in patients’
‘Weight discussed, BMI 16.94. No history of bulimia/laxative
abuse. Don’t think she has an eating disorder but will review as
‘Completed eating disorder questionnaire (positive), says is un-
concerned and weight loss is due to stress and irritable bowel syn-
drome and she is aware of it all. Doesn’t want any treatment, not
depressed and will discuss with own GP if worried’.
‘Questionnaire positive eating disorder’.
‘Given eating disorder questionnaire, was negative at the time of
consultation but patient subsequently changed it in the waiting
room to positive—picked up by students’.
BOX 2: Acceptability of the SCOFF questionnaire to HPs
‘Well it wasn’t too difficult really, not too intrusive or bother-
some’. (Participant B, GP)
‘Patients were quite happy and didn’t seem to have any problems
filling it in’. (Participant G, GP)
BOX 3: HP views on asking patients about disordered eating
‘I suppose I don’t actively seek them out ... I don’t routinely ask
all my patients’. (Participant B, GP)
‘We don’t even get the training for it either ... I think you’d need
training ... You wouldn’t quite know what was the best way to
approach it’. (Participant A, MW)
Family Practice—an international journal
by guest on June 1, 2013
male patients should also be included but that an age
limit as was used in the study should be adhered to (in
order to focus screening upon the age range perceived
as having the highest prevalence of disordered eating).
Summary of results
In total, just under half of the women approached
agreed to be screened, and of these, one in six
screened positively on the SCOFF questionnaire. It
should be noted that a positive score on the SCOFF
questionnaire is not diagnostic, and not all of those
who score positively will have an eating disorder. Luck
et al.4found that 4% of those screened (24% of those
producing a positive result) met the criteria for an eat-
ing disorder using a diagnostic interview.
The quantitative measure of HPs’ opinions indi-
cated that the majority found screening for eating dis-
orders acceptable. However, analysis of the more
detailed interview findings suggests a more complex
picture. This pattern is seen in other studies measuring
acceptability using both quantitative and qualitative
methods.20The interviews suggested that HPs viewed
screening as acceptable in theory but indicated that
there were concerns over what action to take with pa-
tients who screened positively, due to the dissatisfac-
tion of some HPs with the current treatment options
as well as concerns regarding time and cost. Positive
results were rarely recorded in patients’ medical notes,
and treatment was rarely offered.
Strengths and limitations
Steps taken to ensure rigour included triangulation of
data and the availability of an audit trail for the qualita-
tive analysis (enhancing transparency), as well as consid-
eration of reflexivity. However, data collection took
place in only two surgeries, in a single city, which raises
the question of how well the quantitative results of this
study would generalize to other settings. Also, the
screening process was somewhat artificial in that patient
participants were required to agree with the receptionist
that they would speak to researchers and were required
to complete a consent form, prior to screening. These
factors may have decreased the proportion of patients
willing to be screened, compared to routine practice.
Comparison with previous literature
Previous literature has highlighted the need for im-
proved detection of eating disorders in primary care,7
as well as outlining the yield of cases and acceptability
to patients of the SCOFF screening questionnaire.4,11
This study provides a detailed analysis of the feasibil-
ity of screening for eating disorders in primary care,
by exploring the views and actions of HPs. While the
SCOFF questionnaire has been widely adopted within
the UK as a standard screening measure, the absence
of clear care pathways poses an obstacle to its use.
