Rapid Intervention to Support Eating Issues (RISE) Program: Using Quality Improvement to Reduce Medical...

Program-led and focused models may overcome structural barriers to accessing ED care, such as limited availability, for youth with EDs by prioritizing strategic, evidence-based care delivered through a structured approach. The Rapid Intervention to Support Eating Issues (RISE) pilot aimed to promote weight restoration and prevent hospitalization among malnourished adolescents at risk for hospitalization. We used a "home hospital" approach, integrating medical oversight, family-based treatment principles, and nutritional support via structured outpatient care.

Participants completed 4-5 visits with adolescent medicine and nutrition over 8 weeks. They received psychoeducation and support in implementing home hospital. Vital signs, anthropometrics, dietary intake, ED behaviors, and cognitions were assessed.

A total of 27 patients participated. Patients experienced low hospitalization rates (n = 1 throughout; 3.7%) and significant weight gain (M_{end of treatment} = +2.7 kg from baseline, 95% CI: 2.6-4.7). There were statistically significant increases in calorie intake (M_baseline = 43.3% of recommendation; M_{end of treatment} = 76.0% of recommendation; dz = 0.98, 95% CI: 0.45-1.50) and decreases in the report of disordered weight control behaviors (n reporting at baseline = 10 [37%], n reporting at end of treatment = 3 [11.1%]; paired RD = -1.00, 95% CI: -1.00--0.33).

This program-led and focused intervention produced meaningful outcomes and circumvented hospitalization for youth at high risk in a short time frame. This approach offers promise for scalable, early ED care that leverages programmatic expertise, consistent with evolving models of mental health service delivery.