Media Smart-Targeted: Diagnostic outcomes from a two-country pragmatic online eating disorder risk reduction trial for young adults

This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'. Copyright 2018 Wiley Periodicals, Inc. This author accepted manuscript is made available following 6 month embargo from date of publication (January 2018) in accordance with the publisher’s copyright policyBackground: Diagnostic outcomes in eating disorder (ED) risk reduction trials are important but rarely reported. Methods: An online pragmatic randomized-controlled trial was conducted with young-adult women in Australia and New Zealand seeking to improve their body image. Media Smart-Targeted (MS-T) was a 9-module program released weekly while control participants received tips for positive body image. Eating Disorder Examination–Questionnaire (EDE-Q) scores from baseline and 12-month follow-up were used to investigate two outcomes: ED onset in those who were asymptomatic at baseline (prevention effects); and, ED remission in those who met diagnosis at baseline (treatment effects). Results: MS-T participants were 66% less likely than controls to develop an ED by 12-month follow-up (non-significant). MS-T participants who met ED criteria at baseline were 75% less likely than controls to still meet diagnostic criteria at follow-up. This effect was significant and remained so for both those who did and who did not access external face-to-face ED treatment during the trial. Conclusions: Whilst further investigations are necessary, MS-T has fully automated procedures, low implementation costs, the potential to be delivered at-scale to assist those assist those where face-to-face services are limited or not available (e.g., remote areas)