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Eating DisordersNCT04806165

Treatment Uptake Chatbot for Eating Disorders

A study testing Repeated Administration, Personalized Recommendation and Motivational Interviewing in people with Eating Disorders, run by Washington University School of Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Eating disorders (EDs) are serious mental illnesses associated with high morbidity and mortality, clinical impairment, and comorbid psychopathology. Although evidence-based treatments for EDs have been established, the treatment gap is wide. Indeed, <20% of individuals with EDs receive treatment. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Eating Disorders
What is being tested?
Repeated Administration, Personalized Recommendation and Motivational Interviewing
Could I receive a placebo?
No, everyone receives an active treatment
How many people
205 participants
Where
1 siteUnited States
Study dates
9 Mar 2021to 9 May 2022
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • U.S. resident
  • English-speaking
  • Age 18 years or older
  • Owns a personal smartphone
  • Screens positive for a Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) clinical or subclinical eating disorder
  • Not currently receiving treatment for an eating disorder

Who cannot join

  • Non-U.S. resident
  • Younger than 18 years old
  • Does not own a personal smartphone
  • Does not screen positive for a DSM-5 clinical or subclinical eating disorder
  • Screens positive for Avoidant Restrictive Food Intake Disorder
  • Currently receiving treatment for an eating disorder

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Washington University School of Medicine

    St Louis, Missouri, 63110

Other trials in United States

About this study

Official title: Developing an Optimized Conversational Agent or "Chatbot" to Facilitate Mental Health Services Use in Individuals With Eating Disorders

Eating disorders (EDs) are serious mental illnesses associated with high morbidity and mortality, clinical impairment, and comorbid psychopathology. Although evidence-based treatments for EDs have been established, the treatment gap is wide. Indeed, <20% of individuals with EDs receive treatment. There is need for a novel solution not only to identify individuals with EDs but also to encourage mental health services use and to address treatment barriers. This study aims to implement a conversational agent or "chatbot" that is optimized to increase mental health services use among individuals with EDs through such features as: 1) education on the seriousness and consequences of EDs; 2) engaging the user in motivational interviewing to overcome barriers to care; 3) providing a personalized recommendation for seeking intervention; 4) repeated check-ins with the user to encourage follow-up with care. This study will utilize a randomized optimization trial with adults who have completed screening on the National Eating Disorders Association (NEDA) website and screen positive for an ED but are not in treatment to determine chatbot feasibility and to generate data on the effect of the chatbot on motivation for treatment and mental health services use. This trial will employ the Multiphase Optimization Strategy framework, using a 2^4 full factorial design, to randomly assign participants to a combination of the four proposed intervention components (n=16 conditions) to isolate the active ingredients.

Being tested
Repeated Administration, Personalized Recommendation, Motivational Interviewing, Core Modules Only, Motivational Interviewing, Personalized Recommendation, Repeated Administration
Medical subject headings
Feeding and Eating Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Repeated AdministrationBehavioural

    A discussion with the chatbot, including follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • Personalized RecommendationBehavioural

    A discussion with the chatbot, including identifying a personalized recommendation for accessing help for their eating disorder.

  • Motivational InterviewingBehavioural

    A discussion with the chatbot, including motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder.

  • Core Modules OnlyBehavioural

    A discussion with the chatbot, including only the core modules.

  • Motivational Interviewing, Personalized Recommendation, Repeated AdministrationBehavioural

    A discussion with the chatbot, including motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder, identifying a personalized recommendation for accessing help for their eating disorder, and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • Motivational Interviewing, Repeated AdministrationBehavioural

    A discussion with the chatbot, including motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • Motivational Interviewing, Personalized RecommendationBehavioural

    A discussion with the chatbot, including motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder and identifying a personalized recommendation for accessing help for their eating disorder.

  • Personalized Recommendation, Repeated AdministrationBehavioural

    A discussion with the chatbot, including identifying a personalized recommendation for accessing help for their eating disorder and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • PsychoeducationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders.

  • Psychoeducation, Repeated AdministrationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • Psychoeducation, Personalized RecommendationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders and identifying a personalized recommendation for accessing help for their eating disorder.

  • Psychoeducation, Motivational InterviewingBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders and motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder.

  • Psychoeducation, Motivational Interviewing, Personalized RecommendationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders, motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder, and identifying a personalized recommendation for accessing help for their eating disorder.

  • Psychoeducation, Personalized Recommendation, Repeated AdministrationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders, identifying a personalized recommendation for accessing help for their eating disorder, and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • Psychoeducation, Motivational Interviewing, Repeated AdministrationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders, motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder, and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

  • Psychoeducation, Motivational Interviewing, Personalized Recommendation, Repeated AdministrationBehavioural

    A discussion with the chatbot, including psychoeducational content to increase knowledge related to eating disorders, motivational interviewing techniques to help overcome barriers to seeking care for their eating disorder, identifying a personalized recommendation for accessing help for their eating disorder, and follow ups over the course of 2 weeks to encourage help seeking for their eating disorder.

