A Novel Intervention Promoting Eating Disorder Treatment among College Students

促进大学生饮食失调治疗的新型干预措施

• 批准号: 8782040
• 负责人: Sarah Ketchen Lipson
• 金额: $ 3.04万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8782040
• 关键词: 18 year old; Address; Adolescent and Young Adult; Affect; Age of Onset; Attitude; Behavior; Behavioral; Belief; Boxing; Caring; Cognitive; Data; Data Collection; Development; Early Intervention; Eating Disorders; Economics; Education; Electronic Mail; Electronics; Equilibrium; Fellowship; Female; Focus Groups; Group Interviews; Health; Health Services; Health behavior; Individual; International; Intervention; Interview; Knowledge; Lead; Left; Mental Health; Mental Health Services; Mental disorders; Mentors; Modification; Nature; Outcome; Persons; Plant Roots; Population; Prevalence; Public Health; Qualifying; Randomized; Recruitment Activity; Refractory; Reporting; Research; Research Training; Resistance; Sampling; Services; Severities; Site; Structure; Students; Sum; Surveys; Symptoms; Testing; Time; Training; Treatment Factor; Universities; Vulnerable Populations; career; clinically significant; college; coping; cost; design; diet and exercise; disorder prevention; economic outcome; effective intervention; evidence base; experience; follow-up; health care service utilization; help-seeking behavior; improved; innovation; insight; interdisciplinary approach; interest; intervention effect; male; mortality; novel; physical conditioning; prevent; primary outcome; public health relevance; research to practice; service intervention; social; social stigma; success; theories; therapy design; university student; uptake; young adult

DESCRIPTION (provided by applicant): Eating disorders (EDs) have the highest rate of mortality of any mental illness. ED age of onset coincides with the undergraduate years (ages 18-25). As such, colleges provide access to a large, epidemiologically vulnerable population and present a unique opportunity for intervention. On college campuses, 14% of female and 4% of male students screen positive for clinically significant EDs. An estimated 80% of these students do not receive treatment. Left untreated EDs typically become more severe and refractory to treatment. Help-seeking interventions typically focus on minimizing stigma, improving knowledge, and addressing other barriers emphasized by classic theories of health behavior. On the whole, these interventions have failed to increase treatment utilization for the vast majority of students with ED symptoms. Innovative approaches are urgently needed to narrow the ED treatment gap on college campuses. The proposed study builds on the most comprehensive research to date on mental health service utilization in college populations, which I have helped develop with my sponsor. Our findings reveal new insight into the ED treatment gap: students with untreated EDs report not seeking help for reasons such as lack of time, lack of perceived need, ambivalence about the severity of need, belief that the problem will resolve itself without treatment, and a desire to deal with issues "on my own." These reasons imply a lack of urgency but not necessarily a strong resistance to receiving treatment. In similar health contexts (e.g., for diet/exercise, use of preventative care), behavioral economic interventions have produced positive results by exploiting two cognitive biases: (1) the default bias (individuals 'go with the flow' of preset options) and (2) sign effect (losses (negative outcomes) are substantially more psychologically costly than gains (positive outcomes) of equal magnitude). With this fellowship, I will test intervention components addressing lack of urgency and promoting available treatment options in an effort to increase help-seeking among students with untreated ED symptoms (as identified in an online screen). Intervention components will be operationalized in electronic messages delivered over 12- weeks. This proposal has 2 specific aims and 1 sub-aim. In Aim 1, I will test the feasibility of the intervention. Results will inform modifications for Aim 2, which is to examine, using a factorial design, effects of the intervention components on ED treatment utilization (primary outcome). I will also conduct semi-structured interviews with students who do not use treatment during the study period to identify ways in which the intervention could be made more effective (Sub-aim). An intervention of this nature (low-cost, online) could easily be disseminated on a large-scale to promote help-seeking for EDs and other mental health conditions among college students and adolescent and young adult populations more broadly. By enhancing uptake of evidence-based ED treatment, my proposal directly addresses NIMH's objective to "help close the gap between the development of new, research-tested interventions and their widespread use by those most in need."

描述（由申请人提供）：进食障碍（ED）是所有精神疾病中死亡率最高的。艾德的发病年龄与大学生年龄一致（18-25岁）。因此，大学提供了接触大量流行病学脆弱人群的机会，并提供了一个独特的干预机会。在大学校园里，14%的女性和4%的男性学生对临床上显著的ED筛查呈阳性。据估计，这些学生中有80%没有接受治疗。未经治疗的ED通常会变得更严重，并且难以治疗。寻求帮助的干预措施通常侧重于最大限度地减少耻辱，提高知识，并解决健康行为经典理论所强调的其他障碍。总的来说，这些干预措施未能提高绝大多数有艾德症状的学生的治疗利用率。迫切需要创新的方法来缩小大学校园中的艾德治疗差距。这项拟议中的研究建立在迄今为止关于大学人群心理健康服务利用率的最全面的研究基础上，我和我的赞助商一起帮助开发了这项研究。我们的研究结果揭示了对艾德治疗差距的新见解：患有未经治疗的ED的学生报告不寻求帮助的原因包括缺乏时间，缺乏感知需求，对需求严重性的矛盾心理，相信问题会自行解决而无需治疗，以及希望“自己“处理问题。“这些原因意味着缺乏紧迫感，但不一定是对接受治疗的强烈抵制。在类似的健康背景下（例如，对于饮食/锻炼，使用预防性护理），行为经济干预通过利用两种认知偏差产生了积极的结果：（1）默认偏差（个人“随大流”的预设选项）和（2）符号效应（损失（负面结果）在心理上比同等程度的收益（正面结果）更昂贵）。有了这个奖学金，我将测试干预组件解决缺乏紧迫性和促进可用的治疗方案，努力增加寻求帮助的学生与未经治疗的艾德症状（如在网上屏幕上确定）。干预部分将在12周内以电子信息的形式提供。该提案有两个具体目标和一个次级目标。在目标1中，我将测试干预的可行性。结果将为目标2的修改提供信息，目标2是使用析因设计检查干预措施的效果 艾德治疗利用率（主要结局）。我还将与在研究期间不使用治疗的学生进行半结构化访谈，以确定干预措施更有效的方法（子目标）。这种性质的干预（低成本，在线）可以很容易地大规模传播，以促进更广泛地在大学生和青少年和年轻人群体中寻求ED和其他心理健康状况的帮助。通过加强对循证艾德治疗的吸收，我的建议直接涉及NIMH的目标，即“帮助缩小新的、经过研究测试的干预措施的开发与最需要的人广泛使用之间的差距。"