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Trial registered on ANZCTR
Registration number
ACTRN12615000860561
Ethics application status
Approved
Date submitted
27/07/2015
Date registered
18/08/2015
Date last updated
18/08/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
Carers of people with anorexia nervosa: an evaluation of an online web-based skills intervention with and without clinician support
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Scientific title
Carers of people with anorexia nervosa: an evaluation of the feasibility and usefulness of an online web-based skills intervention with and without clinician support
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Secondary ID [1]
287153
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
anorexia nervosa
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Condition category
Condition code
Mental Health
295992
295992
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0
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Eating disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Overcoming Anorexia Online (OAO), 7 modules plus hard copies of an additional two workbooks, providing them with information on how to take care of their own well-being (Workbook 8) and additional information on treatments and resources (Workbook 9). Module 1 gives key information regarding symptoms and diagnosis and discusses myths and misconceptions.Carers are introduced to the systemic cognitive-behavioral approach underpinning the intervention. They are introduced to the 5-area approach to conceptualizing and understanding problems and the process of CBT. Module 2 focuses on helping carers to understand why people value their anorexia nervosa (AN) and the implications this has for their willingness to engage with treatment and for change, using the ‘Stages of Change’ model. It focuses on developing the skills needed to communicate effectively with a person who is ambivalent about change by teaching carers the principles of motivational interviewing. Module 3 addresses how AN affects families and uses the 5 -area approach to help carers to identify and understand how unhelpful behaviors and avoidance can result from difficult situations by teaching them to formulate their own and their loved one’s difficulties and to assess how their own reactions relate to and impact on each other by acting to ‘‘keep the AN going.’’ It also teaches people how to develop a plan to ‘break out’’ of these inter-relating vicious cycles in a manner that is appropriate to the developmental and illness stage of the sufferer. Module 4 concerns how to talk about meal support with the sufferer, make a collaborative plan to address this need and suggests tools and techniques for giving meal support. Module 5 is about risk and prognosis, including understanding and talking about medical risk with the sufferer and how to prepare for an appointment with health professionals. Module 6 tackles understanding the function of difficult behaviors such as bingeing, purging, or self-harm and helping to support the person to stop these. Module 7 This deals with relapse prevention—helping carers to identify the risk of relapse, helping the sufferer to maintain improvement, avoiding entering the cycle of reassurance, dealing with set-backs and looking for support. Modules are offered weekly over a 7-week period. Adherence was monitored via logging on to the online modules. Clinical guidance was provided by email or telephone by a Masters level trainee psychologist once a week. The intervention was only offered to carers and the each module took around 1 hour to complete.
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Intervention code [1]
292423
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Behaviour
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Comparator / control treatment
Random allocation to receiving additional clinician guidance (OAO-G) or no guidance (OAO-NoG) i.e., the no guidance group received OAO only.
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Control group
Active
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Outcomes
Primary outcome [1]
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level of expressed emotion measured with the 38-item Level of Expressed Emotion Scale completed by carers
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Assessment method [1]
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Timepoint [1]
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Secondary outcome [1]
316153
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AN sufferers completed the Level of Expressed Emotion scale to record their perception of their carer’s EE.
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Assessment method [1]
316153
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Timepoint [1]
316153
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Secondary outcome [2]
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General Health Questionnaire, completed by carer
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Assessment method [2]
316473
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Timepoint [2]
316473
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Secondary outcome [3]
316474
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Medical Outcome Study Short Form Scale, completed by carer
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Assessment method [3]
316474
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Timepoint [3]
316474
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Secondary outcome [4]
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Depression Anxiety Stress Scales, completed by carer
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Assessment method [4]
316475
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Timepoint [4]
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Secondary outcome [5]
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25-item Eating Disorder Symptom Impact Scale, completed by carer
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Assessment method [5]
316476
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Timepoint [5]
316476
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Secondary outcome [6]
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Experience of Care Giving Inventory assessing both the positive and negative experiences of caregiving
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Assessment method [6]
316477
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Timepoint [6]
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baseline, post-intervention (within one week of program completion), 3-month follow-up
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Eligibility
Key inclusion criteria
Carers spoke English fluently and were presently caring for a person experiencing anorexia nervosa. The family member with AN was invited to complete questionnaires on expressed emotion at each time point.
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
None
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/10/2010
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Actual
1/10/2010
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Date of last participant enrolment
Anticipated
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Actual
24/08/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
37
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
University
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Name
Flinders University
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Address
GPO Box 2100, Adelaide, SA, 5001
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
290393
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Address [1]
290393
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Country [1]
290393
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Flinders University Social and Behavioural Ethics Committee
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Ethics committee address [1]
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Flinders University, GPO Box 2100, Adelaide, SA, 5001
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
293242
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Approval date [1]
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25/09/2010
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Ethics approval number [1]
293242
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Summary
Brief summary
Objective: To investigate the feasibility and usefulness of an online information and skills development intervention for carers of individuals with anorexia nervosa (AN). Method: Thirty-seven carers and seventeen individuals with AN were recruited; carers completed the intervention Overcoming Anorexia Online (OAO), with random allocation to receiving additional clinician guidance (OAO-G) or no guidance (OAO-NoG). Level of expressed emotion, distress, depressive symptoms, experience of caregiving and impact of eating disorder symptoms were assessed in carers and perceptions of changes in their carers’ expressed emotion were assessed in individuals with AN. Participants completed questionnaires at pre-intervention, post-intervention and 3-month follow-up. Results: Significant reductions were found for carer intrusiveness, negative experiences of caregiving and the impact of starvation and guilt. Within group effect sizes suggested mixed findings with respect to whether greater benefits were conferred for carers receiving clinician guidance. Decreases in perceived intrusiveness of the carer by the individual with AN were associated with a large effect size. Discussion: Results demonstrate the feasibility and usefulness of an online intervention for carers. Further examination of the efficacy of the intervention for both carers and individuals with AN is warranted.
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Trial website
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Trial related presentations / publications
Hoyle D, Slater J, Williams C, Schmidt, U, Wade TD. (2013). Evaluation of a web-based skills intervention for carers of people with anorexia nervosa: a randomised controlled trial. International Journal of Eating Disorders, 46, 634-638.
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Public notes
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Attachments [1]
530
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/AnzctrAttachments/368999-Hoyle_carers_2013.pdf
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Contacts
Principal investigator
Name
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Prof Tracey Wade
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Address
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school of Psychology
Flinders University
GPO Box 2100
Adelaide, SA, 5001
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Country
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Australia
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Phone
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+61 8 82013736
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Tracey Wade
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Address
59055
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school of Psychology
Flinders University
GPO Box 2100
Adelaide, SA, 5001
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Country
59055
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Australia
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Phone
59055
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+61 8 82013736
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Fax
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Email
59055
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[email protected]
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Contact person for scientific queries
Name
59056
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Tracey Wade
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Address
59056
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school of Psychology
Flinders University
GPO Box 2100
Adelaide, SA, 5001
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Country
59056
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Australia
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Phone
59056
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+61 8 82013736
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Fax
59056
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Email
59056
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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