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.

项目概要 获得认知行为疗法 (CBT)，这是治疗以复发为特征的疾病的一线疗法 暴饮暴食（即在不连续的时间内吃大量食物，其特征是失落感 的控制）是有限的。治疗暴饮暴食的 CBT 强度大（16-20 次），价格昂贵（每位患者 1,882 美元），而且 需要接受过专门培训的临床医生。针对暴饮暴食的自助 CBT 是可行的，而且成本低廉 然而，当自助治疗与定期接触高度重视的人相结合时，结果是最好的。 训练有素的临床医生。临床医生可能会改善结果，因为他们接受过利用特定行为的培训 改变技术以促进改善两个关键治疗目标，包括治疗依从性 以及自助 CBT 计划期间的技能运用。鉴于专家临床医生的可用性有限，这一点至关重要 了解如何在没有临床医生参与的情况下提高自助 CBT 的效果。 最近的技术进步已经显示出接近行为变化的潜力 通常由临床专家实施的技术，以提高治疗依从性和技能利用率 在没有临床医生参与的自助 CBT 过程中。特别是基于技术的干预因素，例如 与教练的高级数字数据共享和及时适应性干预 (JITAI) 已表明 有望模仿专业临床医生使用的行为改变技术。先进的数字数据共享 系统可以执行通常由临床专家完成的关键行为任务（例如，确定需要治疗的领域） 干预并就如何干预目标行为提出建议）。教练员（个人 拥有健康相关领域的学士学位）可以使用该系统生成的建议，并且 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， 先进的数字数据共享系统可以让教练以更熟练的方式发挥作用，而无需接收信息 行为改变技术的广泛培训。 JITAI 是一种智能手机干预设计，可进行 实时分析与治疗目标相关的行为数据并确定交付时间和 旨在提高治疗依从性和技能使用的临时干预内容。迄今为止，还没有研究 测试了这些基于技术的干预因素是否能够独立和协同地改善 无需临床医生参与的暴食自助 CBT 的治疗目标和结果。 拟议的研究将采用全因子设计，对 76 名暴食者进行了研究，以确定 两个干预因素（即高级数字数据）的独立和组合协同效应 与教练和 JITAI 共享）假设为 1）提高治疗依从性和技能利用率，以及 2) 与无需临床医生参与的自助 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传播的自助 CBT 计划提供信息 暴饮暴食。