Eating Disorder Dynamic Intervention (EDDI)
Rapid Innovation of Precision Psychiatry Interventions Using Dynamic Systems Modeling and Ecological Quasi-Experiments
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
In this study, 170 adults with eating disorders will take part. They will regularly report on their thoughts, feelings, and behaviors throughout the day. Based on this information, the program will send "just-in-time" support, which involves short, tailored suggestions that encourage the use of helpful coping skills right when they are most needed.
The study has three main goals:
To better understand risk patterns:
The investigators will use real-time data to build personalized models that predict when someone is at higher risk for eating disorder behaviors based on their own data and patterns.
To test which therapy skills work best and why:
The investigators will examine how different evidence-based therapy skills (such as managing urges, improving mood, reducing strict dieting, and improving body image) help reduce eating disorder behaviors in daily life, and what psychological factors explain these effects.
- To evaluate the program's usability:
The investigators will assess whether participants find the digital support helpful, easy to use, and acceptable in their daily routines.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Emily K Presseller, PhD
- Phone Number: (203) 974-2949
- Email: emily.k.presseller@dartmouth.edu
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-70
- At least 12 ED behaviors from the same behavioral category in the past 12 weeks (i.e., at least 12 binge eating episodes, at least 12 compensatory behaviors, and/or at least 12 instances of dietary restriction)
- Ownership of a smartphone
- Willingness to complete ecological momentary assessment (EMA) and sensor data collection
- Live in the United States
- Has a primary care provider or is willing to establish a primary care provider
Exclusion Criteria:
- Inability to fluently speak, read, and write in English
- Body mass index < 17.5 kg/m2
- Medical complications of ED symptoms requiring immediate treatment
- Current ED-focused therapy
- Severe psychopathology (i.e., active suicidal ideation, psychosis, bipolar disorder, or substance use disorder) or intellectual disability inhibiting engagement in study protocols
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: All Participants Receive Just-In-Time Adaptive Interventions (JITAIs) through the EDDI App
All participants will receive just-in-time adaptive interventions when their personalized model identifies that they are at risk for an eating disorder behavior.
The content of the just-in-time adaptive intervention (i.e., the therapy skill targeted) will be randomized at the point of just-in-time adaptive intervention delivery.
|
Participants will use a smartphone-based program designed to support eating disorder recovery in daily life.
Participants will complete brief surveys about their mood, thoughts, and behaviors, and the smartphone will also passively collect activity-related data.
This information is used to detect times when a person may be at higher risk for eating disorder behaviors.
Participants will watch 4 video modules that introduce the core enhanced cognitive-behavioral therapy skills for eating disorders (reducing dietary restraint, urge management, emotion regulation, and improving body image), provide rationale, and prompt participants to complete interactive activities to practice these skills.
Participants will then receive micro-randomized JITAIs prompting them to use these skills in their daily lives; micro-randomization will be used to deliver a JITAI from one of the 4 skill categories (reducing dietary restraint, urge management, emotion regulation, improving body image) or no JITAI.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Area under the receiver operating curve (AUC)
Time Frame: Weeks 5 and 6 of data collection
|
Performance of the eating disorder behavior prediction models will be evaluated by computing the area under the receiver operating curve (AUC) for each participants' models on two-weeks of held out (test) data (collected during weeks 5 and 6 of the data collection procedure).
The AUC can take on values between 0 and 1, with higher values indicating superior model performance.
|
Weeks 5 and 6 of data collection
|
|
Brier Score
Time Frame: Weeks 5 and 6 of data collection
|
Performance of the eating disorder behavior prediction models will be evaluated by computing the Brier score for each participants' models on two-weeks of held out (test) data (collected during weeks 5 and 6 of the data collection procedure).
The Brier score can range from 0 to 1 with lower values indicating less model error (i.e., better model performance).
|
Weeks 5 and 6 of data collection
|
|
Binge eating
Time Frame: Weeks 7 through 16 of data collection
|
Binge eating occurrence during the data collection protocol will be measured.
