Interventions for preventing eating disorders in children and adolescents
Editorial Group: Cochrane Depression, Anxiety and Neurosis Group
Published Online: 22 APR 2002
Assessed as up-to-date: 2 SEP 2004
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Pratt BM, Woolfenden S. Interventions for preventing eating disorders in children and adolescents. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD002891. DOI: 10.1002/14651858.CD002891.
- Publication Status: Edited (no change to conclusions)
- Published Online: 22 APR 2002
Eating disorders represent an extremely difficult, time-consuming and costly condition to treat. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders. There is currently limited evidence in the published literature to suggest that any particular type of program is effective in preventing eating disorders and there has been concern that some interventions have the potential to cause harm.
To determine if eating disorder prevention programs for children and adolescents are effective in: (1) promoting healthy eating attitudes and behaviours; (2) promoting protective psychological factors; (3) promoting satisfactory physical health; (4) having a long-term, sustainable, and positive impact on mental and physical health; and, (5) ensuring safety in relation to possible harmful consequences on mental or physical health.
Relevant trials are identified through searching the Cochrane Controlled Trial Register (CCTR) and relevant biomedical and social science databases, as well as reference lists from articles identified through the search strategy and contact with experts in the field.
Randomised controlled trials (RCTs) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (e.g., BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention.
Data collection and analysis
A total of 1016 titles have been identified through the search to date. Twenty-two studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Twelve studies met the selection criteria outlined above.
Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel 1999; Neumark* 2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. There is insufficient evidence to support the effect of five programs designed to address eating attitudes and behaviours and other adolescent issues in the general community or those classified as being at high risk for eating disorder (Buddeberg* 1998; Dalle Grave 2001; Killen 1993; Santonastaso 1999; Zanetti 1999) and insufficient evidence to support the effect of two programs designed to improve self-esteem (O'Dea 2000; Wade 2003). Data from two didactic eating disorder awareness programs could not be pooled for analysis. There is not sufficient evidence to suggest that harm resulted from any of the prevention programs included in the review.
The one significant pooled effect in the current review does not allow for any firm conclusions to be made about the impact of prevention programs for eating disorders in children and adolescents, although none of the pooled comparisons indicated evidence of harm. The meta-analysis is in the process of being revised to account for the impact of cluster randomised trials.
Plain language summary
Preventing eating disorders in children and adolescents
Eating disorders represent an extremely difficult, time-consuming and costly condition to treat. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders. Several eating disorder prevention programs have been developed and trialled with children and adolescents. There is currently limited evidence in the published literature to suggest that any particular type of program is effective in preventing eating disorders and there has been concern that some interventions have the potential to cause harm. The aim of this systematic review is to determine whether these interventions are effective in the prevention of eating disorders in children and adolescents. Only one statistically significant result was found in the present meta-analysis - a slight effect of media literacy and advocacy programs in reducing acceptance of societal body image ideals. There is not sufficient evidence to suggest that harm was caused by any of the 12 randomised controlled trials included in the review at short-term follow-up. The meta-analysis is in the process of being revised to account for the impact of cluster randomised trials.
搜尋the Cochrane Controlled Trial Register (CCTR)和相關生化、社會科學的資料庫來確認相關的研究，並且搜尋文章後的參考目錄，並與這領域的專家聯繫。
從兩個以媒體文字和宣傳為基礎的預防飲食疾患計劃的綜合資料顯示，在3 – 6個月的追蹤評估中，對於外貌的社會標準內化的程度或接受度已下降Kusel 1999; Neumark* 2000) [SMD −0.28, −0.51 to −0.05, 95% CI].。有五個實行在一般社區，或那些被列為高風險的人的方案中,強調飲食的態度、飲食行為及其他青少年問題並沒有充足的證據支持其有效(Buddeberg* 1998; Dalle Grave 2001; Killen 1993; Santonastaso 1999; Zanetti 1999)。在兩個設計來改善自尊的方案也沒有足夠的證據支持有效(O'Dea 2000; Wade 2003).。從兩個教導飲食疾患的宣傳教育方案的資料不能整合進行分析。在本文獻中也沒有足夠的證據表明任何預防計劃會造成傷害。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。