Publications by authors named "Ellen Fitzsimmons-Craft"

Introduction: Rehabilitation is facing a critical practice gap: Patients seek out rehabilitation services to improve their activity in daily life, yet recent work demonstrates that rehabilitation may be having a limited impact on improving this outcome due to lack of objective data on patients' activity in daily life. Remote monitoring using wearable sensor technology is a promising solution to this address this gap. The purpose of this study was to understand patient and clinician awareness of the practice gap and preferences for integrating wearable sensor technology into rehabilitation care.

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Background: Virtual reality (VR) shows promise for supporting behavior change in children. This study used user-centered design to translate key tenets of behavioral health interventions into VR for children aged 6-12 years and their caregivers and examined the feasibility, acceptability, and preliminary efficacy of the VR experience in a pilot parallel, two-group randomized controlled trial (RCT).

Methods: The VR experience incorporates psychoeducational content from evidence-based behavioral health interventions using voiceover and an interactive go-kart game related to the concepts of "food as fuel" and nutrition guidelines.

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Article Synopsis
  • The study looks at how insomnia (trouble sleeping) is connected to other mental health problems like anxiety and eating disorders in college students.
  • Researchers used a smart computer method to analyze information from over 31,000 college students from 26 U.S. universities to see which mental disorders were linked with insomnia.
  • Results showed that having any mental disorder was tied to worse insomnia, with the findings helping to understand how these issues might affect each other.
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Background: Previous studies showed that comorbidity and demographic factors added to burden on health-related quality of life (HRQoL). Only one study explored the relationship between HRQoL and comorbidity in college students with mental disorders, leaving generalizability of findings uncertain. Less is known about the association of demographics on HRQoL.

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Background: This study is a cost-effectiveness study of two implementation strategies designed to train therapists in college and university counseling centers to deliver interpersonal psychotherapy. Costs of implementing a train-the-trainer (TTT) strategy versus an expert consultation strategy were estimated, and their relative effects upon therapist outcomes were calculated and compared.

Methods: Twenty four counseling centers were recruited across the United States.

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Objective: Few individuals with eating disorders (EDs) receive treatment. Innovations are needed to identify individuals with EDs and address care barriers. We developed a chatbot for promoting services uptake that could be paired with online screening.

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Background: Most individuals with eating disorders (EDs) do not receive treatment, and those who do receive care typically do not receive evidence-based treatment, partly due to lack of accessible provider training. This study developed a novel "all-in-one" online platform for disseminating training for mental health providers in cognitive-behavioral therapy guided self-help (CBTgsh) for EDs and supporting its implementation. The aim of the study was to obtain usability data from the online platform prior to evaluating its effects on provider training outcomes and patient ED symptom outcomes in an open pilot trial.

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Article Synopsis
  • - The study assessed how barriers to mental health treatment among U.S. college students differ based on race and ethnicity, using data from over 5,800 students with mental disorders.
  • - Common barriers included a preference to manage issues independently, time constraints, and financial troubles; Black and Hispanic/Latine students showed more willingness to seek help but faced greater financial obstacles.
  • - The research highlights the need for customized interventions for students of color and emphasizes the importance of developing low-cost, accessible treatment options to overcome these barriers.
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Objective: Individuals with eating disorders (EDs) often do not receive evidence-based care, such as interpersonal psychotherapy (IPT), partly due to lack of accessible training in these treatments. The standard method of training (i.e.

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Objective: The eating disorders field has been limited by a predominant focus on White, Western women, and there is growing recognition of the need to understand cross-cultural variation in key constructs (i.e., ideal body types).

