Pragmatic Indicated Prevention and Early Intervention for Disordered Eating: A Randomized Controlled Trial of Media Smart Targeted Internet Program in Youth.

IF 9.2 1区医学 Q1 PEDIATRICS

Journal of the American Academy of Child and Adolescent Psychiatry Pub Date : 2025-03-26 DOI:10.1016/j.jaac.2025.02.017

Simon M Wilksch, Anne O'Shea, Ross Crosby, Rachel Lawson, Tracey D Wade

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引用次数: 0

Abstract

Objective: We evaluated three new features of Media Smart Targeted (MST), an 8-module internet, self-guided, indicated prevention and early intervention for disordered eating (DE): a broader audience; optimal rate of program delivery; impact on social media (SM) behaviours.

Method: Participants (N=555, 13-25 years of any gender from Australia/New Zealand) were randomized to: MST-Flexible (MST-F: user accesses modules at own rate, n=184); MST-Standard (MST-S: weekly module release, n=187); and control (body image tips, n=184). Primary (Eating Disorder Examination-Questionnaire [EDE-Q] Global and DE diagnostic status), secondary (DE risk factors) and tertiary (SM) outcome measures were completed at baseline, post-program, 6- and 12-month follow-up.

Results: A total of 52.2% of participants randomized to MST-F or MST-S accessed their intervention. Modified intent-to-treat analyses (n=378) included these participants (MST-F = 109; MST-S = 84) and all controls (n=184) showed MST-F participants were more likely to complete each module and full program than MST-S participants. More favourable outcomes for EDE-Q Global were reported in the MST-F condition than control. MST-F and MST-S participants with baseline DE were 94% and 92% respectively less likely than controls to meet DE criteria at any point from post-program onwards (n=36). Compared to controls, the MST-F condition experienced significant improvements for regular eating, clinical impairment, internalization and SM behaviours, including reduced: appearance comparisons; following of appearance-based influencers; use of TikTok; and fewer SM accounts.

Conclusion: Whilst self-guided, internet interventions have lower completion rates and more modest effects than face-to-face indicated prevention programs, MST-F can be delivered at-scale, with low-cost and greater flexibility in target audience, to achieve meaningful reductions in DE risk, symptoms and SM behaviours.

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来源期刊

Journal of the American Academy of Child and Adolescent Psychiatry 医学-精神病学

CiteScore

21.00

自引率

1.50%

发文量

1383

审稿时长

53 days

期刊介绍： The Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP) is dedicated to advancing the field of child and adolescent psychiatry through the publication of original research and papers of theoretical, scientific, and clinical significance. Our primary focus is on the mental health of children, adolescents, and families. We welcome unpublished manuscripts that explore various perspectives, ranging from genetic, epidemiological, neurobiological, and psychopathological research, to cognitive, behavioral, psychodynamic, and other psychotherapeutic investigations. We also encourage submissions that delve into parent-child, interpersonal, and family research, as well as clinical and empirical studies conducted in inpatient, outpatient, consultation-liaison, and school-based settings. In addition to publishing research, we aim to promote the well-being of children and families by featuring scholarly papers on topics such as health policy, legislation, advocacy, culture, society, and service provision in relation to mental health. At JAACAP, we strive to foster collaboration and dialogue among researchers, clinicians, and policy-makers in order to enhance our understanding and approach to child and adolescent mental health.