Study groups in NCT04806165
Study groupRoleWhat they receive
Repeated AdministrationExperimentalNot described
Receives: Behavioral: Repeated Administration
Personalized RecommendationExperimentalNot described
Receives: Behavioral: Personalized Recommendation
Motivational InterviewingExperimentalNot described
Receives: Behavioral: Motivational Interviewing
Core Modules OnlyExperimentalNot described
Receives: Behavioral: Core Modules Only
Motivational Interviewing, Personalized Recommendation, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Motivational Interviewing, Personalized Recommendation, Repeated Administration
Motivational Interviewing, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Motivational Interviewing, Repeated Administration
Motivational Interviewing, Personalized RecommendationExperimentalNot described
Receives: Behavioral: Motivational Interviewing, Personalized Recommendation
Personalized Recommendation, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Personalized Recommendation, Repeated Administration
PsychoeducationExperimentalNot described
Receives: Behavioral: Psychoeducation
Psychoeducation, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Psychoeducation, Repeated Administration
Psychoeducation, Personalized RecommendationExperimentalNot described
Receives: Behavioral: Psychoeducation, Personalized Recommendation
Psychoeducation, Motivational InterviewingExperimentalNot described
Receives: Behavioral: Psychoeducation, Motivational Interviewing
Psychoeducation, Motivational Interviewing, Personalized RecommendationExperimentalNot described
Receives: Behavioral: Psychoeducation, Motivational Interviewing, Personalized Recommendation
Psychoeducation, Personalized Recommendation, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Psychoeducation, Personalized Recommendation, Repeated Administration
Psychoeducation, Motivational Interviewing, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Psychoeducation, Motivational Interviewing, Repeated Administration
Psychoeducation, Motivational Interviewing, Personalized Recommendation, Repeated AdministrationExperimentalNot described
Receives: Behavioral: Psychoeducation, Motivational Interviewing, Personalized Recommendation, Repeated Administration

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rates of Treatment/Services Utilization for Eating, Shape, or Weight Concerns Among All Participants Randomized to the Intervention Following Online Eating Disorder Screening

    Treatment utilization was measured at each follow-up time point (2, 6, and 14 weeks), which was assessed via the prompt, "Have you tried or used any type of mental health help (e.g., self-help app, telehealth/in-person counseling, etc.) for your concerns related to your eating, shape, or weight in the past [2, 6, or 14] weeks?". We defined a participant as having utilized treatment at the first time they responded, "yes" (vs. "no") to this question. The data presented below indicate the rates of self-reported receipt of treatment/services utilization among participants assigned (component on) or not assigned (component off) to each of the four chatbot components (motivational interviewing, psychoeducation, personalized recommendations, repeated administration), as delineated by each time point during which the aforementioned item was assesed.

    Measured: 2, 6, 14 Weeks from Engagement with the Intervention

Secondary outcomes (2)
  1. Mean Willingness to Seek Psychotherapy

    Participants' willingness to seek psychotherapy was assessed via an identical item in the baseline assessment (i.e., before the initial chatbot assessment) as well as each off the follow-up assessments delivered at 2, 6, and 14 weeks post-intervention. The item prompted users to rate their willingness to seek in-person or telehealth psychotherapy in subsequent weeks. Responses were rated on a Likert scale from 1 (not at all important/ready) to 7 (very important/ready). Mean values reported below indicate the average Likert scale willingness rating among all participants at each time point who did (component turned on) and did not (component turned off). Statistical analyses outline the time and component effects on changes in mean willingness to seek pyschotherapy from baseline to 14 weeks post-interventioon.

    Measured: Baseline, 2 Weeks, 6 Weeks, 14 Weeks

  2. Mean Attitude Toward Change for Concerns Related to Eating, Shape, or Weight Concerns Among All Participants Randomized to the Intervention Following Online Eating Disorder Screening

    Participants' attitudes toward making changes (i.e., motivation toward seeking help) to address their personal eating, shape, and weight concerns were measured via identical items in the baseline assessment, and in each of the 2, 6, and 14 week follow-up assessments. Items included, "How important is it for you to change your eating, shape, or weight concerns?" and, "How ready are you to make changes in your eating, shape, or weight concerns?". Both items were rated on a Likert scale from 1 (not at all important/ready) to 7 (very important/ready), and the sum of the two questions was used as an index of change/motivation attitudes. Values below indicate the average Likert scale attitude rating (from 2 (lowest) to 14 (highest)) among all participants at each time point who did (component turned on) and did not (component turned off) receive each component. Analyses outline the time, component, and time by component interaction effects on changes in motivation attitudes since baseline.

    Measured: Baseline, 2 weeks, 6 weeks, 14 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Mar 2021
  2. Study start9 Mar 2021
  3. Primary completion9 Mar 2022
  4. Study completion9 May 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Factorial
Masking
None (open label)
Enrolment
205 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04806165
Sponsor's protocol ID
202007008
Other IDs
K08MH120341
Status last verified
Sep 2023
First submitted
11 Mar 2021
Last updated
11 Oct 2023
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Fitzsimmons-Craft EE, Rackoff GN, Shah J, Strayhorn JC, D'Adamo L, DePietro B, Howe CP, Firebaugh ML, Newman MG, Collins LM, Taylor CB, Wilfley DE. Effects of Chatbot Components to Facilitate Mental Health Services Use in Individuals With Eating Disorders Following Online Screening: An Optimization Randomized Controlled Trial. Int J Eat Disord. 2024 Nov;57(11):2204-2216. doi: 10.1002/eat.24260. Epub 2024 Jul 28.

    PubMed 39072846

Questions about this trial

What is this clinical trial studying?

A study testing Repeated Administration, Personalized Recommendation and Motivational Interviewing in people with Eating Disorders, run by Washington University School of Medicine at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Oct 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rates of Treatment/Services Utilization for Eating, Shape, or Weight Concerns Among All Participants Randomized to the Intervention Following Online Eating Disorder Screening (time frame: 2, 6, 14 Weeks from Engagement with the Intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04806165, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Oct 2023.

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