The Potential of Internet-Based Programs for Eating Disorder Prevention in Students

Abstract

Transition from high school to college is known to be a phase in which students are particularly vulnerable to develop mental disorders. Almost half of female college students display disturbed eating behaviors or try to lose weight, indicating the rationale to target this age cohort with eating disorder (ED) prevention. Using the potential of information and communication technologies (ICT) to enhance health-care interventions, the Center for Psychotherapy Research in Heidelberg has developed the internet-based program Es[s]prit for prevention and early intervention of ED. Following a stepped care approach from universal to targeted prevention up to early intervention, Es[s]prit contains modules of increasing intensity, i.e., psychoeducation, peer support, monitoring, consultation chat, and face-to-face counseling. These technology-enhanced modules enable individualization of support according to participants’ needs: Healthy students remain on low-intensity levels, whereas high-risk individuals are invited to participate in the monitoring program that observes symptom courses continuously and provides supportive feedback. An automated alarm system identifies deteriorations and indicates referral to more intensive modules, i.e., the consultation chat, where the anonymous contact can be used to motivate individuals to seek more intensive treatment, i.e., face-to-face counseling. We present results on a sample of N = 1582 college-age students. Es[s]prit was found to be feasible for large populations and well accepted. This technology-enhanced prevention strategy appears especially promising for the prevention of behavioral disorders such as ED. Furthermore, individualized, stepped care approaches can be applied to other areas of health and disease, such as maintenance treatment and monitoring of patients with multiple illness episodes.