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- Title
Implementation and outcomes of home‐based treatments for adolescents with anorexia nervosa: Study protocol for a pilot effectiveness‐implementation trial.
- Authors
Goldschmidt, Andrea B.; Tortolani, Christina C.; Egbert, Amy H.; Brick, Leslie A.; Elwy, A. Rani; Donaldson, Deidre; Le Grange, Daniel
- Abstract
Objective: Although family‐based treatment (FBT) is considered a first‐line treatment for adolescent anorexia nervosa (AN), it is underutilized in community settings and is unavailable to many families for a multitude of practical reasons (e.g., costs of treatment, transportation constraints). Adapting FBT interventions for delivery in home‐based and community‐based settings may reduce pragmatic barriers to treatment uptake and engagement. Methods: This pilot effectiveness‐implementation trial will assess outcomes, implementation, and mechanisms of FBT adapted for the home setting (FBT‐HB), delivered in the context of community‐based behavioral health agencies. Adolescents with AN‐spectrum disorders (n = 50) and their caregivers will be randomly assigned to either FBT‐HB or home‐based treatment as usual (TAU; integrated family therapy approach). Caregivers and adolescents will provide data on weight, eating, and putative treatment mechanisms, including caregiver self‐efficacy and adolescent eating‐related and weight‐related distress. Implementation constructs of feasibility, acceptability, and appropriateness will be measured among providers and participating families. Hypotheses: We expect that FBT‐HB will be feasible, acceptable, and appropriate, and will outperform TAU in terms of improvements in adolescent weight and eating‐related psychopathology. We further expect that caregiver self‐efficacy and adolescent eating‐related and weight‐related distress, but not general distress, will show greater improvements in FBT‐HB relative to TAU and will be associated with better adolescent weight and eating outcomes in FBT‐HB. Potential implications: The proposed study has clear potential to advance scientific and clinical understanding of the real‐world effectiveness of FBT for AN, including whether adapting it for the home setting improves its accessibility and effects on treatment outcome.
- Subjects
ANOREXIA nervosa treatment; PILOT projects; EVALUATION of human services programs; CONFIDENCE intervals; HOME care services; RESEARCH methodology; FISHER exact test; HUMAN services programs; T-test (Statistics); RANDOMIZED controlled trials; DESCRIPTIVE statistics; DATA analysis software; ADOLESCENCE
- Publication
International Journal of Eating Disorders, 2022, Vol 55, Issue 11, p1627
- ISSN
0276-3478
- Publication type
Article
- DOI
10.1002/eat.23796