Effects of Participant's Choice of Different Digital Interventions on Outcomes for Binge-Spectrum Eating Disorders: A Pilot Doubly Randomized Preference Trial. Issue 2 (March 2023)

• Record Type: Journal Article
• Authors: Linardon, Jake; Shatte, Adrian; Messer, Mariel; McClure, Zoe; Fuller-Tyszkiewicz, Matthew
• Is Part Of: Behavior therapy. Volume 54:Issue 2(2023)
• Page Start: 303
• Page End: 314
• Publication Date: 2023-03
• Subjects: digital intervention -- eating disorders -- binge-eating disorder -- randomized controlled trial -- patient preferences; Behavior therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.beth.2022.09.007
• Languages: English
• ISSNs: 0005-7894

Abstract

Highlights: The benefits of clients choosing between different treatment types are unclear. Tested if choice is linked with better outcomes in digital interventions. Client preference was not causally linked with engagement and improvement. Client preferences may not determine outcomes in digital intervention contexts. Abstract: It is unclear whether offering individuals a choice between different digital intervention programs affects treatment outcomes. To generate initial insights, we conducted a pilot doubly randomized preference trial to test whether offering individuals with binge-spectrum eating disorder a choice between two digital interventions is causally linked with superior outcomes than random assignment to these interventions. Participants with recurrent binge eating were randomized to either a choice ( n = 77) or no-choice ( n = 78) group. Those in the choice group could choose one of the two digital programs, while those in the no-choice group were assigned a program at random. The two digital interventions (a broad and a focused program) took 4 weeks to complete, were based on cognitive-behavioral principles and have demonstrated comparable efficacy, but differ in scope, content, and targeted change mechanisms. Most participants (79%) allocated to the choice condition chose the broad program. While both groups experienced improvements in primary (Eating Disorder Examination Questionnaire global scores and number of binge eating episodes over the past month) and secondary outcomes (dietary restraint, body image concerns, etc.), no significant between-group differences were observed. The two groups did not differ on dropout rates, nor on most indices of intervention engagement. Findings provide preliminary insights towards the role of client preferences in digital mental health interventions for eating disorders. Client preferences may not determine outcomes when digital interventions are based on similar underlying principles, although larger trials are needed to confirm this.