NCT05473013

Brief Summary

The purpose of this study is to identify the independent and combined effects of two types of self-monitoring and two types of micro-interventions when combined with standard cognitive behavioral treatment for bulimia nervosa (BN) and binge eating disorder (BED). The primary aims of this study are (1) to evaluate the optimal complexity of Self-Monitoring and Micro-Interventions on eating pathology (at post-treatment and at 6 and 12-month follow-ups and (2) to test the hypotheses that the optimal complexity level of each component is moderated by baseline deficits in self-regulation. The secondary aim will be to test target engagement for each level of complexity for each component, i.e., to test whether higher complexity of each technological components is associated with better rates of therapeutic skill use and acquisition and that improvements in skill use and acquisition are associated with improvements in outcomes. A final exploratory aim will be to quantify the component interaction effects, which may be partially additive (because components overlap and/or there is diminishing return), fully additive, or synergistic (in that component complexities may partially depend on each other).

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
264

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2023

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 18, 2022

Completed
7 days until next milestone

First Posted

Study publicly available on registry

July 25, 2022

Completed
6 months until next milestone

Study Start

First participant enrolled

January 6, 2023

Completed
2.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2025

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2026

Completed
Last Updated

September 25, 2023

Status Verified

September 1, 2023

Enrollment Period

2.9 years

First QC Date

July 18, 2022

Last Update Submit

September 21, 2023

Conditions

Keywords

Eating disordersBulimia NervosaBulimiaBinge EatingBinge Eating DisorderCognitive Behavioral Treatment for Eating DisordersDigital health technologies (DHTs)Micro-Interventions

Outcome Measures

Primary Outcomes (4)

  • Binge eating frequency assessed by the Eating Disorder Examination

    Frequency (number of days and number of instances) of binge eating over the past 28 days assessed by the Eating Disorder Examination

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

  • Global Eating Pathology

    The Eating Disorder Examination is a semi-structured interview that measures eating. pathology. The EDE yields a total eating pathology score that will be used as an outcome variable. Global eating pathology is on a 0-6 point scale with higher scores indicating more significant eating pathology.

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

  • Remission Status

    Presence or absence of eating disorder diagnosis. Not in remission; in partial remission; or in full remission.

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

  • BMI

    kilogram/(meters\^2), this will be calculated by assessors when participants provide their height and weight at all assessment points

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

Secondary Outcomes (5)

  • Compensatory behavior frequency assessed by the Eating Disorder Examination (EDE)

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

  • Acceptability and Feasibility

    Changes from each assessment time point throughout treatment after baseline so 2 assessments over 16 weeks (the mid-treatment and post-treatment assessments).

  • Frequency of skill use and success of skill use

    Changes from each weekly session over the course of the 16 week treatment

  • Emotional Self-regulation

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

  • Self-regulation: Impulsivity

    Changes from each assessment time point throughout treatment (3 assessments over 16 weeks) and at a 6 month and a 12-month post-treatment follow-up assessment

Study Arms (6)

Base BT (Skills Monitoring Off + No Micro-Interventions)

ACTIVE COMPARATOR

16 weekly sessions of standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns). This will include traditional self-monitoring of participants' eating patterns, binging, and (if applicable) compensatory behaviors via a smartphone application.

Behavioral: Behavioral Therapy for Eating Disorders

Base BT + Skills Monitoring On + No Micro-Interventions

EXPERIMENTAL

16 weekly sessions of standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns). This will include a more complex self-monitoring than the self-monitoring protocol with traditional behavioral treatment. Via a smartphone application, participants will be asked to self-monitor skill usage of the skills provided during treatment sessions on top of monitoring their eating patterns, binging, and (if applicable) compensatory behaviors.

Behavioral: Behavioral Therapy for Eating DisordersBehavioral: Skills Monitoring On

Base BT + Skills Monitoring On + Automated Reminder Messages

EXPERIMENTAL

16 weekly sessions of standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns).This will include a more complex self-monitoring than the self-monitoring protocol with traditional behavioral treatment. Via a smartphone application, participants will be asked to self-monitor skill usage of the skills provided during treatment sessions on top of monitoring their eating patterns, binging, and (if applicable) compensatory behaviors. It will also include participants receiving two randomly time automated push notifications from the application each week to remind them about skills they have learned in session to encourage skill use.

Behavioral: Behavioral Therapy for Eating DisordersBehavioral: Skills Monitoring OnBehavioral: Automated Reminder Messages

Base BT + Skills Monitoring On + JITAIs

EXPERIMENTAL

16 weekly sessions of standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns). This will include a more complex self-monitoring than the self-monitoring protocol with traditional behavioral treatment. Via a smartphone application, participants will be asked to self-monitor skill usage of the skills provided during treatment sessions on top of monitoring their eating patterns, binging, and (if applicable) compensatory behaviors. It will also include participants receiving push notifications each week to remind them about skills they have learned in session to encourage skill use during app-identified moments of need (i.e., JITAIs, just-in-time adaptive interventions).

