TY  - JOUR
AU  - Jacobi, Corinna
AU  - Hütter, Kristian
AU  - Völker, Ulrike
AU  - Möbius, Katharina
AU  - Richter, Robert
AU  - Trockel, Mickey
AU  - Jones Bell, Megan
AU  - Lock, James
AU  - Taylor, C Barr
PY  - 2018
DA  - 2018/12/14
TI  - Efficacy of a Parent-Based, Indicated Prevention for Anorexia Nervosa: Randomized Controlled Trial
JO  - J Med Internet Res
SP  - e296
VL  - 20
IS  - 12
KW  - anorexia nervosa
KW  - indicated prevention
KW  - internet
KW  - parental intervention
KW  - randomized controlled trial
AB  - 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). 
SN  - 1438-8871
UR  - http://www.jmir.org/2018/12/e296/
UR  - https://doi.org/10.2196/jmir.9464
UR  - http://www.ncbi.nlm.nih.gov/pubmed/30552078
DO  - 10.2196/jmir.9464
ID  - info:doi/10.2196/jmir.9464
ER  -