Clinical Effects of Asynchronous Provider-Guided Practice Sessions During Blended Care Therapy for Anxiety and Depression: Pragmatic Retrospective Cohort Study.

Background: Blended care therapy models are intended to increase the efficiency and effectiveness of evidence-based psychotherapy by combining synchronous and asynchronous components of care.

Objective: This retrospective cohort study evaluated the clinical effects of synchronous video therapy sessions and asynchronous guided practice session elements on anxiety and depression in a blended care therapy program, with a novel focus on asynchronous provider feedback messages.

Methods: Participants were adults (N=33,492) with clinical symptoms of anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7] score of ≥8) and depression (Patient Health Questionnaire 9-item scale [PHQ-9] score of ≥10) at intake.

A baseline comparison of three diagnostic groups using the Progress Monitoring Tool for Eating Disorders.

Utilisation of intensive inpatient treatment for eating disorders (EDs) has climbed in the last decade, illuminating a need for better consensus on what constitutes effective treatment and context-appropriate progress/outcome monitoring during residential stays. The novel Progress Monitoring Tool for Eating Disorders (PMED) measure is specifically designed for inpatient settings. Previous research supports the factorial validity and internal consistency of the PMED; however, additional work is needed to determine its appropriateness for complex patient populations.

Applying a Social Determinants of Health Framework to Guide Digital Innovations That Reduce Disparities in Chronic Disease.

Chronic diseases are among the top causes of global death, disability, and health care expenditure. Digital health interventions (e.g.

Real-time versus retrospective self-report assessment of loss-of-control eating in adults undergoing bariatric surgery.

Objective: Loss-of-control (LOC) eating is common in adults undergoing bariatric surgery. Agreement between real-time and retrospective assessment methods is unclear.

Methods: Adults with severe obesity reported on LOC eating over the preceding 28 days via Eating Disorder Examination-Questionnaire (EDE-Q) items and in near real time over 10 days via ecological momentary assessment (EMA; involving daily repeated surveys delivered via smartphone in the natural environment), with both assessment forms completed before surgery and at 3, 6, and 12 months after surgery.

The Indirect Effects of a Mindfulness Mobile App on Productivity Through Changes in Sleep Among Retail Employees: Secondary Analysis.

Background: Chronic sleep disturbance is prevalent among United States employees and associated with costly productivity impairment. Mindfulness interventions improve sleep (ie, insomnia and daytime sleepiness) and productivity outcomes, and mobile apps provide scalable means of intervention delivery. However, few studies have examined the effects of mindfulness mobile apps on employees, and no research to date has tested the role of sleep improvement as a potential mechanism of action for productivity outcomes.

Testing the Pragmatic Effectiveness of a Consumer-Based Mindfulness Mobile App in the Workplace: Randomized Controlled Trial.

Background: Mental health and sleep problems are prevalent in the workforce, corresponding to costly impairment in productivity and increased health care use. Digital mindfulness interventions are efficacious in improving sleep and mental health in the workplace; however, evidence supporting their pragmatic utility, potential for improving productivity, and ability to reduce employer costs is limited.

Objective: This pragmatic, cluster randomized controlled trial aimed to evaluate the experimental effects of implementing a commercially available mindfulness app-Calm-in employees of a large, multisite employer in the United States.

Dietary lapses are associated with meaningful elevations in daily caloric intake and added sugar consumption during a lifestyle modification intervention.

Objective: Lapses from the dietary prescription in lifestyle modification interventions for overweight/obesity are common and impact weight loss outcomes. While it is expected that lapses influence weight via increased consumption, there are no studies that have evaluated how dietary lapses affect dietary intake during treatment. This study examined the association between daily lapses and daily energy and macronutrient intake during a lifestyle modification intervention.

Pragmatic implementation of a fully automated online obesity treatment in primary care.

Objective: Behavioral obesity treatment implemented in primary care is efficacious but typically involves face-to-face or phone contact. This study evaluated enrollment, engagement, and 12-week weight loss in a fully automated online behavioral weight-loss intervention implemented pragmatically in a primary care network.

Methods: As part of routine primary care, providers and nurse care managers offered a no-cost online obesity treatment program to 1,721 patients.

Traditional versus developmental measures of weight suppression: Exploring their relationships with bulimic psychopathology.

Objective: Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z-BMI to current z-BMI (called developmental weight suppression [DWS] here).

Contextual influences on implementation of online behavioral obesity treatment in primary care: formative evaluation guided by the consolidated framework for implementation research.

Online behavioral obesity treatment is a promising first-line approach to weight management in primary care. However, little is known about contextual influences on implementation. Understand qualitative contextual factors that affect the implementation process, as experienced by key primary care stakeholders implementing the program.

Primary care clinicians' perspectives on clinical decision support to enhance outcomes of online obesity treatment in primary care: A qualitative formative evaluation.

Objective: Online behavioral treatment for obesity produces clinically-meaningful weight losses among many primary care patients. However, some patients experience poor outcomes (i.e.

Energy, Attentiveness, and Fatigue After Bariatric Surgery and Associations with Daily Physical Activity and Weight Loss: an Ecological Momentary Assessment Study.

