Using factorial design to examine efficacies of technology-based augmentations for improving treatment adherence and skills utilization in a self-help CBT program for binge eating.

使用析因设计来检验基于技术的增强措施在针对暴食症的自助 CBT 计划中提高治疗依从性和技能利用率的功效。

• 批准号: 10507528
• 负责人: Paakhi Srivastava
• 金额: $ 22.73万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10507528
• 关键词: Abstinence; Aftercare; Algorithms; Area; Bachelor' s Degree; Behavior; Behavior Disorders; Behavioral; Binge Eating; Books; Cellular Phone; Clinical; Cognitive Therapy; Companions; Data; Development; Disease; Eating; Eating Disorders; Electronic Mail; Evidence based program; Feedback; Fibrinogen; Food; Frequencies; Health; Healthcare Systems; Individual; Intervention; Meta-Analysis; Monitor; Outcome; Pathway interactions; Patients; Pattern; Periodicity; Recommendation; Recurrence; Self Administration; Self-Direction; System; Techniques; Technology; Testing; Therapeutic; Time; Training; Treatment outcome; Validation; acceptability and feasibility; adaptive intervention; base; behavior change; cost effective; data sharing; design; digital; discrete time; efficacy evaluation; feasibility testing; follow-up; improved; improved outcome; overtreatment; programs; self help; skills; smartphone Application; technological innovation; therapy design; treatment adherence; treatment program; web site

PROJECT SUMMARY Access to cognitive behavioral therapy (CBT), the first-line treatment for disorders characterized by recurrent binge eating (i.e., eating large amounts of food within a discrete-time period, characterized by a sense of loss of control) is limited. CBT for binge eating is intensive (16-20 sessions), expensive ($1,882 per patient), and requires access to clinicians with specialized training. Self-help CBTs for binge eating are accessible and cost- effective, however, outcomes are best when the self-help treatment is paired with periodic contact with a highly trained clinician. Clinicians likely improve outcomes because they are trained to utilize specific behavior change techniques for facilitating improvements in two key treatment targets including treatment adherence and skills utilization during self-help CBT program. Given the limited availability of expert clinicians, it is critical to understand how to enhance outcomes from self-help CBTs without clinician involvement. Recent technological advancements have shown the potential to closely approximate the behavior change techniques typically implemented by expert clinicians to enhance treatment adherence and skills utilization during self-help CBT without clinician involvement. In particular, technology-based intervention factors such as Advanced Digital Data Sharing with Coaches and Just-in-time adaptive interventions (JITAIs) have shown promise in emulating behavior change techniques used by an expert clinician. Advanced Digital Data Sharing systems can perform key behavioral tasks typically accomplished by expert clinician (e.g., identify areas for intervention and generate recommendations on how to intervene on target behaviors). Coaches (individuals with bachelor’s degree in health-related fields) may use the recommendations generated by this system and provide support to patients via weekly emails for improving treatment adherence and skills utilization. Thus, Advanced Digital Data Sharing system may allow coaches to function in a more skilled way without receiving extensive training in behavior change techniques. JITAIs are a smartphone intervention design that conducts real-time analysis of behavioral data related to treatment targets and determines the time of delivery and content of momentary interventions designed to improve treatment adherence and skills use. To date, no study has tested whether these technology-based intervention factors can independently and synergistically improve treatment targets and outcomes from self-help CBTs for binge eating without clinician involvement. The proposed study will use a full factorial design with 76 individuals with binge eating to identify the independent and combined synergistic efficacies of two intervention factors (i.e., Advanced Digital Data Sharing with Coaches and JITAIs) hypothesized to 1) improve treatment adherence and skills utilization, and 2) enhance treatment outcomes when combined with a self-help CBT program without clinician involvement. Results of the study will inform development of effective and highly disseminable self-help CBT program for binge eating.

项目摘要 获得认知行为疗法（CBT），这是以复发性疾病为特征的疾病的一线治疗方法。 暴饮暴食（即，在不连续的时间段内吃大量的食物，特征是有一种失落感 控制）是有限的。暴食的CBT是密集的（16-20次），昂贵的（每位患者1，882美元）， 需要有经过专业培训的临床医生。自助CBT暴食是可获得的，成本- 然而，当自助治疗与定期与高风险患者接触时，效果最好。 训练有素的临床医生。临床医生可能会改善结果，因为他们受过训练，利用特定的行为 改变技术，以促进两个关键治疗目标的改善，包括治疗依从性 和技能的利用在自助CBT计划。鉴于专家临床医生的有限性， 了解如何在没有临床医生参与的情况下提高自助CBT的结果。 最近的技术进步已经显示出接近行为变化的潜力 通常由专家临床医生实施的技术，以提高治疗依从性和技能利用率 在没有临床医生参与的情况下进行自助CBT。特别是基于技术的干预因素，如 先进的数字数据共享与教练和即时适应性干预（JITAIs）已经表明， 在模仿临床专家使用的行为改变技术方面有希望。高级数字数据共享 系统可以执行通常由专家临床医生完成的关键行为任务（例如，确定区域， 干预并产生关于如何干预目标行为建议）。教练（个人 具有健康相关领域的学士学位）可以使用该系统生成的建议， 通过每周电子邮件向患者提供支持，以提高治疗依从性和技能利用率。因此，在本发明中， 先进的数字数据共享系统可以让教练以更熟练的方式工作，而无需接收 广泛的行为改变技巧培训。JITAI是一种智能手机干预设计， 实时分析与治疗目标相关的行为数据，并确定交付时间， 旨在改善治疗依从性和技能使用的瞬时干预的内容。迄今为止，没有研究 已经测试了这些基于技术的干预因素是否可以独立和协同改善 在没有临床医生参与的情况下，自助式CBT对暴饮暴食的治疗目标和结果。 这项拟议的研究将使用76名暴饮暴食者的全析因设计，以确定 两种干预因素的独立和组合的协同功效（即，高级数字数据 与教练和JITAI共享）假设1）改善治疗依从性和技能利用率，以及 2)在没有临床医生参与的情况下，与自助CBT计划相结合，可提高治疗效果。 研究结果将为制定有效且高度可传播的自助CBT计划提供信息， 暴食。