Improving compliance in on-line, structured self-help programs: evaluation of an eating disorder prevention program

Area of Science:

• Public Health
• Health Education
• Psychology

Background:

• Eating disorders are a significant concern among college-aged women.
• Computer-assisted health education (CAHE) programs offer a scalable approach to prevention.
• Participant compliance is a critical factor for the effectiveness of CAHE programs.

Purpose of the Study:

• To evaluate and improve compliance rates in a CAHE program designed for eating disorder prevention.
• To compare the effectiveness of different program delivery models and incentive structures on participant compliance.

Main Methods:

• Four iterations of the "Student Bodies" CAHE program were tested with 116 undergraduate women.
• Program models varied in delivery method (CD-ROM vs. web-based), anonymity, structure, reminders, and incentives.
• Compliance was measured as the percentage of assigned screens accessed, with direct computer logs used for Models 2-4.

Main Results:

• Initial self-reported compliance in Model 1 was 53%.
• Directly measured compliance increased significantly from 66% in Model 2 to 85% in Model 3 and 84% in Model 4.
• Increased compliance was statistically significant (p < 0.01) and correlated with improved health outcomes.

Conclusions:

• Modifications to CAHE programs, including structure, anonymity, and incentives, can substantially increase participant compliance.
• Higher compliance rates are associated with better program outcomes.
• Findings offer valuable insights for designing effective CAHE interventions for eating disorder prevention.