Purpose: Energy and fatigue are thought to improve after bariatric surgery. Such improvements could be related to weight loss and/or increased engagement in day-to-day health behaviors, such as moderate-to-vigorous physical activity (MVPA). This study used ecological momentary assessment (EMA) to evaluate several aspects of energy/fatigue in real-time in patients' natural environment during the first year after surgery and assessed the associations of percent total weight loss (%TWL) and daily MVPA with daily energy/fatigue levels.

Prediction of eating disorder treatment response trajectories via machine learning does not improve performance versus a simpler regression approach.

Objective: Patterns of response to eating disorder (ED) treatment are heterogeneous. Advance knowledge of a patient's expected course may inform precision medicine for ED treatment. This study explored the feasibility of applying machine learning to generate personalized predictions of symptom trajectories among patients receiving treatment for EDs, and compared model performance to a simpler logistic regression prediction model.

Evaluation of intervention components to maximize outcomes of behavioral obesity treatment delivered online: A factorial experiment following the multiphase optimization strategy framework.

Background: Behavioral lifestyle intervention (BLI) is recommended as a first-line treatment for obesity. While BLI has been adapted for online delivery to improve potential for dissemination while reducing costs and barriers to access, weight losses are typically inferior to gold standard treatment delivered in-person. It is therefore important to refine and optimize online BLI in order to improve the proportion of individuals who achieve a minimum clinically significant weight loss and mean weight loss.

Latent trajectories of eating disorder treatment response among female patients in residential care.

Objective: Eating disorder (ED) treatment outcomes are highly variable from beginning to end of treatment; however, little is known about differential trajectories during the course of treatment. This study sought to characterize heterogeneous patterns of ED treatment response during residential care.

Method: Participants were adolescent girls and adult women (N = 360) receiving residential ED treatment for anorexia nervosa, bulimia nervosa, binge-eating disorder, other specified feeding or eating disorder, unspecified feeding or eating disorder, or avoidant/restrictive food intake disorder.

Development and validation of a progress monitoring tool tailored for use in intensive eating disorder treatment.

Objective: Despite calls for routine use of progress and outcome monitoring in private and intensive treatment centres for eating disorders (EDs), existing measures have limited relevance to these supervised treatment settings. This study sought to develop and validate the progress monitoring tool for eating disorders, a multidimensional measure for progress monitoring in the context of intensive ED treatment.

Method: Thirty-seven items were generated by a team of content experts, clinicians, and administrative staff from the target treatment setting.

Weight variability during self-monitored weight loss predicts future weight loss outcome.

Background: Obesity treatments often do not produce long-term results. It is therefore critical to better understand biological and behavioral correlates or predictors of future weight change.

Objective: We tested the hypothesis that greater weight variability, independent of total body weight change, during early weight loss would predict degree of long-term success.

Qualitative perceptions of and preferences for the research process among patients with eating disorders.

Objective: Low participation and retention rates are persistent problems in eating disorder (ED) research. In order to improve the research process, this study used a qualitative approach to examine factors promoting and limiting research study participation among patients with EDs, and their preferences during research.

Method: Five 90-min focus groups were conducted with adult women (N = 29) enrolled at a residential ED treatment facility.

The independent and interacting effects of weight suppression and admission body mass index on treatment weight change in patients with anorexia nervosa or bulimia nervosa.

Objective: Weight suppression (WS) and body mass index (BMI) have predicted weight change in individuals with eating disorders, but the interaction between these variables is understudied. Furthermore, WS is usually measured as absolute WS-the numeric difference between current weight and highest past weight-overlooking the potentially important influence of how much a person weighed at their highest historical weight.

Method: The current study investigated the independent and interacting effects of BMI and two measures of WS at admission on residential treatment weight change.

Mediating role of experiential avoidance in the relationship between anxiety sensitivity and eating disorder psychopathology: A clinical replication.

Objective: This study sought to examine whether anxiety sensitivity was associated with eating disorder (ED) symptom severity among patients with severe EDs, and to determine whether this relationship was mediated by experiential avoidance.

Method: Adolescent and adult females (N = 625) seeking residential ED treatment completed self-report measures of anxiety sensitivity, experiential avoidance, and ED psychopathology. Linear regression evaluated the cross-sectional association between ED symptom severity and three dimensions of anxiety sensitivity (social, physical, and cognitive).

Rationale and design for a pragmatic effectiveness-implementation trial of online behavioral obesity treatment in primary care.

Background: Current guidelines recommend behavioral intervention to achieve a modest weight loss (e.g., 3-5%) as a first-line obesity treatment.

Body concerns and BMI as predictors of disordered eating and body mass in girls: An 18-year longitudinal investigation.

Body concerns (e.g., body dissatisfaction and weight preoccupation) are well-supported prospective risk factors for the development of eating disorders in women.

Implementation of transdiagnostic treatment for emotional disorders in residential eating disorder programs: A preliminary pre-post evaluation.

: Data are lacking from empirically supported therapies implemented in residential programs for eating disorders (EDs). Common elements treatments may be well-suited to address the complex implementation and treatment challenges that characterize these settings. This study assessed the preliminary effect of implementing a common elements therapy on clinician treatment delivery and patient ( = 616) symptom outcomes in two residential ED programs.