# Development and Pilot Testing of a Cognitive-Behavioral Therapy-Guided Self-Help Mobile App for the Post-Acute Treatment of Anorexia Nervosa

> **NIH NIH R34** · WASHINGTON UNIVERSITY · 2022 · $244,178

## Abstract

PROJECT SUMMARY/ABSTRACT
Anorexia nervosa (AN) is a costly and life-threatening illness. Patients with severe AN are often treated in the
acute setting, but relapse after treatment is common. Further, the discharge criterion in acute settings is
typically weight restoration. However, research has indicated that weight-based recovery is not “enough” and
that full recovery involves physical, behavioral, and psychological components. Cognitive-behavioral therapy
(CBT) is useful with this population, including following discharge, and may aid in addressing psychological
symptoms, achieving full recovery, and decreasing relapse. However, very few patients have access to
providers trained in these techniques. mHealth technologies have great potential to exponentially increase
access to high-quality services for the post-acute treatment of AN by addressing barriers to treatment, but to
date, research on these approaches has been extremely limited. Our team has successfully developed a
guided self-help CBT-based mobile app, StudentBodies-Eating Disorders (SB-ED), which has demonstrated
effectiveness among college women with binge/purge-type EDs. At the same time, we have demonstrated
support for in-person CBT for the post-acute care and relapse prevention of adult AN. The overarching goal of
this R34 is to develop and test a CBT-based, coached mobile app to address the post-acute care and relapse
prevention of AN, based on: 1) our own app for the treatment of binge/purge-type EDs; 2) our work on in-
person use of CBT for post-acute care of AN; and 3) research on an additional feature that has high theoretical
potential for supporting individuals with AN in the post-acute period—a social networking feature that provides
the opportunity for positive interactions with individuals with shared experiences. In Aim 1 of the proposed
work, guided by an Advisory Board of relevant stakeholders, we will adapt the existing SB-ED app for this
population and add a social networking feature. Then, we will further refine the intervention through three
rounds of usability testing with N=20 total. In Aim 2, we will conduct a pilot randomized controlled trial (N=90)
of the mobile intervention versus the mobile intervention plus social networking versus treatment as usual
(TAU). We will estimate the preliminary feasibility and effectiveness of the mobile intervention versus the
mobile intervention plus social networking versus TAU in terms of reducing ED psychopathology (primary
outcome), reducing ED behaviors, achieving weight maintenance, reducing depression and suicidal ideation,
and reducing clinical impairment. We will also examine whether the mobile intervention changes the proposed
targets and whether changes in targets are associated with clinical benefit, as well as conduct exploratory
analyses to identify within-app predictors and moderators of outcome. Effect size and attrition estimates will aid
in the planning of an R01 randomized controlled trial where we will...

## Key facts

- **NIH application ID:** 10452653
- **Project number:** 5R34MH127203-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Ellen E. Fitzsimmons-Craft
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $244,178
- **Award type:** 5
- **Project period:** 2021-08-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452653

## Citation

> US National Institutes of Health, RePORTER application 10452653, Development and Pilot Testing of a Cognitive-Behavioral Therapy-Guided Self-Help Mobile App for the Post-Acute Treatment of Anorexia Nervosa (5R34MH127203-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10452653. Licensed CC0.

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