An evaluation of an Internet-delivered eating disorder prevention program for adolescents and their parents

Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, California 94305-5722, USA.
Journal of Adolescent Health (Impact Factor: 3.61). 11/2004; 35(4):290-6. DOI: 10.1016/j.jadohealth.2003.10.010
Source: PubMed


To evaluate the effectiveness of Student Bodies, an Internet-delivered eating disorder prevention program for adolescents, and a supplemental program for their parents.
One hundred fifty-two 10th grade females completing a health course at a private sectarian school, and 69 of their parents were assigned to either the Internet-delivered intervention group or to a comparison group (students) or wait-list control group (parents). Student participants completed subscales of the Eating Disorder Inventory, Eating Disorder Examination-Questionnaire, and a content knowledge test. Parents completed the Parental Attitudes and Criticism Scale.
The main effects of the intervention were assessed pre- to post- and post- to follow-up using ANCOVA, with the baseline assessment of the independent variable as the covariate. Students using the program reported significantly reduced eating restraint and had significantly greater increases in knowledge than did students in the comparison group. However, there were no significant differences at follow-up. Parents significantly decreased their overall critical attitudes toward weight and shape.
The program demonstrates the feasibility of providing an integrated program for students and their parents with short-term positive changes in parental attitudes toward weight and shape.

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    • "Although the majority of studies in the review reported a significant improvement in some type of eating behavior or diet-related physical change (n = 11) as a result of the intervention, only three employed follow-up measures, ranging from 3–18 months, with none demonstrating that any diet-related changes were maintained over time (Brown et al. 2004, Williamson et al. 2006, Doyle et al. 2008). These findings indicate that computer-and webbased interventions can be successful, but maintenance strategies must be implemented to sustain the positive behavior change. "
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    ABSTRACT: AIMS: To: (1) determine the effect of computer- and web-based interventions on improving eating behavior (e.g. increasing fruit and vegetable consumption; decreasing fat consumption) and/or diet-related physical outcomes (e.g. body mass index) among children and adolescents; and (2) examine what elements enhance success. BACKGROUND: Children and adolescents are the heaviest they have ever been. Excess weight can carry into adulthood and result in chronic health problems. Because of the capacity to reach large audiences of children and adolescents to promote healthy eating, computer- and web-based interventions hold promise for helping to curb this serious trend. However, evidence to support this approach is lacking. DESIGN: Systematic review using guidelines from the Cochrane Effective Practice and Organisation of Care Group. DATA SOURCES: The following databases were searched for studies from 1998-2011: CINAHL; PubMed; Cochrane; PsycINFO; ERIC; and Proquest. REVIEW METHODS: Fifteen randomized controlled trials or quasi-experimental studies were analysed in a systematic review. RESULTS: Although a majority of interventions resulted in statistically significant positive changes in eating behavior and/or diet-related physical outcomes, interventions that included post intervention follow-up, ranging from 3-18 months, showed that changes were not maintained. Elements, such as conducting the intervention at school or using individually tailored feedback, may enhance success. CONCLUSION: Computer- and web-based interventions can improve eating behavior and diet-related physical outcomes among children and adolescents, particularly when conducted in schools and individually tailored. These interventions can complement and support nursing efforts to give preventive care; however, maintenance efforts are recommended.
    Journal of Advanced Nursing 07/2012; 69(1). DOI:10.1111/j.1365-2648.2012.06086.x · 1.74 Impact Factor
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    • "Brown et al. [76] "
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    ABSTRACT: This systematic review explores how computer-tailored, behavioral interventions implemented and delivered via the Web have been operationalized in a variety of settings. Computer-tailored, online behavioral intervention studies published from 1996 to early 2007 were selected and reviewed by two independent coders. Of 503 studies screened, 30 satisfied the selection criteria. The level of sophistication of these interventions varied from immediate risk/health assessment, tailored web content to full-blown customized health programs. The most common variables for tailoring content were health behaviors and stages of change. Message tailoring was achieved through a combination mechanisms including: feedback, personalization and adaptation. Tailored, self-guided health interventions delivered via the Web to date have involved a great diversity of features and formats. While some programs have been relatively brief and simple, others have involved complex, theory-based tailoring with iterative assessment, tools for development of self-regulatory skills, and various mechanisms for providing feedback. Our ability to fully optimize the use of computer-assisted tailoring will depend on the development of empirically based guidelines for tailoring across populations, health foci, health behaviors and situations. Further outcome research is needed to enhance our understanding of how and under what conditions computer-tailoring leads to positive health outcomes in online behavioral interventions.
    Patient Education and Counseling 11/2008; 74(2):156-73. DOI:10.1016/j.pec.2008.08.023 · 2.20 Impact Factor
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    • "Results are not easy to compare with previous investigations into Internet-based or e-mail based treatments because they differ distinctively in setting, sample and method. In general, reported effects regarding a new way of coping with the illness or with the affected person, the reduction of emotional stress and an increased acceptance of the illness as such by relatives are in line with results of previous studies (Brown et al., 2004; Winzelberg et al., 2000; Zabinski et al., 2003). Furthermore, a large percentage of affected respondents (31.3%) gained insight into the need to seek further professional help after the online consultation . "
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    ABSTRACT: This paper describes an independent online consulting service for persons affected with eating disorders and their relatives ( which was developed by physicians and psychologists in Germany. This study aims to understand the individual use of the online consulting by affected persons and their relatives. In order to do this, two online questionnaires were developed: one for affected persons and one for their relatives. These questionnaires were sent digitally to those people who had posted an e-mail to the online consulting service between 1/1999 and 11/2003 (n = 2760). Finally, 240 data sets of affected persons and 85 of relatives were included in the analysis. Respondents said that the online consulting had had important effects on their lives: (a) 22.5% of affected persons and 49.4% of relatives stated that the answers provided by the online consultants led to a better understanding of the disease; (b) 32.1% of affected persons and 52.9% of relatives experienced that they had been talking more about the disease since they had contacted the online consulting service; (c) 20% of affected persons went to see a therapist as a consequence of the online consultation. 55.4% of affected persons and 81.2% of relatives had not turned to professional help before they contacted the online service. The results of the evaluation sugest that people seeking help are made sensitive to their existing problem and that they have been encouraged by the online consultation to seek further professional help. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.
    European Eating Disorders Review 07/2006; 14(4):218 - 225. DOI:10.1002/erv.712 · 2.46 Impact Factor
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