Efficacy of Eat Breathe Thrive, a Yoga-Based Program

NCT03348345 | Completed

• 1 other identifier: EBTC01
• Study Type: interventional
• Target: 266
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate the efficacy of the 7-week Eat Breathe Thrive (EBT) program which was designed to increase positive body image, awareness, self-regulation, and mindful eating habits. This program aims to achieve these things through psychoeducation of cultural influences of beauty standards, the basic neuropsychological systems in the body and how they affect eating habits, creating a community within the group members for support, and finally through the practice of yoga. In this randomized-controlled trial (RCT), investigators will be looking at whether EBT is effective in a community sample of adult (18-65 years old) men and women at preventing and decreasing eating disorder risk and increasing positive body image and emotion regulation skills through being in tune with one's own body, mind, and community. This will take place in a sample of community members taken at ten different sites around the United States and the United Kingdom.

Conditions

Eating Disorder Symptom

Keywords

eating disorders; prevention; yoga; mindfulness; embodiment; self-regulation; functional action; interoceptive awareness

Outcome Measures

Primary Outcomes (21)

• Ecological Momentary Assessments (EMA's)

  These questions assess eating disorder symptoms, positive coping, and emotion regulation and are sent randomly to participants' mobile phones up to three questions per day.

  7 weeks

• Integrity Scale

  Self-report measure of truth and honesty questions. Participants are asked to indicate in the past week whether it's been very difficult, difficult, neutral, easy, or very easy to be honest in the past week with self and with others (1 = very difficult, 2 = difficult, 3= neutral, 4 = easy, 5 = very easy ) and how honest they've been in the past week with themselves and others (1 = not at all honest (about 0%), 2 = a little honest (about 25% of the time), 3= somewhat honest (about 50% of the time), 4 = quite honest (about 75% of the time), 5 = extremely honest (nearly 100% of the time). Higher scores indicate better outcomes (higher levels of ability to be honest and higher frequencies of being honest).

  7 weeks

• The PTSD Checklist for DSM-5 (PCL-5)

  Self-report measure of PTSD symptoms

  7 weeks

• Functional Appreciation Scale (FAS)

  Self-report measure of levels of functionality appreciation. Participants are asked to indicate the extent to which they agree with statements on appreciation for the functionality of their body (strong agree, disagree, neither agree nor disagree, agree, or strongly agree). Scores on the seven FAS items are averaged, with higher scores reflecting higher levels of functionality appreciation.

  7 weeks

• Body Appreciation Scale (BAS)

  Self-report scale of body appreciation. Scale assesses extent of appreciation for one's body. Responses for 10 items are on a 5-point scale (1 = Never, 5 = Always). Scoring procedure entails averaging participants' responses to Items 1-10. Higher scores indicate higher levels of body appreciation.

  7 weeks

• Eating Disorder Examination Questionnaire (EDE-Q)

  Participants are to indicate on how many of the past 28 days have they engaged in eating disordered behaviors (0 = no days, 6 = every day) and to what extent have they experienced eating disordered-related cognitions and emotions (0 = not at all, 6 = markedly). It provides frequency data on key behavioral features of eating disorders in terms of number of episodes of the behavior and in some instances number of days on which the behavior has occurred. It provides subscale scores on the severity of aspects of the psychopathology of eating disorders. Subscales are Restraint, Eating Concern, Shape Concern and Weight Concern. The ratings for the relevant items are added together and the sum divided by the total number of items forming the subscales. Higher scores indicate worse outcomes.

  7 weeks

• Mindful Self-Care Scale-Short (MSCS-S)

  The MSCS-S is a 33-item scale that measures the self-reported frequency of behaviors that measure self-care behavior. Subscales are positively correlated with body esteem and negative correlated with substance use and eating disordered behavior. There are six additional clinical questions and two general questions for a total of 42 items. The scale helps identify areas of strength and weakness in mindful self-care behavior and assess interventions that serve to improve self-care. The 6 domains are: physical care, supportive relationships, mindful awareness, self-compassion and purpose, mindful relaxation, and supportive structure. There are also 6 clinical items and 3 general items assessing the individual's general/global practices. Participants are asked to indicate the frequency of their self-care behavior over the past week (how much or how often on a scale of 0= never to 6-7 = regularly). The number of items in each domain are averaged. Higher scores indicate better outcome.