This state of affairs is likely to impede access of pa-
tients to evidence-based treatments as outlined in the
NICE guideline.7Treatments recommended for use in
primary care (such as guided self-help) may not be ac-
cessed by many patients due to barriers to the detec-
highlight a number of potential problems that must be
addressed before screening can be successfully imple-
mented. HPs’ concerns about asking about disordered
eating, and uncertainty about how to proceed in the
The present findings
BOX 5: Uncertainty about available options for addressing
a positive screening result
‘I wouldn’t just think oh I can do that, that and that about it [if
a positive screening result was produced], I’d have to think about
it and look into it, it wouldn’t be an easy thing to do. (S: No) So
I can imagine that’s why some people just brush it under the
carpet’. (Participant A, MW)
‘there’s the big stumbling block again as to what you do when you
find them. Um ... so it’s [screening] sort of stirring things up and
bringing it more of an issue for the patient, then if you’re not go-
ing to be able to help anything apart from give a printout of the
local, er, you know, eating disorders support group and then
that’s all there is, then um ... I’m not sure that’s really helping
the patient’. (Participant E, GP)
‘To have something to screen you need to have something good
to do about it when you screen, that’s what I’m getting at and I
don’t know if there is at the moment ... Well, it comes back to
what I said at the beginning really, you screen for these people
and then you think they’ve got an eating disorder but then what
do you do with all these people?’ (Participant F, GP)
‘it might be helpful to have some sort of protocol about what’s
the best way of dealing with it. (S: Yeah) So, like we don’t, we
certainly don’t get any training on it so I suppose I feel as if I
don’t know enough about what, what would be the best route to
go down, you know, the research basis to ... um, what would be
the most helpful thing for them, really’. (Participant H, HV)
BOX 6:Patient lack of motivation as a barrier to addressing
positive screening results
‘what has amazed me is that they filled in a questionnaire saying
that they do all these (S: Yeah) things like making themselves
sick or whatever, [slight laugh from P] and yet when you ask
them they are blatantly unconcerned by it and they think it’s nor-
mal and, and if they are, and if they do consider their behaviour is
normal then obviously there’s, there’s very little we can do about
it ... I mean if they don’t, they don’t see themselves or perceive
themselves as having a problem (S: No) then obviously there’s
nothing you can do, there’s no, there’s no further action to be
taken’. (Participant G, GP)
‘the difficult issue is then how to treat it once you’ve got a positive
test and I suspect that eating disorders are a little bit like alcohol
problems, but until the patient wants to do something about it
you’re on a xxx to nothing really. You may have identified the
problem but then it’s what to do with it really ... it’s not only lim-
ited options, it’s also engaging them to do something about it as
well, as sometimes they’re not ready to’. (Participant B, GP)
Screening for eating disorders
by guest on June 1, 2013
case of positive results, as well as the tendency not to
record positive screening results in medical notes and
not to offer treatment would at present limit the utility
of any screening programme.
The present results echo findings on screening for
the similarly ‘hidden’ problem of domestic violence in
primary care. Research by Richardson et al.21has
highlighted the reluctance of primary care HPs to en-
gage in screening for domestic violence. In a later
study,22although it was found that 17% of respond-
ents had experienced physical violence from a partner
within the last year, the case for screening was weak-
ened by factors such as the gap between women’s ex-
periences and their medical records (which may have
been produced by under-recording of disclosure) and
limited acceptability of screening to patients (at least
20% objected to screening for domestic violence).
Implications for practice
Before screening is adopted, it is a prerequisite that ac-
ceptable and accessible treatment facilities should be
available. This does not seem to be the case in eating
disorders, given the uncertainty over referral. The find-
ings suggest that dissemination of a protocol outlining
action to be taken in the case of positive screening re-
sults would be necessary in order to enhance the feasi-
bility of screening for eating disorders in primary care.
HP education about management options (e.g. guided
self-help) would also be beneficial. Some participants
explicitly referred to their lack of training in the area of
disordered eating, and indeed there is currently no wide-
spread training of HPs in the screening and assessment
of people with eating disorders. Most MWs and HVs un-
dergo very little training in mental health. While around
40% of GP trainees complete a 6-month post in Psychia-
try, for most this will not include any specific training on
eating disorder detection and evaluation.
The findings also raise the issue of potential screening
burden. The challenge to primary care is handling and
sustaining the task of screening without affecting other
priorities, and there isa needfor evaluation of the extent
to which this is possible. As noted above, the SCOFF
does produce false positives, withonly 24% of those pro-
ducing a positive screening result in research by Luck
et al.4meeting diagnostic criteria for an eating disorder.
