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

Background: Early intervention increases the likelihood of eating disorder (ED) 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]) and conducted a feasibility trial of the tool. Methods: 16- to 25-year-olds with a suspected ED and no previous specialist treatment were randomly allocated to FREED-M or 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 were able to over-recruit 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 (SD 2.0) years, 89% identified as female and 64% as white. Mean BMI was 23.1 (6.3). N=83 participants had an anorexia nervosa-like disorder, 101 had another ED or ED high 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-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). Conclusions: Although the attrition rate was high, recruitment exceeded expectations. Acceptability of FREED-M was high. Motivation and readiness to change are candidates for primary outcomes in a future randomised controlled trial.