Confirming the Effectiveness and Efficiency of Online Guided Self-Help Family-Based Treatment for Adolescent Anorexia Nervosa
确认在线指导自助家庭治疗青少年神经性厌食症的有效性和效率
基本信息
- 批准号:10505414
- 负责人:
- 金额:$ 66.97万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-20 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdolescentAdoptionAnorexia NervosaAttitudeBehaviorBlindedBody WeightCase SeriesChildClinicClinicalClinical TrialsCognitionDSM-VDataDisease remissionDivorceDoseEarly treatmentEatingEating DisordersEffectivenessFamilyFamily StudyFeasibility StudiesFundingHealth Services AccessibilityHealth systemHealthcare SystemsIncidenceIndividualIntentionInterventionInterviewMeasuresMediatingMediator of activation proteinMorbidity - disease rateObsessionOntarioOutcomeParentsPatient-Focused OutcomesPatientsPediatric HospitalsPersonsPilot ProjectsRandomizedReadingRecoveryResistanceSelf EfficacySeveritiesSingle ParentStructureTestingTimeTreatment EffectivenessTreatment outcomeVideo RecordingVideoconferencingWeightWeight GainYouthbasecomparative effectivenesscomparative effectiveness studycosteffective therapyeffectiveness testingefficacious treatmentempoweredevidence baseexperiencefamily structureflexibilityfollow-uphybrid type 1 designimplementation facilitatorsimprovedimproved outcomemortalitypreventive interventionprimary outcomereconstitutionrecruitresponsesecondary outcomeself helpservice interventionsevere mental illnesstreatment comparisontreatment effecttreatment programtreatment servicestreatment site
项目摘要
The application responds to PAR-21-130: Clinical Trials to Test the Effectiveness of Treatment, Prevention,
and Services Interventions. With an incidence rate of about 1%, Anorexia Nervosa (AN) is a serious mental
disorder associated with high mortality, morbidity and cost but becomes highly resistant once it has taken an
enduring course. The first-line treatment for adolescents with AN is Family Based Treatment (FBT), but is not
available to many patients. An effective strategy used with other eating disorders to address impediments to
scaling effective treatments is guided self-help (GSH) versions of efficacious treatments. We developed,
refined, and tested GSH-FBT in case series and pilot studies. Results of a multisite randomized feasibility
study comparing GSH-FBT to FBT-V found that both treatments were similarly acceptable to families with good
recruitment rates, low attrition rates, high completion rates of assessments, and were safe to deliver while
achieving similar improvements in eating related cognitions and weight. However, GSH-FBT achieved these
outcomes with greater efficiency (e.g., larger ratio of improvement in weight and cognitions to therapist
treatment time) by utilizing approximately 75% less therapist time than FBT-V. The main aim of this proposed
comparative effectiveness study is to confirm that clinical improvements in GSH-FBT are achieved with greater
efficiency than FBT-V in generalizable clinical settings. If this outcome is confirmed, it will lead to an increased
opportunity to utilize and scale an effective treatment for adolescent AN, promote increased access and
improve outcomes for these patients. We will also explore therapist attitudes toward GSH-FBT. To conduct this
study 200 adolescents with DSM-5 AN and their families will be randomized to either GSH-FBT or FBT-V in
two treatment sites (Stanford Children’s Hospital Eating Disorder Clinic and the Ontario Provincial Network of
Ministry-funded Specialized Treatment Services for Eating Disorders). The main outcome will be clinical
efficiency (the ratio of change in weight and eating related distorted cognitions to therapist time). Parental self-
efficacy will be assessed as a potential mediator of treatment effect. Family structure and severity of eating
related obsessions will be examined as moderators. Weights will be collected from session 1-4 to assess early
weight gain as a predictor of weight remission at the end of treatment (EOT). Data on therapists’ views of
GSH-FBT implementation will be collected by quantitative measures at BL and EOT, as well as by individual
semi-structured qualitative interviews. Both primary and secondary outcomes will be analyzed in line with the
intention to treat principle.