Behavioral: Behavioral Therapy for Eating DisordersBehavioral: Skills Monitoring OnBehavioral: JITAIs

Base BT + Skills Monitoring Off + Automated Reminder Messages

EXPERIMENTAL

16 weekly sessions of standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns). This will include traditional self-monitoring of participants' eating patterns, binging, and (if applicable) compensatory behaviors via a smartphone application. It will also include participants receiving two randomly time automated push notifications from the application each week to remind them about skills they have learned in session to encourage skill use.

Behavioral: Behavioral Therapy for Eating DisordersBehavioral: Automated Reminder Messages

Base BT + Skills Monitoring Off + JITAIs

EXPERIMENTAL

16 weekly sessions of standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns). This will include traditional self-monitoring of participants' eating patterns, binging, and (if applicable) compensatory behaviors via a smartphone application. It will also include participants receiving push notifications each week to remind them about skills they have learned in session to encourage skill use during app-identified moments of need (i.e., JITAIs, just-in-time adaptive interventions).

Behavioral: Behavioral Therapy for Eating DisordersBehavioral: JITAIs

Interventions

Standard behavioral therapy for eating disorders aimed at changing behaviors that maintain binge eating (e.g. rigid dietary restriction outside of binge episodes, irregular or chaotic eating patterns).

Base BT (Skills Monitoring Off + No Micro-Interventions)Base BT + Skills Monitoring Off + Automated Reminder MessagesBase BT + Skills Monitoring Off + JITAIsBase BT + Skills Monitoring On + Automated Reminder MessagesBase BT + Skills Monitoring On + JITAIsBase BT + Skills Monitoring On + No Micro-Interventions

Integrates behavioral treatment for eating disorders with a more complex self-monitoring than the self-monitoring protocol with traditional behavioral treatment. Via a smartphone application, participants will be asked to self-monitor skill usage of the skills provided during treatment sessions on top of monitoring their eating patterns, binging, and (if applicable) compensatory behaviors.

Also known as: Enhanced Skills Monitoring
Base BT + Skills Monitoring On + Automated Reminder MessagesBase BT + Skills Monitoring On + JITAIsBase BT + Skills Monitoring On + No Micro-Interventions

Integrates behavioral treatment for eating disorders with two randomly time automated push notifications from a smartphone application each week to remind participants about skills they have learned in session to encourage skill use.

Also known as: Micro-Intervention 1
Base BT + Skills Monitoring Off + Automated Reminder MessagesBase BT + Skills Monitoring On + Automated Reminder Messages
JITAIsBEHAVIORAL

Integrates behavioral treatment for eating disorders with push notifications each week from a smartphone application to remind participants about skills they have learned in session to encourage skill use during app-identified moments of need (i.e., JITAIs, just-in-time adaptive interventions).

Also known as: Micro-Intervention 2
Base BT + Skills Monitoring Off + JITAIsBase BT + Skills Monitoring On + JITAIs

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Have experienced 12 or more loss of control episodes within the previous 3 months
  • Have a BMI at or above 18.5
  • Are located in the US and willing/able to participate in treatment and assessments
  • Are able to give consent

You may not qualify if:

  • Are unable to fluently speak, write and read English
  • Have a BMI below 18.5
  • Are already receiving treatment for an eating disorder
  • Require immediate treatment for medical complications as a result of eating disorder symptoms
  • Have a mental handicap, or are experiencing other severe psychopathology that would limit the participants' ability to comply with the demands of the current study (e.g. severe depression with suicidal intent, active psychotic disorder, severe substance use)
  • Are pregnant or are planning to become pregnant

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Drexel University, Stratton Hall

Philadelphia, Pennsylvania, 19104, United States

RECRUITING

Related Publications (1)

  • Juarascio AS, Presseller EK, Trainor C, Boda S, Manasse SM, Srivastava P, Forman EM, Zhang F. Optimizing digital health technologies to improve therapeutic skill use and acquisition alongside enhanced cognitive-behavior therapy for binge-spectrum eating disorders: Protocol for a randomized controlled trial. Int J Eat Disord. 2023 Feb;56(2):470-477. doi: 10.1002/eat.23864. Epub 2022 Nov 30.

MeSH Terms

Conditions

Bulimia NervosaBulimiaBinge-Eating DisorderFeeding and Eating Disorders

Interventions

Behavior Therapy

Condition Hierarchy (Ancestors)

Mental DisordersHyperphagiaSigns and Symptoms, DigestiveSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

PsychotherapyBehavioral Disciplines and Activities

Study Officials

  • Adrienne S Juarascio, Ph.D.

    Drexel University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Sashi Govier, B.A.

CONTACT

Adrienne Juarascio, Ph.D.

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
FACTORIAL
Model Details: MOST: multiphase optimization strategy
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 18, 2022

First Posted

July 25, 2022

Study Start

January 6, 2023

Primary Completion

December 1, 2025

Study Completion

March 1, 2026

Last Updated

September 25, 2023

Record last verified: 2023-09

Data Sharing

IPD Sharing
Will share

We will follow all guidelines for data sharing through the National Database for Clinical Trials Related to Mental Illness (NDCT) and the NIMH Data Archive (NDA). All de-identified data will be submitted to the NDA at the item level and subject level.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Within one year of project completion
Access Criteria
We will include supporting documentation to allow other researchers to use this data easily and appropriately.

Locations