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Article Synopsis
  • * Focus groups with 9 survivors and 11 parents revealed concerns about mental and physical health, perceptions of weight, and barriers to healthy behaviors, leading to specific adaptations in family-based treatment (FBT).
  • * The adaptations include virtual delivery methods, a focus on weight management for survivors, education on late effects, and tailored content addressing emotional health and body esteem, with a pilot trial currently evaluating the effectiveness of these changes.
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Article Synopsis
  • A study developed a chatbot to support adults with eating disorders (EDs) who are not currently in treatment, offering enrollment in research with the chatbot after an online screening.
  • Out of 6747 eligible respondents, only 3.0% enrolled in the study, but a notable 90.2% of those enrolled went on to use the chatbot.
  • The results showed that older respondents (≥25 years) were more likely to enroll and use the chatbot, while those practicing regular dietary restriction were less likely to participate; future efforts will focus on understanding barriers to participation and improving treatment access.
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Background: A better understanding of the structure of relations among insomnia and anxiety, mood, eating, and alcohol-use disorders is needed, given its prevalence among young adults. Supervised machine learning provides the ability to evaluate the discriminative accuracy of psychiatric disorders associated with insomnia. Combined with Bayesian network analysis, the directionality between symptoms and their associations may be illuminated.

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Objective: Anorexia nervosa (AN) is often treated in the acute setting, but relapse after treatment is common. Cognitive-behavioral therapy (CBT) is useful in the post-acute period, but access to trained providers is limited. Social support is also critical during this period.

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Introduction: It is crucial to identify and evaluate feasible, proactive ways to reach teens with eating disorders (EDs) who may not otherwise have access to screening or treatment. This study aimed to explore the feasibility of recruiting teens with EDs to a digital intervention study via social media and a publicly available online ED screen, and to compare the characteristics of teens recruited by each approach in an exploratory fashion.

Method: Teens aged 14-17 years old who screened positive for a clinical/subclinical ED or at risk for an ED and who were not currently in ED treatment completed a baseline survey to assess current ED symptoms, mental health comorbidities, and barriers to treatment.

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Background Publicly-insured and uninsured individuals-many of whom are marginalized because of race/ethnicity, disability and/or sexual preferences-experience barriers to accessing evidence-based interventions for eating disorders (EDs). Additionally, EBIs have not been developed with or for diverse populations, exacerbating poor treatment uptake. Mobile technology is perfectly positioned to bridge this gap and increase access to low-cost, culturally-sensitive EBIs.

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This Virtual Issue of the International Journal of Eating Disorders honors the legacy of the late Dr. C. Barr Taylor in the eating disorders (EDs) field.

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Less than 20% of individuals with eating disorders (EDs) ever receive treatment. Digital interventions offer one solution to this problem and have demonstrated promise, but there is a need to understand predictors, moderators, and mediators of response, which McClure and colleagues aimed to do in their systematic review. Yet their review also raised key definitional and measurement issues pertinent to conducting research on digital interventions for EDs and other mental health problems, which may have impacted the conclusions drawn and which may stem from applying what has "always been done" in research on more traditional psychological interventions to research on digital interventions.

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Labelling specific psychiatric concerns as 'niche' topics relegated to specialty journals obstructs high-quality research and clinical care for these issues. Despite their severity, eating disorders are under-represented in high-impact journals, underfunded, and under-addressed in psychiatric training. We provide recommendations to stimulate broad knowledge dissemination for under-acknowledged, yet severe, psychiatric disorders.

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Accessible, low-cost intervention options are necessary to address the rise in mental health problems among college students. Digital guided self-help, or coached, programs have been developed to provide such services, with many commercially available. As such, there are a large and growing number of individuals coaching these programs.

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Background: Avoidant/restrictive food intake disorder (ARFID) is a serious, albeit under-researched, feeding or eating disorder. This exploratory study utilized data from adult respondents to the National Eating Disorders Association online eating disorder screen to validate items assessing the presence of ARFID and examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen.

Methods: Among 50,082 adult screen respondents between January 2022 and January 2023, the prevalence of a positive ARFID screen was calculated.

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Article Synopsis
  • Researchers explored strategies to boost participation in online mental health surveys, finding that motivational appeals in emails ironically decreased participation rates in a screening survey.
  • In a follow-up experiment using a TikTok influencer video, participation rates did not significantly change compared to a humorous gif, although the video performed better among White and non-Hispanic participants.
  • The study highlights the importance of carefully considering email content length and the effectiveness of different strategies among diverse groups before applying them broadly.
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