Table 18 Cognitive-behavioural programs (without discussion groups) for emerging adults (18–25 years)

Franko et al. [79]

RCT

Female university students at-risk or low risk for EDs

n = 116 Food, Mood, and Attitude

n = 115 Control

FMA: 2-h CD-ROM addressing ED risk factors (perceived pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, negative affect); based on cognitive-behavioural and interpersonal/relational theories

Program satisfaction, EDE-Q, SATAQ, Knowledge Test, Q-EDD

FMA group improved on all measures relative to controls. Significant time x condition x risk status interactions were found on measures of internalization of sociocultural attitudes about thinness, shape and weight concerns, indicating that at-risk participants in FMA improved to a greater extent than did low-risk participants from baseline to 3-month follow-up. At 3-month follow-up, fewer women in intervention reported overeating and excessive exercise relative to controls. 97% of students were ‘very satisfied’ or ‘extremely satisfied’ with program

Franko et al. [80]

RCT

Female, Latina university students

n = 32 to either Food, Mood, and Attitude or

MyStudentBody

n = 30 Control

FMA: 2-h CD-ROM addressing ED risk factors (perceived pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, negative affect); based on cognitive-behavioural and interpersonal/relational theories

MyStudentBody.com-Nutrition: website to provide nutrition education

Control: 2 non-eating-related websites

Stages of dietary and physical activity change questionnaire, BSQ, SATAQ

BSQ scores decreased from pre to post-test only for intervention groups at the level of a trend (not significant). SATAQ data indicated no intervention effects (both interventions and control groups decreased scores over time). Some promise in decreasing body dissatisfaction and increasing fruit and vegetable intake among Latina students via 2 computer-based interventions

Fitzsimmons-Craft et al. [81]

RCT

Females screening as high-risk for an ED

n = 352 Body Positive chatbot

intervention

n = 348 delayed control

Body Positive chatbot: fully automated, conversation-based, cognitive-behavioural computer program, simulating human conversation, and designed to improve body image. It was based on Student Bodies (SB), similarly addressing topics like the thin- ideal and media literacy, but interactions were synchronous. Conversations based on these topics were programmed into the chatbot and the chatbot initiated conversations with users. Participants were to complete 2 conversations (sessions) per week (10 min each) for 1 month

Delayed control: provided access to the chatbot 6 months later

WCS, SATAQ (thin/low body fat subscale), EDE-Q, PHQ-8, GAD-7, helpfulness (e.g., asked “did you find that conversation helpful today?”)

There was a significantly greater reduction in weight/shape concerns in the chatbot intervention vs. control at 3-month (d = -0.20; p = 0.03) and 6-month (d = -0.19; p = 0.04) follow-up. There were no differences in change in thin-ideal internalization, depression, or anxiety. Compared to controls, the intervention was associated with significantly greater reductions in overall ED psychopathology at 3-months (d = -0.29; p = 0.003), but not 6-month follow-up. The odds of remaining nonclinical for EDs were significantly higher in intervention vs. control at both 3- (OR = 2.37, 95% CI [1.37, 4.11]) and 6-month follow-ups (OR = 2.13, 95% CI [1.26, 3.59])