Leveraging Social Media to Identify and Connect Teens with Eating Disorders to a Mobile Guided Self-Help Mobile Intervention

项目摘要 临床或亚临床饮食失调(EDs)影响着10%的人的一生，其特点是 严重的功能障碍、早期死亡、慢性病和情绪困扰。ED症状经常出现 出现在青春期，高峰发病年龄在十几岁。早期识别和治疗这些疾病 为了防止长期后果和慢性病程，需要毁灭性的疾病。最多(80%) 患有EDS的个人，包括患有EDS的青少年(TwEDs)，不接受治疗。由于存在重大障碍， 为了获得和提供TWED治疗，需要一种新的服务提供模式，这种模式可以 识别并帮助TWED。我们在社交媒体上研究了与ED相关的网络，并展示了我们的 能够利用在青少年中普遍使用的社交媒体来识别和高效地招聘大型 TWED的数量。同时，我们团队成功开发了一种指导性自助认知-- 基于行为疗法(CBT)的手机应用程序--学生身体进食障碍(SB-ED)，其中包括 针对主要ED治疗目标的个性化指导和互动会议，并已演示 患有EDS的女大学生的疗效。此工具具有很大的潜力，可用于解决特定的 两人的需求。在拟议研究的目标#1中，我们将更新和调整SB-ED，以创建#ByeED for TWED通过1)简化语言并使内容与青少年问题相关，2)包括奖励 促进应用程序持续使用的功能，3)包括应用程序内的社交网络功能，以促进群组 交流和教练指导的每周小组会议，以及4)利用机器学习来消化用户的社交 在#Byeed内建立网络数据，以实时应对潜在的恢复挫折并进行量身定制的指导 互动。在TWED的一个小焦点小组评估对这款应用的初步印象后，#Byeed将被 在从Instagram招募的20名TwED中进行试点，通过混合方法在 效率、技术有效性和对#Byeed的满意度。该应用程序将进一步完善，为一小 AIM#2的试点随机对照试验(RCT)，我们将再次利用Instagram招募 没有从事治疗的TWED。这一区域工作队将接近#年的初步效力。 (n=50)与对照组(鼓励在其社区进行面对面治疗，n=50)相比，减少ED 症状，改善生活质量，增加护理，并影响与以下方面相关的目标 结果。我们将探索应用程序内结果的预测因素，治疗效果的潜在调节因素(例如， 精神疾病)，以及参与者对潜在的额外父母参与的观点 #再见。影响规模和损耗估计将有助于规划更大的RCT(R01机制)，其中我们 将进一步扩展#Byeed(例如，自动化辅导、家长参与)，并在更大范围内测试该应用程序 以提高其潜力，以减轻青少年中急救药物的非凡负担。

Project Summary Clinical or subclinical eating disorders (EDs) impact 10% of individuals in their lifetime and are marked by significant functional impairment, early mortality, chronicity, and emotional distress. ED symptoms often emerge in adolescence, with peak onset age in the teenage years. Early recognition and treatment of these devastating illnesses are needed to prevent long-term consequences and a chronic course. Most (80%) individuals with EDs, including teens with EDs (TwEDs), do not receive treatment. Due to major barriers to access and to the delivery of treatment for TwEDs, there is a need for a new model of service delivery that can identify and help TwEDs. We have studied ED-related networking on social media and have demonstrated our ability to harness social media, which is used ubiquitously among teens, to identify and efficiently recruit large numbers of TwEDs. At the same time, our team has successfully developed a guided self-help cognitive- behavioral therapy (CBT)-based mobile app, StudentBodies-Eating Disorders (SB-ED), which includes personalized coaching and interactive sessions to address key ED treatment targets and has demonstrated efficacy among college women with EDs. This tool has great potential to be adapted to address the specific needs of TwEDs. In Aim #1 of the proposed study, we will update and adapt SB-ED to create #ByeED for TwEDs by 1) simplifying language and making content relevant to adolescent issues, 2) including a rewards feature to motivate continued app use, 3) including a within-app social networking feature to facilitate group exchanges and coach-led weekly group sessions, and 4) harnessing machine learning to digest users’ social networking data within #ByeED to respond to potential recovery setbacks in real-time and tailor coaching interactions. Following a small focus group of TwEDs to assess initial impressions of the app, #ByeED will be piloted among 20 TwEDs recruited from Instagram, garnering feedback via a mixed methods approach on the efficiency, technical effectiveness, and satisfaction with #ByeED. The app will be further refined for a small pilot randomized controlled trial (RCT) in Aim #2, where we will again leverage Instagram for recruitment of TwEDs who are not engaged in treatment. This RCT will approximate the preliminary effectiveness of #ByeED (n=50) versus a control group (encouraging in-person treatment in their communities, n=50) in reducing ED symptoms, improving quality of life, increasing uptake of care, and impacting targets that are associated with outcomes. We will explore within-app predictors of outcomes, potential moderators of treatment effects (e.g., psychiatric comorbidity), and participant perspectives on potential additional parental involvement in #ByeED. Effect size and attrition estimates will aid in the planning of a larger RCT (R01 mechanism) where we will further expand #ByeED (e.g., automated coaching, parental involvement) and test the app on a larger scale to improve its potential to reduce the extraordinary burden of EDs among teens.