  7 weeks

• Embodied Intimacy Scale (EIS)

  The EIS is a 10-item scale that assesses levels of embodied intimacy in relationship with self and others (i.e. body expression, body awareness, ability to communicate through the body, ability to maintain boundaries through physical touch). Range is from 0 = never to 5, always. Items 4, 5, and 6 are reversed scored. To score, items are summed and averaged by total number of items. The higher the score, the higher the level of embodied intimacy.

  7 weeks

• Social Subscale of the Social and Emotional Loneliness Scale for Adults-Short (SELSA-S)

  The SELSA-S consists of 15 items assessing social and emotional loneliness. It has a 7-point Likert-type response scale ranging from 1 (strongly agree) to 7 (strongly disagree). There are three subscales: Social, Family, and Romantic. Subscale scores are computed by calculating the mean of subscale item responses. Items 2, 3, 5, 6, 8, 9, 11, 12, and 14 are reversed scored. To compute a total score, items indicated are reversed scored then a total mean is computed. High scores indicate high levels of emotional and social loneliness.

  7 weeks

• Multidimensional Assessment of Interoceptive Awareness (MAIA)

  The MAIA is a 32-item self-report measure of interoceptive body awareness. It assesses 8 constructs: Noticing, Non-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Self-Regulation, Body Listening, and Trusting. The range is from 0 = never, to 5 = always. Summary Score = sum of subscale scores average of each subscale scores ÷ 5. Reverse-score items are 5, 6, and 7 on Not-Distracting, and items 8 and 9 on Not-Worrying. The higher the score, the higher the levels of interoceptive body awareness.

  7 weeks

• Mindful Eating Questionnaire (MEQ)

  Self-report measure of mindful eating

  7 weeks

• Difficulties in Emotion Regulation Scale (DERS)

  DERS is a 36-item multidimensional assessment of emotion regulation and dysregulation. Total score is the sum of all subscales. The measure yields a total score as well as scores on six sub-scales: Nonacceptance of emotional responses, Difficulty engaging in Goal-directed behavior, Impulse control difficulties, Lack of emotional awareness, Limited access to emotion regulation strategies, and Lack of emotional clarity. Range is from 0 = never to 5 = always. Higher scores suggest greater problems with emotion regulation.

  7 weeks

• Distress Tolerance Scale (DTS)

  DTS is a 15-item assessment of beliefs about feelings of distress. Range is from 1 = strongly agree to 5 = disagree. Item 6 is reverse scored. Subscale scores are the mean of the items. The higher-order DTS is formed from the mean of the four subscales. The higher the score, the more positive the outcome.

  7 weeks

• Substance Abuse subscale of College Counseling Assessment of Psychological Symptoms (CCAPS)

  Self-report measure of substance abuse. Range is from "never used" to "used 30-60 days in the past 60 days" to assess alcohol and substance use and on the item concerning drinking, three or fewer to seven or more drinks. The higher the score, the more negative the outcome.

  7 weeks

• Self-Compassion Scale-Short (SCS-S)

  The SCS-S scale assesses levels of self-compassion. Range is from 1 = almost never to 5 = almost always. Subscale scores are computed by calculating the mean of subscale item responses. To compute a total self-compassion score, reverse score the negative subscale items - self-judgment, isolation, and over-identification (i.e., 1 = 5, 2 = 4, 3 = 3, 4 = 2, 5 = 1) - then compute a total mean. The higher the score, the higher the level of self-compassion.

