In the current dissertation the effectiveness and cost-effectiveness of Featback, an internet-based self-help intervention for eating disorders, and online support by individuals with a lived... Show moreIn the current dissertation the effectiveness and cost-effectiveness of Featback, an internet-based self-help intervention for eating disorders, and online support by individuals with a lived experience of an eating disorder were investigated. The findings suggest that low-threshold internet-based interventions for eating disorders, such as Featback, can complement existing treatment options in three ways. First, they have been repeatedly found to be effective in reducing eating disorder symptomatology. Second, such interventions can reach individuals that are currently not reached by other forms of treatment and stimulate them to get professional help. Finally, internet-based interventions are likely to be cost-effective compared to care as usual. Concordantly, implementing highly scalable and easily accessible interventions like Featback likely helps to reduce both the individual and societal burden of eating disorders. Show less
Rohrbach, P.J.; Dingemans, A. E.; Spinhoven, P.; Ginkel, J.R. van; Fokkema, M.; Wildermans, T.F.; ... ; Furth, E.F. van 2022
Objective: Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the... Show moreObjective: Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the effectiveness of Featback, a fully automated online self-help intervention, online expert-patient support and their combination.Method: A randomized controlled trial with a 12-month follow-up period was conducted. Participants aged 16 or older with at least mild eating disorder symptoms were randomized to four conditions: (1) Featback, a fully automated online selfhelp intervention, (2) chat or email support from a recovered expert patient, (3) Featback with expert-patient support and (4) a waiting list control condition. The intervention period was 8 weeks and there was a total of six online assessments. The main outcome constituted reduction of eating disorder symptoms over time. Results: Three hundred fifty five participants, of whom 43% had never received eating disorder treatment, were randomized. The three active interventions were superior to a waitlist in reducing eating disorder symptoms (d = -0.38), with no significant difference in effectiveness between the three interventions. Participants in conditions with expert-patient support were more satisfied with the intervention. Discussion: Internet-based self-help, expert-patient support and their combination were effective in reducing eating disorder symptoms compared to a waiting list control condition. Guidance improved satisfaction with the internet intervention but not its effectiveness. Low-threshold interventions such as Featback and expert-patient support can reduce eating disorder symptoms and reach the large group of underserved individuals, complementing existing forms of eating disorder treatment. Public significance statement: Individuals with eating-related problems who received (1) a fully automated internet-based intervention, (2) chat and e-mail support by a recovered individual or (3) their combination, experienced stronger reductions in eating disorder symptoms than those who received (4) usual care. Such brief and easyaccess interventions play an important role in reaching individuals who are currently not reached by other forms of treatment. Show less
The aim of this dissertation was to investigate whether and how E-health can help to improve health care for individuals with eating disorder symptoms. The main goal was to evaluate two E-health... Show moreThe aim of this dissertation was to investigate whether and how E-health can help to improve health care for individuals with eating disorder symptoms. The main goal was to evaluate two E-health interventions: e-community ‘Proud2Bme’ and fully automated Internet-based intervention ‘Featback’. The effectiveness and cost-effectiveness of Featback with and without therapist support in comparison to a waiting was examined in a randomized controlled trial. Furthermore, potential moderators and mediators were investigated: what works for whom and what is the psychological mechanism that explains how Featback achieves its beneficial effects? Also, all online therapist communication within the Featback intervention was qualitatively examined. What did therapists actually do within the online support sessions as offered in addition to Featback? And can therapist behaviors predict participants’ outcome and satisfaction? Finally, this dissertation includes a systematic review of treating eating disorders over the Internet, as well a chapter about the emerging findings, issues, and opportunities regarding E-health for eating disorders in the past few years (2013-2015). How effective are Internet-based self-help interventions, -treatment, and -relapse prevention programs? What is the potential of Smartphone applications in treating eating disorders? What are the opportunities and challenges for the development and implementation of E-health for eating disorders? Show less
