SATED: A Cultural Pre-Treatment for Disordered Eating Prevention Programs

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 DESCRIPTION (provided by applicant): Subthreshold eating disorders (EDs) among women in emerging adulthood are reportedly as high as 61%. Left untreated, subthreshold EDs can develop into full-blown EDs, which are accompanied by issues such as cardiovascular problems, psychological impairment, and in some cases, even death. Despite demonstrating ED rates equivalent to White women, ethnic minority women (i.e., African American and Asian American women) are less likely to seek treatment for EDs and are more likely to terminate ED-related treatment prematurely. Currently, one of the most successful programs for ED prevention is the dissonance-based intervention (DBI) created by Stice and colleagues (2008). The intervention is based on cognitive dissonance theory, which maintains that individuals will be motivated to change cognitions when they experience psychological discomfort as a result of conflicting cognitions. One major limitation of the Stice DBI is that it has not been adequately validated among diverse samples and it lacks cultural adaptation. The current proposal investigates whether a novel, culturally-tailored pre-treatment effectively enhances retention to and outcomes of (i.e., treatment-seeking motivation) a DBI for EDs among young adult African American and Asian American women. In doing so, the current proposal aligns with AHRQ's mission to target priority populations by focusing on ethnic minority women. A sample of 156 women from 18-30 will be recruited via an introductory psychology pool, student organizations, and community organizations. Participants will be pre-screened using the Eating Disorder Examination - Questionnaire (EDE-Q) and Eating Disorder Examination (EDE). 36 women will complete focus groups which will inform the pre-treatment. 120 women will be assigned either to a pre- treatment condition or a no pre-treatment condition prior to completing a DBI for EDs which will take place over two 2-hour sessions. Women participating in the intervention will complete a battery of questionnaires at baseline, post-intervention, and post-post-intervention (3-month follow-up). Constructs assessed will include ED symptomatology, attitudes towards seeking professional psychological help, retention, body dissatisfaction, thin-ideal internalization, self-objectification, weight and shape self-efficacy, and ethnic identity. Key hypotheses in a 2X3 mixed-subjects ANOVA: 1) participants assigned to the pre-treatment condition will have higher rates of treatment-seeking motivation and retention than those in the no pre-treatment condition; 2) groups in the pre-treatment condition will have lower self-objectification, ED-related symptomatology, body dissatisfaction, and higher weight and shape self-efficacy after the intervention than participants in the no pre- treatment condition; 3) ethni identity and thin-ideal internalization will potentially moderate these relationships. Qualitative analysis and ANOVA will be utilized. Results may inform feasibility issues that accompany translational, community-based research with ethnic minority groups and inform current health-related treatment of these women by utilizing methods that increase treatment-seeking motivation and retention.