Using factorial design to examine efficacies of technology-based augmentations for improving treatment adherence and skills utilization in a self-help CBT program for binge eating.

NIH RePORTER · NIH · R34 · $227,250 · view on reporter.nih.gov ↗

Abstract

PROJECT SUMMARY Access to cognitive behavioral therapy (CBT), the first-line treatment for disorders characterized by recurrent binge eating (i.e., eating large amounts of food within a discrete-time period, characterized by a sense of loss of control) is limited. CBT for binge eating is intensive (16-20 sessions), expensive ($1,882 per patient), and requires access to clinicians with specialized training. Self-help CBTs for binge eating are accessible and cost- effective, however, outcomes are best when the self-help treatment is paired with periodic contact with a highly trained clinician. Clinicians likely improve outcomes because they are trained to utilize specific behavior change techniques for facilitating improvements in two key treatment targets including treatment adherence and skills utilization during self-help CBT program. Given the limited availability of expert clinicians, it is critical to understand how to enhance outcomes from self-help CBTs without clinician involvement. Recent technological advancements have shown the potential to closely approximate the behavior change techniques typically implemented by expert clinicians to enhance treatment adherence and skills utilization during self-help CBT without clinician involvement. In particular, technology-based intervention factors such as Advanced Digital Data Sharing with Coaches and Just-in-time adaptive interventions (JITAIs) have shown promise in emulating behavior change techniques used by an expert clinician. Advanced Digital Data Sharing systems can perform key behavioral tasks typically accomplished by expert clinician (e.g., identify areas for intervention and generate recommendations on how to intervene on target behaviors). Coaches (individuals with bachelor’s degree in health-related fields) may use the recommendations generated by this system and provide support to patients via weekly emails for improving treatment adherence and skills utilization. Thus, Advanced Digital Data Sharing system may allow coaches to function in a more skilled way without receiving extensive training in behavior change techniques. JITAIs are a smartphone intervention design that conducts real-time analysis of behavioral data related to treatment targets and determines the time of delivery and content of momentary interventions designed to improve treatment adherence and skills use. To date, no study has tested whether these technology-based intervention factors can independently and synergistically improve treatment targets and outcomes from self-help CBTs for binge eating without clinician involvement. The proposed study will use a full factorial design with 76 individuals with binge eating to identify the independent and combined synergistic efficacies of two intervention factors (i.e., Advanced Digital Data Sharing with Coaches and JITAIs) hypothesized to 1) improve treatment adherence and skills utilization, and 2) enhance treatment outcomes when combined with a self-help CBT program ...

Key facts

NIH application ID
10507528
Project number
1R34MH130480-01
Recipient
DREXEL UNIVERSITY
Principal Investigator
Paakhi Srivastava
Activity code
R34
Funding institute
NIH
Fiscal year
2022
Award amount
$227,250
Award type
1
Project period
2022-09-01 → 2025-07-31