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Accurso EC, Mu KJ, Landsverk J, et al. Adaptation to family-based treatment for Medicaid-insured youth with anorexia nervosa in publicly-funded settings: Protocol for a mixed methods implementation scale-out pilot study. J Eat Disord. 2021;9(1):99doi: 10.1186/s40337-021-00454-0.
Accurso, E. C., Mu, K. J., Landsverk, J., & Guydish, J. (2021). Adaptation to family-based treatment for Medicaid-insured youth with anorexia nervosa in publicly-funded settings: Protocol for a mixed methods implementation scale-out pilot study. Journal of eating disorders, 9(1), 99. https://doi.org/10.1186/s40337-021-00454-0
Accurso, Erin C, et al. "Adaptation to family-based treatment for Medicaid-insured youth with anorexia nervosa in publicly-funded settings: Protocol for a mixed methods implementation scale-out pilot study." Journal of eating disorders vol. 9,1 (2021): 99. doi: https://doi.org/10.1186/s40337-021-00454-0
Accurso EC, Mu KJ, Landsverk J, Guydish J. Adaptation to family-based treatment for Medicaid-insured youth with anorexia nervosa in publicly-funded settings: Protocol for a mixed methods implementation scale-out pilot study. J Eat Disord. 2021 Aug 13;9(1):99. doi: 10.1186/s40337-021-00454-0. PMID: 34389052; PMCID: PMC8360814.
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J Eat Disord. 2021 Aug 13;9(1):99. doi: 10.1186/s40337-021-00454-0.

Adaptation to family-based treatment for Medicaid-insured youth with anorexia nervosa in publicly-funded settings: Protocol for a mixed methods implementation scale-out pilot study.

Journal of eating disorders

Erin C Accurso, Karen J Mu, John Landsverk, Joseph Guydish

Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA. [email protected].
  2. Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
  3. San Francisco Department of Public, Health Behavioral Health Services, San Francisco, CA, USA.
  4. Oregon Social Learning Center, Eugene, OR, USA.
  5. Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.

PMID: 34389052 PMCID: PMC8360814 DOI: 10.1186/s40337-021-00454-0

Abstract

BACKGROUND: Family-based treatment (FBT) for anorexia nervosa is an evidence-based treatment, but its effectiveness is untested among socioeconomically disadvantaged and racially diverse youth. Adapting FBT may facilitate "scale-out" for Medicaid-insured youth served in publicly-funded settings and potentially improve outcomes for more diverse populations.

METHODS: This mixed methods effectiveness-implementation Hybrid Type 3 pilot study protocol included a planning period in collaboration with the San Francisco Department of Public Health, culminating in a two-day in-person FBT training for 25 therapists in the county, followed by the opportunity to engage in one year of weekly supervision. The training incorporated FBT adaptations intended to improve fit for low-income families within community-based settings. Treatment appropriateness and acceptability will be measured immediately post-training. Following the training, cases referred for FBT will only be assigned to the trained clinicians who voluntarily opted into long-term group supervision. Clinicians treating at least one FBT case during the supervision period will report on implementation, adaptations, and patient weight gain. Finally, semi-structured interviews with clinician participants will be conducted, focused on implementation challenges and facilitators, local treatment adaptations, and overall satisfaction with FBT.

DISCUSSION: Learning about clinician adaptations will advance knowledge about treatment of eating disorders in publicly-funded community clinics, which serve a racially/ethnically and socioeconomically diverse group of youth. This project is designed to accelerate FBT implementation in publicly-funded mental health systems, and inform service improvements for underserved youth with eating disorders.

© 2021. The Author(s).

Keywords: Adaptation; Anorexia nervosa; Atypical anorexia nervosa; Children and adolescents; Family-based treatment (FBT); Hybrid effectiveness-implementation Type 3 design; Implementation; Mixed methods; Protocol; Publicly-funded settings; “Scale-out”

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