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）：饮食失调（EDS）的死亡率最高。 ED发作年龄与本科年份（18-25岁）一致。因此，大学提供了对大型，流行病学上脆弱的人口的访问权限，并为干预提供了独特的机会。在大学校园里，女性的14％和4％的男学生的筛查对临床意义的ED呈阳性。这些学生中估计有8​​0％没有接受治疗。未经治疗的ED通常会变得更加严重和对治疗难治性。寻求帮助的干预措施通常集中于最大程度地减少污名，改善知识并解决经典健康行为理论强调的其他障碍。总体而言，这些干预措施未能增加对ED症状的绝大多数学生的治疗利用。迫切需要使用创新的方法来缩小大学校园的ED治疗差距。拟议的研究基于迄今为止在大学人群中精神卫生服务利用率的最全面的研究，我帮助了赞助商。我们的发现揭示了对ED治疗差距的新见解：未经治疗的ED报告的学生不寻求帮助，原因是缺乏时间，缺乏感知需求，对需求的严重性的矛盾情绪，人们相信问题会在没有治疗的情况下解决问题，并且渴望处理“我自己”的问题。这些原因意味着缺乏紧迫性，但不一定对接受治疗具有强烈的抵抗力。在类似的健康环境（例如，用于饮食/锻炼，使用预防性护理）中，行为经济干预通过利用两个认知偏见而产生了积极的结果：（1）默认偏见（个人与预设选项的流动”和（2）符号效应（负面的（负面拆除）在基本上具有比较成本相同的型号（损失）比相等的（损失）相等（比相等）（损失）相等（比较倍增）。通过此奖学金，我将测试解决缺乏紧迫性并促进可用治疗方案的干预组件，以增加未经治疗的ED症状的学生的帮助（如在在线屏幕上确定）。干预组件将在12周内传递的电子消息中运行。该提议具有2个特定目标和1个子AIM。在AIM 1中，我将测试干预的可行性。结果将为AIM 2的修改提供信息，即使用阶乘设计检查干预的效果 ED治疗利用的组成部分（主要结果）。我还将对在研究期间不使用治疗的学生进行半结构化访谈，以确定可以使干预更有效的方法（Sub-aim）。可以轻松地在大规模上分发这种性质（低成本，在线）的干预措施，以更广泛地在大学生以及青少年和年轻人中为ED和其他心理健康状况寻求帮助。通过增强对证据基于证据的ED治疗的吸收，我的建议直接解决了NIMH的目标，即“有助于弥合新的，研究测试的干预措施的发展与最有需要的人的广泛使用之间的差距”。