While 16% of participants in the present study produced
a positive screening result, previous research4suggests
that only 4% would meet criteria for disordered eating.
Currently, all individuals producing a positive screening
result would require referral to more specialist services
for exclusion of an eating disorder diagnosis, creating
difficulties in terms of patient anxiety and cost to serv-
ices. The alternative option would be to have a second
stage of assessment within primary care, using a more
structured interview-based or questionnaire-based diag-
nostic test, for which the HPs would need considerable
training. The results also suggest that screening may
sometimes be impractical within the constraints of pri-
mary care, as suggested by the fact that 27/138 individuals
did not complete the SCOFF due to interruption.
Implications for further research
Future research should explore whether the extent to
which positive screening results lead to action by staff
is improved by use of a protocol outlining action to be
taken in the case of positive screening results, and ed-
ucation about management options. In addition, the
burden upon services produced by screening should
be evaluated in greater depth.
Patient uptake of screening is relativelylow, although this
could have been influenced by the slightly artificial con-
straints of the study. HPs have concerns about the op-
tions open to them if they suspect that a patient has an
eating disorder, and may not take action in relation to
positive screening results. Guidance on action to be taken
in response to positive results could improve the feasibil-
ity of screening for eating disorders in primary care.
Thanks are due to the participants who gave up their
time to take part in this study, and to the medical re-
ceptionists who helped with recruitment.
Ethical approval: Granted by Southampton and South
West Hampshire LREC, reference number 04/Q1704/67.
Funding: No project funding (4th year study in-depth
project for the University of Southampton BM degree;
administrative costs covered by the School of Medi-
cine). This work was conducted while OJ was in re-
ceipt of a postdoctoral fellowship from the Health
Foundation and the DH/NCC RCD Programme.
Contributors: All authors contributed to the planning
of the study, analysis and reporting. Data were col-
lected by GF and SC.
Conflicts of interest: None.
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Appendix Topic guide for HP interviews
Responses to positive screening results in this study
During the course of this study, you have been asked
to fill in a staff survey form for any patient producing a
positive result on the SCOFF screening questionnaire.
I would like to start off by asking you a bit more about
your thoughts on these positive screening results. [Fol-
lowing questions repeated for each positive screening
result received by the HP]:
? When you were told about this result, what did it
mean to you?
? How did the screening result compare to your
own perception of whether or not the patient was
experiencing disordered eating?
? On the survey form you indicated [what you
planned to do in response to this positive screen-
ing result]. Can you tell me a bit about what influ-
enced that choice?
? Why did you decide not to ... [choose the other
options listed on the survey form, such as ...]?
? Probe around whatinfluencedany decisions or plans
about action before receiving screening result.
General responses to suspecting disordered eating
? In general, what influences how you will respond if
you suspect that a patient has disordered eating?
? What options do you feel are open to you if you
suspect that a patient has disordered eating?
? How do you feel about these options?
Views on screening in general
? Do you ever ask patients screening questions if
you suspect they have disturbed eating?
? If no: Can you tell me a bit about why you tend
not to do this?
? If yes: Can you tell me a bit about the circumstan-
ces in which you would ask these questions? What
sort of questions do you ask? How do you find
asking about this?
? How do you feel about the use of screening for
disturbed eating in primary care?
? How do you feel screening for disturbed eating
fits with your role as a GP/MW/HV?
? What do you think are the advantages and disad-
vantages of screening? If you envisage any prob-
lems with screening, how do you think these
could be overcome?
? What method of screening, if any, do you think
would be best (e.g. targeting specific groups/blan-
ket screening, screening in general waiting rooms
or in specific clinics, face to face or postal, oral or
written, different instrument/questions)? Can you
tell me a bit more about this?
accepting screening, producing positive results, etc)
? Now that you have heard about these results,
what do you think about the use of screening for
disturbed eating in primary care?
? Does this change any of your views? If so, how
have your views changed?
Screening for eating disorders
by guest on June 1, 2013