A Randomized Controlled Trial of an Interactive Non-Stigmatizing Intervention to Prevent Eating Disorder in Youths Through Strengthening of Protective Factors with Potential for Wide Implementation

Research area and aims Eating disorders (EDs) are common and cause significant morbidity and mortality. Due to stigma, only 25% seek help and only 50% fully recover after receiving treatments. Large-scale prevention is urgently needed to reduce the emergence and burden of EDs at a population level.

However, current prevention programs do not meet requirements for efficient and economically attractive large-scale implementation.

The main aim of this project is to investigate the efficacy and cost-effectiveness of a scalable, brief, and interactive prevention program based on reinforcement of protective factors against EDs using a randomized controlled design.

A focus on protective factors disrupts the processes by which risk factors increase the probability for EDs to emerge and minimizes the risks for stigmatization.

Research questions: How effective is an internet-based prevention program, that reinforces protective factors against EDs, in reducing the onset of EDs 6, 12, and 24 months post-intervention?Does the intervention reduce the incidence of EDs through enhancement of specifically targeted protective factors (mediators)?Is prevention of EDs based on reinforcement of protective factors cost-effective?How sustainable are virtual communities for maintenance of future recruitment and prevention on a large scale?

Secondary questions concern gender differences in enrollment and compliance, potential moderators of outcome, participation in booster sessions, and potential risk for stigma.

Data and MethodParticipants (15-20-years old, n=644, based on power analysis) will be recruited online and randomized to prevention or a credible placebo.

The intervention will be selective (target those with significant body dissatisfaction), delivered in a scalable format (Internet-based), brief (45 minutes/week for four weeks), and with interactive components of the program moderated by artificial intelligence for future scalability. Assessments will be done using the gold standard within the field of EDs.

Plan for project realisationThe proposed project is an extension of our previous work, including the largest controlled trial of prevention of EDs in Sweden. Recruitment, intervention, and assessments will be done using established methods. The costs are necessary for running a large randomized controlled trial.

RelevanceA brief, scalable and efficacious prevention program is the pre-requisite for reducing the emergence and burden of EDs on public health level.