  7 weeks

• Demographic information

  Questions on demographic information

  7 weeks

• State-Trait Anxiety Inventory for Adults

  Self-report measure of anxiety symptoms

  7 weeks

• Beck's Depression Inventory

  A self-report measure of depression symptoms

  7 weeks

• Treatment Integrity

  A weekly assessment of treatment integrity

  7 weeks

• Pre-Post Class Questions

  A weekly assessment of stress, relaxation and embodiment

  7 weeks

• EBT Program Acceptability and Feasibility Questions

  Post-test assessment of participants' perceptions of acceptability and feasibility of the EBT program

  7 weeks

Secondary Outcomes (2)

• Program Questions for Post-Test and Follow Up

  7 weeks

• Brief COPE Inventory

  7 weeks

Study Arms (2)

Eat Breathe Thrive Intervention

EXPERIMENTAL

A manualized program designed to prevent eating disorders using psychoeducation, group work, and yoga.

Behavioral: Eat Breathe Thrive

Wait-List

NO INTERVENTION

Participants are placed on a wait-list receiving no intervention.

Interventions

Eat Breathe Thrive BEHAVIORAL

Eat Breathe Thrive (EBT) program which was designed to increase positive body image, awareness, self-regulation, and mindful eating habits. This program aims to achieve these things through psychoeducation of cultural influences of beauty standards, the basic neuropsychological systems in the body and how they affect eating habits, creating a community within the group members for support, and finally through the practice of yoga.

Eat Breathe Thrive Intervention

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Those included will be men and women between the ages of 18 and 65 who are not pregnant, are willing to sign the consent form, are English-speakers, have not taken EBT before, and have been deemed eligible to participate in the EBT program by EBT facilitators.

You may not qualify if:

• Since the scope of this study is adult, non-pregnant English-speaking adults, those excluded will be men and women who are below 18 years old or above 65, pregnant, unable/refuse to sign the consent form, non-English speakers, have taken EBT before, and whom have been deemed ineligible to participate in the EBT program by EBT facilitators.

Sponsors & Collaborators

• University at Buffalo: lead
• Give Back Yoga Foundation: collaborator
• Eat Breathe Thrive: collaborator
• State University of New York at Buffalo: collaborator

Study Sites (1)

University at Buffalo

Buffalo, New York, 14260, United States

Location

Related Publications (4)

• Cook-Cottone, C. P. (2006). The attuned representational model for the primary prevention of eating disorders: An overview for school psychologists. Psychology in the Schools, 43, 223-230.

  BACKGROUND

• Cook-Cottone CP. Incorporating positive body image into the treatment of eating disorders: A model for attunement and mindful self-care. Body Image. 2015 Jun;14:158-67. doi: 10.1016/j.bodyim.2015.03.004. Epub 2015 Apr 15.

  PMID: 25886712 BACKGROUND

• Cook-Cottone, C. P., Tribole, E., & Tylka, T. (2013). Healthy eating in schools: Evidenced-based interventions to help kids thrive. Washington, DC: American Psychological Association.

  BACKGROUND

• McIntosh VV, Bulik CM, McKenzie JM, Luty SE, Jordan J. Interpersonal psychotherapy for anorexia nervosa. Int J Eat Disord. 2000 Mar;27(2):125-39. doi: 10.1002/(sici)1098-108x(200003)27:23.0.co;2-4.

  PMID: 10657886 BACKGROUND

MeSH Terms

Conditions

Feeding and Eating Disorders; Self-Control

Condition Hierarchy (Ancestors)

Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Mental Disorders; Social Behavior; Behavior

Study Officials

• Catherine Cook-Cottone, PhD

  University at Buffalo

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: A computer system will randomly select participants to be enrolled in the program or waitlisted at both time points.
• Purpose: PREVENTION
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: A computer system will randomly select 100 participants (from 200) to be enrolled in the Eat Breathe Thrive (EBT) intervention group (once a week for two hours) and the other 100 will be wait-listed (WL) for seven weeks. Assessments will be done at week 1 and week 7. At week 7, WL will be enrolled in the 7-week Eat Breathe Thrive program. A second post-test will be given at the end of the second round of Eat Breathe Thrive, administered to those 100 participants only. There will also be three month follow up for all 200 participants.

Study Record Dates

• First Submitted: November 16, 2017
• First Posted: November 20, 2017
• Study Start: January 31, 2018
• Primary Completion: October 4, 2019
• Study Completion: October 4, 2019
• Last Updated: October 3, 2022

Record last verified: 2020-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)