Binge eating at each ecological momentary assessment survey will be assessed by the question, "Thinking about your most recent eating episode, did you experience loss of control?" (Answer choices = Yes or No).
|
Weeks 7 through 16 of data collection
|
|
Dietary restriction
Time Frame: Weeks 7 through 16 of data collection
|
Dietary restriction will be measured during the data collection protocol.
Dietary restriction will be assessed at each ecological momentary assessment survey by the questions, "Thinking about your most recent eating episode, did you limit the amount of food you ate to influence your shape?", "Thinking about your most recent eating episode, did you exclude specific foods to influence your shape or weight?", and Since the last survey, have you skipped a meal or snack?" (Answer Choices = Yes or No).
|
Weeks 7 through 16 of data collection
|
|
Compensatory behaviors
Time Frame: Weeks 7 through 16 of data collection
|
Dietary restriction will be measured during the data collection protocol.
Dietary restriction will be assessed at each ecological momentary assessment survey by the questions, "Since the last survey, have you engaged in any of the following?
Self-induced vomiting," "Laxative use (to influence shape or weight)," "Diuretic use (to influence shape or weight)," "Diet pill use (to influence shape or weight)," "Exercise (to influence shape or weight)," and "Other behavior to influence shape or weight" (Answer Choices = Yes or No).
|
Weeks 7 through 16 of data collection
|
|
Feasibility and Acceptability Questionnaire
Time Frame: End of study assessment (after week 16 of data collection)
|
Acceptability will be evaluated via the Feasibility and Acceptability Questionnaire.
These data will be collected after participants have completed the 16 weeks of data collection using the EDDI app.
Mean ratings ≥ 5 (on the seven-point Likert rating scales) on acceptability items will be considered to indicate acceptability.
The response scale is as follows: 1=Strongly Disagree 2=Disagree 3=Disagree a little 4=Neither agree nor disagree 5=Agree a little 6=Agree 7=Strongly Agree, with higher scores indicating greater acceptability.
|
End of study assessment (after week 16 of data collection)
|
|
System Usability Scale
Time Frame: End of study assessment (after week 16 of data collection)
|
Acceptability will be evaluated via the System Usability Scale.
These data will be collected after participants have completed the 16 weeks of data collection using the EDDI app.
Mean ratings ≥ 4 (on the five-point Likert rating scale) on System Usability Scale items will be considered to indicate acceptability.
The response scale runs from 1 = Strongly Disagree (minimum value) to 5 = Strongly Agree (maximum value), with higher ratings indicating greater usability.
Items 2, 4, 6, 8, and 10 will be reverse coded to align with higher ratings indicating greater usability.
|
End of study assessment (after week 16 of data collection)
|
|
Percentage of Eligible Participants Enrolled
Time Frame: Through study completion, an average of 4 months
|
Feasibility of the EDDI app will be evaluated by computing the percentage of eligible participants enrolled.
This will be computed by dividing the number of enrolled participants by the total number of eligible participants and multiplying by 100.
At least 85% of eligible participants enrolled will be considered to demonstrate feasibility.
|
Through study completion, an average of 4 months
|
|
Attrition Rate
Time Frame: Through study completion, an average of 4 months
|
Feasibility of the EDDI app will be evaluated by computing the attrition (drop out) rate.
This will be computed by dividing the number of participants who discontinue the study prior to the end of study assessment by the total number of enrolled participants and multiplying by 100.
An attrition rate of less than 15% will be considered to demonstrate feasibility.
|
Through study completion, an average of 4 months
|
|
Percentage of JITAIs Producing Skill Use
Time Frame: Through study completion, an average of 4 months
|
Feasibility of the EDDI app will be evaluated by computing the percentage of JITAIs that produce participant-reported skill use.
This will be computed by dividing the instances of reported skills used by the total number of delivered JITAIs and multiplying by 100.
JITAIs producing skill use at least 80% of the time will be considered to demonstrate feasibility.
|
Through study completion, an average of 4 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Body image concerns (Eating Disorder Examination Questionnaire-Short Form)
Time Frame: Weeks 7 through 16 of data collection
|
Body image concerns will be measured as a possible mediator of the effect of JITAIs on eating disorder behaviors.
