An Intensive Ambulatory Care Program for Adolescents with Eating Disorders Combining In-Person and Virtual Care: Protocol for a Naturalistic Feasibility, Acceptability, and Preliminary Effectiveness Trial (Preprint)

Abstract

The incidence of eating disorders among adolescents has increased significantly since the beginning of the COVID-19 pandemic. Hybrid care, combining virtual and in-person modalities, is a promising approach for adolescents with eating disorders but remains understudied in this population.

We aim to implement a novel, hybrid (virtual and in-person) intensive ambulatory program for youth and evaluate its feasibility, acceptability, and preliminary effectiveness.

We will use a naturalistic pretest-posttest design to evaluate our proposed pilot intensive ambulatory care program (IACP). This novel type of day hospital care follows evidence-based principles and uses a family-centered, educational, and motivational approach. It will be tailored to the psychological needs of each participant and delivered in a hybrid format. One hundred participants meeting DSM-5 criteria for eating disorders, aged 12-18 years, will be recruited over the 2-year trial period. We will examine (1) recruitment, retention, and adhesion to protocol rates, (2) participant and family satisfaction, and (3) preliminary effectiveness using quantitative self-report questionnaires.

We expect to recruit approximately 80% of eligible participants, to retain at least 75% of eligible participants, and to have at least 70% of participants complete at least one therapeutic session per week and all pre- and post-intervention questionnaires. We base our estimates on previous literature and consider that the highly flexible design of the IACP, with no additional work required from participants to participate in the study will lead to high levels of feasibility. We anticipate that participants and their families will be satisfied both with the program and with the hybrid delivery format. We expect that participation in the IACP will be associated with a medium effect size reduction in eating disorder psychopathology, from baseline to end-of-treatment.

Given the high clinical burden associated with eating disorders, this project has the potential to fill an important research gap, by testing the implementation of a novel hybrid mode of intervention. If shown feasible, acceptable, and effective, the IACP could lead to important improvements in healthcare services for adolescents with eating disorders.