@Article{info:doi/10.2196/jmir.9464,
author="Jacobi, Corinna
and H{\"u}tter, Kristian
and V{\"o}lker, Ulrike
and M{\"o}bius, Katharina
and Richter, Robert
and Trockel, Mickey
and Jones Bell, Megan
and Lock, James
and Taylor, C Barr",
title="Efficacy of a Parent-Based, Indicated Prevention for Anorexia Nervosa: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2018",
month="Dec",
day="14",
volume="20",
number="12",
pages="e296",
keywords="anorexia nervosa; indicated prevention; internet; parental intervention; randomized controlled trial",
abstract="Background: Web-based preventive interventions can reduce risk and incidence of bulimia and binge eating disorders among young high-risk women. However, their specific effects on core symptoms of anorexia nervosa (AN) are rather weak. Objective: The primary objective of this study was to evaluate the efficacy of an indicated, parent-based, Web-based preventive program Eltern als Therapeuten (E@T) in reducing risk factors and symptoms of AN. Methods: Girls aged between 11 and 17 years were screened by selected risk factors and early symptoms of AN. At-risk families were then randomized to E@T or an assessment-only control condition. Assessments took place at pre- and postintervention (6 weeks later) and at 6- and 12-month follow-up (FU). Results: A total of 12,377 screening questionnaires were handed out in 86 German schools, and 3941 including consent returned. Overall, 477 (447/3941, 12.10{\%}) girls were identified as at risk for AN and 256 of those could be contacted. In all, 66 families (66/256, 25.8{\%} of those contacted) were randomized to the E@T or a wait-list control condition, 43 (43/66, 65{\%}) participated in postassessments, and 27 (27/66, 41{\%}) in 12-month FUs. Due to low participation and high dropout rates of parents, recruitment was terminated prematurely. At 12-month FU, girls' expected body weight (EBW) percentage was significantly greater for intervention participants compared with control participants (group by time interaction beta=21.0 [CI 5.81 to 36.13], P=.007; group by time squared interaction beta=−15.5 [CI −26.6 to −4.49], P=.007; estimated Cohen d=0.42]. No other significant effects were found on risk factors and attitudes of disturbed eating. Conclusions: Despite a significant increase in girls' EBW percentage, parental participation and adherence to the intervention were low. Overall, parent-based, indicated prevention for children at risk for AN does not seem very promising, although it might be useful for parents who engage in the intervention. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 18614564; http://www.isrctn.com/ISRCTN18614564 (Archived by WebCite at http://www.webcitation.org/74FTV1EpF). ",
issn="1438-8871",
doi="10.2196/jmir.9464",
url="http://www.jmir.org/2018/12/e296/",
url="https://doi.org/10.2196/jmir.9464",
url="http://www.ncbi.nlm.nih.gov/pubmed/30552078"
}