Hans Kordy

Use of Text Messaging for Monitoring Sugar-sweetened Beverages, Physical Activity, and Screen Time in Children: A Pilot Study

OBJECTIVE To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children. DESIGN All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via paper diaries (PD) or participated in a no-monitoring control (C) for 8 weeks. SETTING University of North Carolina at Chapel Hill. PARTICIPANTS Fifty-eight children (age 5-13) and parents participated; 31 completed (SMS: 13/18, PD: 7/18, C: 11/22). INTERVENTION Children and parents participated in a total of 3 group education sessions (1 session weekly for 3 weeks) to encourage increasing physical activity and decreasing screen time and sugar-sweetened beverage consumption. MAIN OUTCOME MEASURES Treatment acceptability, attrition, and adherence to self-monitoring. ANALYSIS Descriptive statistics and nonparametric tests were used to analyze differences across time and group. RESULTS Children in SMS had somewhat lower attrition (28%) than both PD (61%) and C (50%), and significantly greater adherence to self-monitoring than PD (43% vs 19%, P < .02). CONCLUSIONS AND IMPLICATIONS Short message service may be a useful tool for self-monitoring healthful behaviors in children, although the efficacy of this approach needs further study. Implications suggest that novel technologies may play a role in improving health.

Enhancement of care through self-monitoring and tailored feedback via text messaging and their use in the treatment of childhood overweight

OBJECTIVE This paper first illustrates the general potential of the short message service (SMS) for symptom and behavior monitoring and the provision of tailored feedback. Second, an SMS-based maintenance treatment (SMSMT) is introduced aimed at enhancing the treatment of childhood overweight. METHODS After a 12-week cognitive behavioral group treatment (CBGT), 40 children were assigned to the SMSMT for a period of 36 weeks. Children were asked to send weekly self-monitoring data on eating behavior, exercise behavior, and emotions and received tailored feedback. The adherence to SMSMT and changes in Body Mass Index Standard Deviation Scores (BMI-SDS) during the first and second treatment phase were analysed. RESULTS Children (mean age=10.05, SD=1.28) submitted 67% of the weekly SMS that they were expected to send in. During CBGT a significant reduction by 0.20 BMI-SDS was observed. The reduction by 0.07 BMI-SDS during the SMSMT did not reach statistical significance. CONCLUSION The results support the feasibility of SMSMT in the treatment of childhood overweight. The efficacy of the intervention needs to be demonstrated in an RCT. PRACTICE IMPLICATIONS SMSMT is a promising intervention that may extend the reach of treatment centers for childhood overweight at reasonable cost and effort.

The Exploration of the Effectiveness of Group Therapy through an Internet Chat as Aftercare: A Controlled Naturalistic Study

Background: Modern communication technologies offer novel opportunities for the provision of stepped care for patients with mental disorders. This study investigated the effectiveness of group therapy delivered through an Internet chat following inpatient treatment. The main goal of the program was to reduce the risk of losing the therapeutic benefits achieved during the preceding inpatient treatment. Methods: 114 patients participated in one of two parallel groups of 8–10 patients that met with a group therapist in an Internet chat room. The groups met weekly for 12–15 weeks for 90 min. Controls were 114 patients who did not participate in the chat groups and were matched by application of propensity score methods. The main criterion was derived from comprehensive assessments of changes in health status comprising the psychological and physical condition of the patients. Assessments were conducted at admission, discharge and 12 months after discharge. Results: 12 months after discharge, chat participants showed a substantially lower risk (24.7%) for negative outcome than controls (38.5%). Furthermore, the low dropout rate and the high session attendance supported the expectation that this novel offer met patients’ needs, and thus, opens a new avenue for the optimization of care for patients with mental disorders.

Computer-assisted feedback-driven quality management for psychotherapy: the Stuttgart-Heidelberg model.

The authors present the Stuttgart-Heidelberg Model for quality management of psychotherapy. The system is characterized as an active internal approach with external support from researchers. Problem-solving activities are initiated and maintained by computer-assisted feedback on possible treatment shortcomings. The system provides support for the 3 key tasks of quality management: (a) monitoring of relevant quality criteria in the clinical routine, (b) standardized assessment that allows comparison with established standards at various levels of service provision, and (c) transfer of information on achieved quality to those whom it concerns. The central function of the system is an alarm function, signaling a possible deficit of the provided psychotherapy on the basis of the standard evaluation of treatment outcome for individual patients. In this article, the main system components are described and data on its feasibility and validity are presented.

