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Evaluating the role of digital intervention design in treatment outcomes and adherence to eTherapy programs for eating disorders: A systematic review and meta‐analysis
Author(s) -
Barakat Sarah,
Maguire Sarah,
Smith Kathryn E.,
Mason Tyler B.,
Crosby Ross D.,
Touyz Stephen
Publication year - 2019
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.23131
Subject(s) - psycinfo , psychological intervention , psychology , cinahl , medline , meta analysis , interactivity , intervention (counseling) , clinical psychology , ehealth , eating disorders , medicine , applied psychology , multimedia , computer science , psychiatry , health care , political science , law , economics , economic growth
Objective Despite the existence of reviews which document the effectiveness of online therapies, there is little consensus regarding the exact components of online treatment delivery that are most effective in maintaining user engagement and reducing eating disorder (ED) symptomology. The current review and meta‐analysis aimed to determine which components of web‐based, ED self‐help interventions are associated with lower attrition and improved therapeutic outcome. Method A systematic search of electronic databases (PsycINFO, Medline, Web of Science, Scopus) was conducted for published studies of web‐based interventions for EDs and a meta‐analysis of the final included studies was performed. Each intervention was coded across four dimensions, including the multimedia channels employed (e.g., text, audio, videos), degree of user interactivity (e.g., online self‐monitoring, skills exercises), level of automated feedback (e.g., reminders, personalized feedback), and technological device through which the program was accessed (e.g., smartphone, computer). Results A final 23 papers were included. The results of meta‐regressions indicated that higher scores on the multimedia subscale were associated with greater ED symptom improvement in treatment groups. Conversely, a higher degree of feedback in the treatment group was associated with a group difference in ED psychopathology favoring the control group. Other intervention components were not associated with treatment outcome or dropout. Discussion The results are discussed in relation to limitations of the scale used to quantify digital intervention features, as well as the limited diversity and technological sophistication of available ED digital interventions. Such findings indicate the importance of understanding the digital components, which differentiate online therapeutic programs.