A randomised controlled feasibility trial of FREED-Mobile, a smartphone-friendly decision-making tool, designed to facilitate help-seeking in young people with eating disorders

BACKGROUND: Early intervention increases the likelihood of eating disorder recovery but many young people delay help-seeking. We developed a smartphone-friendly, online decision-making tool to address this gap (FREED-Mobile (FREED-M)). AIMS: To conduct a randomised controlled feasibility trial of the FREED-M decision-making tool with 16- to 25-year-olds with a suspected eating disorder and no previous treatment for this. METHOD: Participants were randomly allocated to FREED-M or an active control in a parallel group, two-arm trial. Outcomes were measured at weeks 0 (baseline), 4 (post-intervention) and 12 (follow-up). The primary feasibility outcome was attrition at follow-up. Other outcomes included motivational, clinical and economic measures. RESULTS: We over-recruited with 204 randomised participants (including 20 fraudulent participants). Main analyses were conducted with 184 genuine responders (FREED-M: n = 91, control: n = 93). At baseline, participants' mean age was 21.0 (s.d. 2.0) years, 89% identified as female and 64% as White. Mean body mass index was 23.1 kg/m2 (6.3). N = 83 participants had an anorexia nervosa-like disorder, 101 had another eating disorder or high eating disorder risk. Attrition at week 12 was n = 112 (61%). Of the n = 42 FREED-M participants who provided acceptability ratings, 79% liked the intervention and 66% found it useful. Between-group effect sizes for motivation and readiness to change were small to medium at 4 weeks (d = 0.27 and d = 0.15, respectively) favouring FREED-M, but differences were not sustained at follow-up (d = -0.02 and d = -0.12, respectively). DISCUSSIONS: Although the attrition rate was high, recruitment exceeded expectations. Acceptability of FREED-M was high among participants who provided acceptability ratings. Motivation/readiness to change and help-seeking are candidates for primary outcomes in a future randomised controlled trial.