Accepted for/Published in: JMIR Mental Health
Date Submitted: Jun 10, 2019
Open Peer Review Period: Jun 11, 2019 - Jun 18, 2019
Date Accepted: Oct 3, 2019
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Title: A Randomized Trial Comparing an Adaptive Self-Help Mobile App to a Standard Self-Monitoring App for the Treatment of Eating Disorders
ABSTRACT
Background:
Eating disorders severely impact psychological, physical and social functioning and yet the majority of individuals with eating disorders do not receive treatment. mHealth apps have the potential to decrease access barriers to care and reach individuals who have been underserved by traditional treatment modalities.
Objective:
This study evaluates the effectiveness of an adaptive, fully automated self-help version of Recovery Record, an app developed for eating disorder management. We examined differences in eating disorder symptom change in app users that were randomized to receive either a standard, Cognitive Behavioral Therapy (CBT) based version of the app or an adaptive version that included algorithmically determined clinical content aligned with baseline and evolving user eating disorder symptom profiles.
Methods:
Participants were recruited via the open-access Recovery Record app to participate in this randomized trial. We examined both continuous and categorical clinical improvement outcomes (measured with the self-report Eating Disorder Examination Questionnaire [EDE-Q]) in both intervention groups.
Results:
Between December 2016 and August 2018, 3,294 Recovery Record app users were recruited into the study, of whom 959 were considered engaged, completed follow-up assessments and were included in the analyses. Both study groups achieved significant overall outcome improvement, with 61.6% of the adaptive group and 55.4% of the standard group achieving a clinically meaningful change in the EDE-Q, on average. There were no statistically significant differences between randomized groups for continuous outcomes, but a pattern of improvement being greater in the adaptive group was evident. The rate of remission on the EDE-Q at 8 weeks was significantly greater in the group receiving the adaptive version (d = 0.22; P= <0.001).
Conclusions:
This is the first report to compare the relative efficacy of two versions of a smartphone app for eating disorders. The data suggest that tailoring app content to specific clinical presentations may be more effective in promoting symptomatic remission on the EDE-Q than content that offers a generic approach. Clinical Trial: ClinicalTrials.gov NCT02503098
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Copyright
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