Why and when is expert-patient support effective?: A randomized controlled trial on the effectiveness of expert-patient support in the online treatment of eating disorders

Background: Many individuals with eating disorders (EDs) do not receive appropriate treatment. It is therefore important to make treatment more accessible. This can be done through online interventions. Online interventions can be enhanced by the use of guidance, e.g., by expert patients. However, little is known about why and when expert-patient support is effective. Objective: The aim of this study was to clarify why and under which conditions expert-patient support may be effective in reducing ED symptomatology. Specifically, self-efficacy was investigated as mediator and perceived similarity as moderator in the relation between offering expert-patient support and ED symptom reduction. Methods: Participants (n=355) were recruited via the websites of Featback, WEET and Proud2Bme and were aged 16 years or older and had self-reported ED symptoms. They were randomized to four conditions: (1) Featback, an online self-help program for eating disorders (2) Weekly expert-patient support...Show moreBackground: Many individuals with eating disorders (EDs) do not receive appropriate treatment. It is therefore important to make treatment more accessible. This can be done through online interventions. Online interventions can be enhanced by the use of guidance, e.g., by expert patients. However, little is known about why and when expert-patient support is effective. Objective: The aim of this study was to clarify why and under which conditions expert-patient support may be effective in reducing ED symptomatology. Specifically, self-efficacy was investigated as mediator and perceived similarity as moderator in the relation between offering expert-patient support and ED symptom reduction. Methods: Participants (n=355) were recruited via the websites of Featback, WEET and Proud2Bme and were aged 16 years or older and had self-reported ED symptoms. They were randomized to four conditions: (1) Featback, an online self-help program for eating disorders (2) Weekly expert-patient support via chat or email, (3) combination of Featback and expert-patient support, and (4) waiting list condition. Online assessments were completed at baseline, post-intervention (8 weeks after baseline), and at one-year follow-up. Outcome measures were ED symptoms, self-efficacy and perceived similarity. Results: Self-efficacy was not a mediator and perceived similarity not a moderator in the relation between expert-patient support and ED symptom reduction. However, perceived similarity, which was not correlated with actual similarity, was a predictor of ED symptom reduction: people who felt more similar to their expert patient experienced a greater reduction in ED symptoms. Conclusions: Findings of this study indicate that people who perceive a higher similarity between themselves and the expert patient have less ED symptoms after one year, suggesting that the treatment of EDs can be enhanced by effective employment of expert patients.Show less

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Why and when is expert-patient support effective? A randomized controlled trial on the effectiveness of expert-patient support in the online treatment of eating disorders