Body image concerns will be quantified as the mean rating across the body image items on the Eating Disorder Examination Questionnaire-Short Form, adapted to be rated on a five-point Likert scale as follows: 0=Very slightly/not at all 1 = A little 2 =Moderately 3 = Quite a bit 4= Extremely.
Higher mean ratings indicate great body image concerns.
Minimum mean score on the items is 0 and maximum is 4.
|
Weeks 7 through 16 of data collection
|
|
Cognitive dietary restraint (Eating Disorder Examination-Questionnaire)
Time Frame: Weeks 7 through 16 of data collection
|
Cognitive dietary restraint will be measured as a possible mediator of the effects of JITAIs on eating disorder behaviors.
Cognitive dietary restraint is assessed by the mean score across four selected dietary restraint items from the Eating Disorder Examination Questionnaire, modified to be assessed on the following response scale: 0=Very slightly/not at all 1 = A little 2 =Moderately 3 = Quite a bit 4= Extremely.
The minimum mean score is 0 and the maximum mean score is 4, with higher scores indicating greater dietary restraint.
|
Weeks 7 through 16 of data collection
|
|
Negative affect (Positive and Negative Affect Schedule)
Time Frame: Weeks 7 through 16 of data collection
|
Negative affect will be measured as a possible mediator of the effects of JITAIs on eating disorder behaviors.
Negative affect is assessed by the mean score across six selected negative affect items (upset, hostile, ashamed, afraid, nervous, guilty from the Positive and Negative Affect Schedule, modified to be assessed on the following response scale: 0=Very slightly/not at all 1 = A little 2 =Moderately 3 = Quite a bit 4= Extremely.
The minimum mean score is 0 and the maximum mean score is 4, with higher scores indicating greater negative affect.
|
Weeks 7 through 16 of data collection
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- STUDY00033481
- 1DP5OD039510-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Anorexia Nervosa
-
NCT07566546Enrolling by invitationAnorexia Nervosa | Atypical Anorexia Nervosa
-
NCT05073679TerminatedBulimia Nervosa | Impulsive Behavior | Purging (Eating Disorders) | Eating Disorders | Eating Disorders in Adolescence | Anorexia Nervosa/Bulimia | Anorexia in Adolescence | Anorexia Nervosa, Atypical | Anorexia Nervosa, Binge Eating/Purging Type
-
NCT06050421RecruitingAnorexia Nervosa | Anorexia Nervosa in Remission | Anorexia Nervosa Restricting Type
-
NCT00672906CompletedAdolescent Anorexia Nervosa | Subthreshold Anorexia Nervosa
-
NCT05507008Active, not recruitingAnorexia Nervosa | Bulimia Nervosa | Atypical Anorexia Nervosa | Atypical Bulimia Nervosa
-
NCT06000774RecruitingAnorexia Nervosa | Bulimia Nervosa | Anorexia Nervosa in Remission
-
NCT03097874CompletedAnorexia Nervosa | Anorexia | Eating Disorder | Eating Disorders in Adolescence | Anorexia in Adolescence | Anorexia Nervosa, Atypical | Anorexia Nervosa Restricting Type | Anorexia in Children
-
NCT06437002RecruitingAnorexia Nervosa/Bulimia
-
NCT06712485Not yet recruitingAnorexia Nervosa Restricting Type | Anorexia Nervosa (DSM-IV Revised Criteria)
-
NCT06244576Active, not recruitingAnorexia Nervosa | Anorexia in Adolescence | Anorexia Nervosa, Atypical
Clinical Trials on Eating Disorder Dynamic Intervention
-
NCT05071521CompletedEating Disorder Symptom and Body Image Dissatisfaction
-
NCT06594913RecruitingAnorexia Nervosa | Binge-Eating Disorder | Bulimia Nervosa | Avoidant Restrictive Food Intake Disorder
-
NCT04378101CompletedAnorexia Nervosa | Binge-Eating Disorder | Bulimia Nervosa
-
NCT05596799CompletedAnorexia Nervosa | Eating Disorders | Anorexia Nervosa in Remission
-
NCT04810403CompletedEating Disorder Symptom
-
NCT04876183CompletedBinge Eating Disorder
-
NCT06256380Recruiting
-
NCT02284685Completed