A broad v. focused digital intervention for recurrent binge eating: a randomized controlled non-inferiority trial

Linardon, Jake, Shatte, Adrian, McClure, Zoe, and Fuller-Tyszkiewicz, Matthew (2023) A broad v. focused digital intervention for recurrent binge eating: a randomized controlled non-inferiority trial. Psychological Medicine, 53 (10). pp. 4580-4591.

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Background: Empirically validated digital interventions for recurrent binge eating typically target numerous hypothesized change mechanisms via the delivery of different modules, skills, and techniques. Emerging evidence suggests that interventions designed to target and isolate one key change mechanism may also produce meaningful change in core symptoms. Although both ‘broad’ and ‘focused’ digital programs have demonstrated efficacy, no study has performed a direct, head-to-head comparison of the two approaches. We addressed this through a randomized non-inferiority trial.

Method: Participants with recurrent binge eating were randomly assigned to a broad (n = 199) or focused digital intervention (n = 199), or a waitlist (n = 202). The broad program targeted dietary restraint, mood intolerance, and body image disturbances, while the focused program exclusively targeted dietary restraint. Primary outcomes were eating disorder psychopathology and binge eating frequency.

Results: In intention-to-treat analyses, both intervention groups reported greater improvements in primary and secondary outcomes than the waitlist, which were sustained at an 8-week follow-up. The focused intervention was not inferior to the broad intervention on all but one outcome, but was associated with higher rates of attrition and non-compliance.

Conclusion: Focused digital interventions that are designed to target one key change mechanism may produce comparable symptom improvements to broader digital interventions, but appear to be associated with lower engagement.

Item ID: 81626
Item Type: Article (Research - C1)
ISSN: 1469-8978
Keywords: binge eating; bulimia nervosa; digital intervention; eating disorders; e-health; randomized trial; smartphone app
Copyright Information: © The Author(s), 2022. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Funders: National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC APP1196948
Date Deposited: 23 Jan 2024 01:50
FoR Codes: 46 INFORMATION AND COMPUTING SCIENCES > 4608 Human-centred computing > 460806 Human-computer interaction @ 40%
42 HEALTH SCIENCES > 4203 Health services and systems > 420302 Digital health @ 40%
52 PSYCHOLOGY > 5203 Clinical and health psychology > 520399 Clinical and health psychology not elsewhere classified @ 20%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200409 Mental health @ 40%
22 INFORMATION AND COMMUNICATION SERVICES > 2204 Information systems, technologies and services > 220407 Human-computer interaction @ 60%
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