Clinician knowledge and perceptions of evidence-based practice in pediatric eating disorders in Western Canada

Evidence-based practice (EBP) for pediatric eating disorders (EDs), including the strongly recommended family-based treatment (FBT), is not always available to children, adolescents or emerging adults and their families. Our aim was to investigate clinician knowledge and perspectives of EBP, including FBT, and explore barriers and facilitators to its implementation.

Clinicians working in Western Canada who were engaged in care for pediatric EDs were invited to participate. A multimethod design was employed using an online survey and subsequent phone interview for data collection. Descriptive data was summarized using means and frequencies. Qualitative data was analysed using a mixed approach encompassing inductive and deductive techniques.

Eighty-four clinicians completed the survey and 24 completed the interview. A total of 64% of clinicians providing therapy were offering FBT in their practice. Of these, 12.5% had no formal training in the modality. Clinicians identified a range of barriers and facilitators to EBP, including FBT, such as service-centered reasons (inadequate training, staff beliefs around which professionals should be involved, program mandates, and private practice therapists struggling to get other professionals on the 'same page' in FBT), clinician-centered reasons (desire to offer more holistic care, lack of inclusion of dietetics, belief that FBT was better suited to hospital settings), and patient/family-centered reasons (co-occurring conditions in parents or children, lack of financial privilege).

The barriers to delivering EBP, and low rates of formal FBT training indicate a need to improve capacity building efforts for pediatric ED clinicians, including improved access to training and consultation.