PAR-21-130:临床试验,以测试治疗,预防,
服务干预。神经性厌食症(Anorexia Nervosa,AN)是一种严重的精神疾病,发病率约为1%,
与高死亡率、发病率和成本相关的疾病,但一旦服用
持久的课程青少年AN的一线治疗是家庭治疗(FBT),但不是
对许多患者来说都是可行的。一种有效的策略用于其他饮食失调,以解决障碍,
缩放有效治疗是有效治疗的引导自助(GSH)版本。我们开发了,
在病例系列和试点研究中完善和测试GSH-FBT。多中心随机可行性的结果
一项比较GSH-FBT和FBT-V的研究发现,两种治疗方法都能被良好的家庭接受。
招聘率、自然减员率低、评估完成率高,交付安全,
在饮食相关认知和体重方面也取得了类似的改善。然而,GSH-FBT实现了这些
具有更高效率的结果(例如,体重和认知改善的比例较大
治疗时间),比FBT-V减少约75%的治疗时间。
比较有效性研究的目的是证实GSH-FBT的临床改善,
在可推广的临床环境中比FBT-V更有效。如果这一结果得到证实,
有机会利用和扩大对青少年AN的有效治疗,促进增加获得和
改善这些患者的预后。我们还将探讨治疗师对GSH-FBT的态度。进行是次
研究200名DSM-5 AN青少年及其家庭将随机接受GSH-FBT或FBT-V,
两个治疗地点(斯坦福大学儿童医院饮食失调诊所和安大略省网络,
政府资助的饮食失调症专门治疗服务)。主要结果将是临床
效率(体重和饮食相关的扭曲认知的变化与治疗时间的比率)。父母的自我-
疗效将作为治疗效果的潜在介导因素进行评估。家庭结构和饮食的严重性
相关的痴迷将被审查为版主。将从第1-4阶段收集权重,以进行早期评估
体重增加作为治疗结束(EOT)时体重缓解的预测因素。治疗师对以下问题的看法
GSH-FBT实施情况将通过BL和EOT时的定量测量以及个人收集
半结构化定性访谈。主要和次要结局均将根据
意图对待原则。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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JAMES D LOCK其他文献
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{{ truncateString('JAMES D LOCK', 18)}}的其他基金
Confirming the Effectiveness and Efficiency of Online Guided Self-Help Family-Based Treatment for Adolescent Anorexia Nervosa
确认在线指导自助家庭治疗青少年神经性厌食症的有效性和效率
- 批准号:
10707470 - 财政年份:2022
- 资助金额:
$ 66.97万 - 项目类别:
Confirming the Efficacy/Mechanism of Family Therapy for Children with Low Weight Avoidant/Restrictive Food Intake Disorder (ARFID)
确认家庭治疗对低体重回避/限制性食物摄入障碍(ARFID)儿童的功效/机制
- 批准号:
10212222 - 财政年份:2020
- 资助金额:
$ 66.97万 - 项目类别:
Confirming the Efficacy/Mechanism of Family Therapy for Children with Low Weight Avoidant/Restrictive Food Intake Disorder (ARFID)
确认家庭治疗对低体重回避/限制性食物摄入障碍(ARFID)儿童的功效/机制
- 批准号:
10427302 - 财政年份:2020
- 资助金额:
$ 66.97万 - 项目类别:
Confirming the Efficacy/Mechanism of Family Therapy for Children with Low Weight Avoidant/Restrictive Food Intake Disorder (ARFID)
确认家庭治疗对低体重回避/限制性食物摄入障碍(ARFID)儿童的功效/机制
- 批准号:
10682614 - 财政年份:2020
- 资助金额:
$ 66.97万 - 项目类别:
Confirming the Efficacy/Mechanism of Family Therapy for Children with Low Weight Avoidant/Restrictive Food Intake Disorder (ARFID)
确认家庭治疗对低体重回避/限制性食物摄入障碍(ARFID)儿童的功效/机制
- 批准号:
10039552 - 财政年份:2020
- 资助金额:
$ 66.97万 - 项目类别:
Confirming the Efficacy/Mechanism of an Adaptive Treatment for Adolescent Anorexia Nervosa
确认青少年神经性厌食症适应性治疗的功效/机制
- 批准号:
9884814 - 财政年份:2017
- 资助金额:
$ 66.97万 - 项目类别:
Optimizing a Smartphone Application for Individuals with Eating Disorders
为饮食失调患者优化智能手机应用程序
- 批准号:
9276789 - 财政年份:2016
- 资助金额:
$ 66.97万 - 项目类别:
Optimizing a Smartphone Application for Individuals with Eating Disorders
为饮食失调患者优化智能手机应用程序
- 批准号:
8982118 - 财政年份:2015
- 资助金额:
$ 66.97万 - 项目类别:
Feasibility of Combining Family and Cognitive Therapy to Prevent Chronic Anorexia
结合家庭和认知疗法预防慢性厌食症的可行性
- 批准号:
8569906 - 财政年份:2013
- 资助金额:
$ 66.97万 - 项目类别:
Feasibility of Combining Family and Cognitive Therapy to Prevent Chronic Anorexia
结合家庭和认知疗法预防慢性厌食症的可行性
- 批准号:
8701414 - 财政年份:2013
- 资助金额:
$ 66.97万 - 项目类别:
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