An interactive internet-based intervention for women at risk of eating disorders: a pilot study.

OBJECTIVE: The Internet serves as a potentially effective method of treatment delivery through widespread education and interaction via synchronous Internet relay chat (IRC). The current study explores the feasibility of IRC in the delivery of an eating disorders prevention intervention. METHOD: This small pilot study describes the delivery of an efficacious eating disorder treatment using a novel medium. The on-line sessions are based on cognitive-behavioral treatment and are facilitated by a moderator. In addition to feasibility, preliminary evidence of acceptability and efficacy for an on-line intervention with college-aged women is reported. RESULTS: Results indicate that IRC is an acceptable and feasible format for treatment delivery. In addition, descriptive and qualitative data suggest that this method of treatment delivery is potentially effective. DISCUSSION: This pilot study provides increased knowledge of the viability of treatment delivery over the Internet, specifically, a psychoeducational IRC for eating disorder prevention.

Reducing risk factors for eating disorders: targeting at-risk women with a computerized psychoeducational program.

OBJECTIVE: This controlled study evaluated whether an 8-week program offered over the Internet would significantly decrease body image dissatisfaction, disordered eating patterns, and preoccupation with shape/weight among women at high risk for developing an eating disorder. METHOD: Fifty-six college women were recruited on the basis of elevated scores (> or =110) on the Body Shape Questionnaire (BSQ). Psychological functioning, as measured by the Eating Disorder Inventory Drive for Thinness (EDI-DT) subscale, Eating Disorder Examination-Questionnaire (EDE-Q), and the BSQ, was assessed at baseline, posttreatment, and at 10-week follow-up. RESULTS: All participants improved over time on most measures, although effect sizes suggest that the program did impact the intervention group. DISCUSSION: Findings suggest that technological interventions may be helpful for reducing disordered eating patterns and cognitions among high-risk women. Future research is needed to assess whether such programs are effective over time for prevention of and reduction in eating disorder symptomatology.

Reducing risk factors for eating disorders: comparison of an Internet- and a classroom-delivered psychoeducational program.

This controlled trial compared Internet- (Student Bodies [SB]) and classroom-delivered (Body Traps [BT]) psychoeducational interventions for the reduction of body dissatisfaction and disordered eating behaviors/attitudes with a control condition. Participants were 76 women at a private university who were randomly assigned to SB, BT, or a wait-list control (WLC) condition. Measures of body image and eating attitudes and behaviors were measured at baseline, posttreatment, and 4-month follow-up. At posttreatment, participants in SB had significant reductions in weight/shape concerns and disordered eating attitudes compared with those in the WLC condition. At follow-up, disordered behaviors were also reduced. No significant effects were found between the BT and WLC conditions. An Internet-delivered intervention had a significant impact on reducing risk factors for eating disorders.

Effectiveness of an Internet-based program for reducing risk factors for eating disorders.

This study evaluated an Internet-delivered computer-assisted health education (CAHE) program designed to improve body satisfaction and reduce weight/shape concerns--concerns that have been shown to be risk factors for the development of eating disorders in young women. Participants were 60 women at a public university randomly assigned to either an intervention or control condition. Intervention participants completed the CAHE program Student Bodies. Measures of body image and disordered eating attitudes were assessed at baseline, postintervention, and 3-month follow-up. At follow-up, intervention participants, compared with controls, reported a significant improvement in body image and a decrease in drive for thinness. This program provides evidence for the feasibility and effectiveness of providing health education by means of the Internet.

Student bodies: psycho-education communities on the web.

We have developed a Web-delivered, multimedia health educational program, Student Bodies, designed to improve body satisfaction, a probable risk factor for the development of eating disorders in young women. The program includes psycho-educational content and a newsgroup for communication, and is delivered in a structured framework of weekly readings, assignments and postings to the newsgroup. Intervention group participants improved their body image, and reduced other attitudes that predispose to eating disorders.

Effects of a body image curriculum for college students on improved body image.

OBJECTIVE: This study evaluated the effects of an undergraduate body image course, "Body Traps: Perspectives on Body Image," on decreasing body dissatisfaction, weight concern, and disordered eating behaviors. METHODS: Twenty-four undergraduate females enrolled in the body image course. Measures of body image and disordered eating patterns were assessed at baseline and at postintervention. RESULTS: Subjects significantly decreased the frequency and severity of their body dissatisfaction and disordered eating. No changes in body mass index or global self-esteem were observed. DISCUSSION: This is the first investigation to demonstrate that a formal, academic course can result in the reduction of both attitudinal and behavioral eating disorder risk factors. Future controlled studies need to be undertaken to substantiate this effect.

Evaluation of a computer-mediated eating disorder intervention program.

OBJECTIVE: This study evaluated an eating disorder intervention multimedia program modeled after self-help eating disorder treatment programs. It was hypothesized that women who completed the program would increase their body satisfaction and decrease their preoccupation with weight and frequency of disordered eating behaviors. METHOD: Participants were 57 undergraduate females randomly assigned to either the intervention or control group. Psychological functioning was assessed at baseline, at 3 months postintervention, and at 3 months follow-up. RESULTS: Intervention group subjects significantly improved their scores on all psychological measures over time. When compared to the control group, however, only the intervention group's improvements on the Body Shape Questionnaire were statistically significant. DISCUSSION: This study has demonstrated that minimally effective eating disorder intervention programs can be delivered. A revised program that eliminates interface problems and increases the structure of the intervention is likely to be even better received and more effective.

An evaluation of human papillomavirus testing as part of referral to colposcopy clinics.

OBJECTIVE: To determine the usefulness of human papillomavirus (HPV) testing as a triage method for predicting which women referred to a colposcopy clinic were most likely to have histologically confirmed cervical intraepithelial neoplasia (CIN). METHODS: Papanicolaou tests, ViraPap tests for HPV infection, and colposcopically directed biopsies were performed concurrently on 482 women referred to a student health colposcopy clinic. RESULTS: The results demonstrated that HPV positivity was associated with a greatly increased likelihood of histologic confirmation of CIN, especially among women with concurrent cytologic findings that were negative or showed only atypical squamous cells of undetermined significance. CONCLUSIONS: Testing for HPV appears to have a role in the triage of students now being referred to our colposcopy clinic. A combination of HPV testing and repeated cytologic screening would provide reasonably sensitive screening for cervical neoplasia while limiting the use of colposcopic services, which are currently overburdened. The eventual usefulness of HPV testing will depend on the cost and availability of colposcopy services, the cost of Papanicolaou tests, the cost and accuracy of HPV tests, and the predictive value of HPV detection in the population being screened.