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.

项目总结 获得认知行为疗法(CBT)，这是以反复发作为特征的障碍的一线治疗 暴饮暴食(即在一段不连续的时间内吃下大量食物，以失落感为特征 控制)是有限的。暴饮暴食的CBT是密集的(16-20次)，昂贵(每个患者1,882美元)，以及 需要接受过专门培训的临床医生。用于暴饮暴食的自助CBT是可以获得的，而且成本很低- 然而，当自助治疗与高度接触的周期性接触相结合时，效果最好。 训练有素的临床医生。临床医生可能会改善结果，因为他们接受了利用特定行为的培训 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 以及在自助CBT项目中的技能利用。鉴于专业临床医生的有限可得性，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式CBTS的疗效。 最近的技术进步已经显示出接近行为变化的可能性 通常由专业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，以技术为基础的干预因素，如 与教练的高级数字数据共享和即时适应干预(JITAI)已显示 承诺模仿专家临床医生使用的行为改变技术。高级数字数据共享 系统可以执行通常由专业临床医生完成的关键行为任务(例如，识别 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)可以使用此系统生成的推荐，并 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允许教练以更熟练的方式工作，而不需要接收 行为改变技巧方面的广泛培训。JITAI是一款智能手机干预设计，它进行 实时分析与治疗目标相关的行为数据，并确定交付时间和 旨在改善治疗依从性和技能使用的瞬时干预内容。到目前为止，还没有研究 测试了这些以技术为基础的干预因素是否可以独立和协同地改善 无临床医生参与的暴饮暴食自助CBTS的治疗目标和结果。 这项拟议的研究将使用完全析因设计，对76名暴饮暴食的人进行研究，以确定 两个干预因素(即先进数字数据)的独立和联合协同效应 与教练和JITAI分享)被假设为1)提高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，可以提高治疗结果。 研究结果将为制定有效和高度可传播性的自助CBT计划提供参考 暴饮暴食。