Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review.
digital intervention
eating disorders
mediator
moderator
predictor
systematic review
Journal
The International journal of eating disorders
ISSN: 1098-108X
Titre abrégé: Int J Eat Disord
Pays: United States
ID NLM: 8111226
Informations de publication
Date de publication:
27 Oct 2023
27 Oct 2023
Historique:
revised:
05
10
2023
received:
02
05
2023
accepted:
06
10
2023
medline:
27
10
2023
pubmed:
27
10
2023
entrez:
27
10
2023
Statut:
aheadofprint
Résumé
Digital interventions show promise as an effective prevention or self-management option for eating disorders (EDs). However, it remains unclear how, for whom, and through what mechanisms they work in this population, as a synthesis of outcome predictors, moderators, and mediators is lacking. This systematic review synthesized empirical research investigating predictors, mediators, and moderators of response to digital interventions for EDs. Six databases were searched (PROSPERO CRD42022295565) for studies that assessed predictors, moderators, or mediators of response (i.e., uptake, drop-out, engagement, and symptom level change) to a digital prevention or treatment program for EDs. Variables were grouped into several overarching categories (demographic, symptom severity, psychological, etc.) and were synthesized qualitatively across samples without a formally diagnosed ED (typically prevention-focused) and samples with a formally diagnosed ED (typically treatment-focused). Eighty-six studies were included. For studies recruiting samples without a formal diagnosis (n = 70 studies), most predictors explored were statistically unrelated to outcome, although participant age, baseline symptom severity, confidence to change, motivation, and program engagement showed preliminary evidence of prognostic potential. No robust moderators or mediators were identified. Few studies recruiting samples with a formal diagnosis emerged (n = 16), of which no reliable predictors, moderators, or mediators were identified. It remains unclear how, for whom, and under what circumstances digital programs targeting EDs work. We offer several recommendations for future research with the aim of advancing understanding of client characteristics and intervention elements that signal success from this intervention modality. Digital interventions have shown potential as an effective, scalable, and accessible intervention option for EDs. However, responsiveness varies, so advancing understanding of predictors, mediators, and moderators of outcome to digital interventions for EDs is needed. Such knowledge is important for enabling safe and efficient treatment matching, and for informing future development of effective digital interventions. Las intervenciones digitales se muestran prometedoras como una opción eficaz de prevención o autocontrol de los trastornos de la conducta alimentaria (TCA). Sin embargo, sigue sin estar claro cómo, para quién y a través de qué mecanismos funcionan en esta población, ya que falta una síntesis de los predictores de resultados, moderadores y mediadores. Esta revisión sistemática sintetiza la investigación empírica que estudia los predictores, mediadores y moderadores de la respuesta a las intervenciones digitales para los TCA. MÉTODO: Se realizaron búsquedas en seis bases de datos (CRD42022295565) de estudios que evaluaron predictores, moderadores o mediadores de la respuesta (es decir, admisión, abandono, compromiso y cambio en el nivel de síntomas) a un programa digital de prevención o tratamiento de los TCA. Las variables se agruparon en varias categorías generales (demográficas, gravedad de los síntomas, psicológicas, etc.) y se sintetizaron cualitativamente en muestras sin un TCA diagnosticado formalmente (normalmente centradas en la prevención) y muestras con un TCA diagnosticado formalmente (normalmente centradas en el tratamiento). Se incluyeron 86 estudios. Para los estudios que reclutaron muestras sin un diagnóstico formal (n = 70 estudios), la mayoría de los predictores explorados no estaban estadísticamente relacionados con el resultado, aunque la edad del participante, la gravedad de los síntomas basales, la confianza en el cambio, la motivación y el compromiso con el programa mostraron evidencia preliminar de potencial pronóstico. No se identificaron moderadores o mediadores sólidos. Surgieron pocos estudios que reclutaran muestras con un diagnóstico formal (n = 16), de los cuales no se identificaron predictores, moderadores o mediadores fiables. DISCUSIÓN: Sigue sin estar claro cómo, para quién y en qué circunstancias funcionan los programas digitales dirigidos a los TCA. Ofrecemos varias recomendaciones para futuras investigaciones con el objetivo de avanzar en la comprensión de las características de los consultantes y los elementos de intervención que señalan el éxito de esta modalidad de intervención.
Autres résumés
Type: Publisher
(spa)
Las intervenciones digitales se muestran prometedoras como una opción eficaz de prevención o autocontrol de los trastornos de la conducta alimentaria (TCA). Sin embargo, sigue sin estar claro cómo, para quién y a través de qué mecanismos funcionan en esta población, ya que falta una síntesis de los predictores de resultados, moderadores y mediadores. Esta revisión sistemática sintetiza la investigación empírica que estudia los predictores, mediadores y moderadores de la respuesta a las intervenciones digitales para los TCA. MÉTODO: Se realizaron búsquedas en seis bases de datos (CRD42022295565) de estudios que evaluaron predictores, moderadores o mediadores de la respuesta (es decir, admisión, abandono, compromiso y cambio en el nivel de síntomas) a un programa digital de prevención o tratamiento de los TCA. Las variables se agruparon en varias categorías generales (demográficas, gravedad de los síntomas, psicológicas, etc.) y se sintetizaron cualitativamente en muestras sin un TCA diagnosticado formalmente (normalmente centradas en la prevención) y muestras con un TCA diagnosticado formalmente (normalmente centradas en el tratamiento).
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Health and Medical Research Council Investigator Grant
ID : APP1196948
Informations de copyright
© 2023 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.
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