Computergestützte quantitative Textanalyse. Äquivalenz und Robustheit der deutschen Version des Linguistic Inquiry and Word Count

Zusammenfassung. Im Beitrag wird die deutsche Adaptation des Linguistic Inquiry and Word Count (LIWC) vorgestellt. Das LIWC ist ein computergestutztes Textanalyseprogramm mit integriertem Worterbuch, das von Pennebaker und Kollegen (2001) entwickelt wurde, um Essays aus Experimenten zum expressiven Schreiben zu untersuchen. Es werden zwei Studien zur Gute und Praktikabilitat des deutschen LIWC berichtet: (1) An einer Stichprobe zweisprachig vorliegender Texte (N = 122) wird die Aquivalenz der deutschen Ubersetzung mit dem Original uberpruft. (2) An einer Stichprobe von N = 104 E-Mails wird die Robustheit des Verfahrens gegenuber Schreibfehlern untersucht. Fur die meisten LIWC-Kategorien zeigt sich eine gute Aquivalenz. Des Weiteren erweist sich das LIWC als robust gegenuber Schreibfehlern. Diese Befunde sprechen fur die Brauchbarkeit des LIWC fur die Analyse deutscher Texte. Die beobachtete Robustheit ist von erheblicher praktischer Bedeutung fur die Analyse naturlicher geschriebener Sprache aus der compu...

Technology-enhanced maintenance of treatment gains in eating disorders: efficacy of an intervention delivered via text messaging.

OBJECTIVE Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. METHOD The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on the utilization of outpatient treatment during follow-up was investigated. One hundred sixty-five female patients with bulimia nervosa or a related eating disorder not otherwise specified were randomly assigned to a control group (treatment as usual; TAU) or an intervention group (SMS-based maintenance intervention; SMS). After hospital discharge, participants in the intervention group submitted a weekly symptom report via text message for 16 weeks and received tailored feedback. Primary outcome was the rate of partial remission 8 months after discharge from inpatient treatment. RESULTS The difference in remission rates reached significance in the intent-to-treat analyses (SMS = 51.2%; TAU = 36.1%), χ²(1) = 3.81, p = .05, and approached significance in the completer analysis (SMS = 59.2%; TAU = 43.5%), χ²(1) = 3.44, p = .06. There were no differences in the utilization of outpatient treatment. Remission rates between the intervention and control groups were not significantly different among patients who used outpatient treatment (63.2% vs. 55.6%), χ²(1) = 0.44, p = .51. A significant difference was found in those who did not utilize such treatment (54.5% vs. 30.3%), χ²(1) = 3.97, p = .046. CONCLUSION The aftercare intervention was efficacious in enhancing treatment outcome after discharge from inpatient treatment.

Therapy Amount and Outcome of Inpatient Psychodynamic Treatment of Eating Disorders in Germany: Data From a Multicenter Study

The present study investigates (a) factors that determine length of treatment and (b) the effect of treatment duration and other factors on outcome for patients with eating disorders. In this observational study, the symptomatic status of 1,171 patients was observed for 2.5 years after admission to 1 of 43 participating hospitals. Treatment and outcome were modeled using hierarchical linear models and logistic regression. To control for possible confounding factors, propensity score adjustment was used. Treatment modalities, especially length and intensity, varied considerably between and within hospitals and were related to patient characteristics to a very small degree. At 2.5-year follow-up, 33% of anorexia patients and 25% of bulimia patients were symptom free. Length of treatment showed a weak effect on outcome and only in interaction with other patient characteristics of relevance, whereas treatment intensity was not related to outcome. Implications for treatment planning are discussed.

The effect of a short message service maintenance treatment on body mass index and psychological well‐being in overweight and obese children: a randomized controlled trial

Maintaining weight loss results in childhood obesity treatment is difficult to achieve. Self‐management techniques such as self‐monitoring are associated with increased weight loss and maintenance. This study analyzes whether self‐monitoring of lifestyle behaviours through a short message service maintenance treatment (SMSMT) via mobile phones with personalized feedback positively effects weight, lifestyle behaviours and psychological well‐being in obese children.

ES(S)PRIT an Internet-based programme for the prevention and early intervention of eating disorders in college students

ABSTRACT New communication technologies offer novel possibilities for the prevention of mental illness, in which geographical and psychosocial distances often hamper help-seeking. This paper introduces ES[S]PRIT, an Internet-based eating disorders (ED) prevention programme for university students. The programme follows a stepped-care approach combining various support components of increasing intensity. These components comprise psychoeducation, symptom monitoring, supportive feedback, peer support, and professional online counselling. Participants who develop substantial ED symptoms during their participation are referred to the University Student Counselling Center. We outline the underlying concepts and various components of the programme and report first experiences with the approach in a sample of German college students. Finally, potentials of the approach are highlighted and the need for further research is stressed.

Fragebogen zum Ergebnis von Psychotherapie

Zusammenfassung.Theoretischer Hintergrund: Routinemasige Qualitatssicherung psychotherapeutischer Versorgung erfordert Instrumente zur unaufwendigen, aber zuverlassigen Erfassung von Behandlungsergebnissen. Fragestellung: Ziel der Studie ist eine deutsche Adaptation (EB-45) des in den USA bewahrten Outcome Questionnaire 45.2. Methode: Der EB-45 wurde von einer nicht-klinischen Stichprobe (n =232) im Abstand von 2 Wochen zweimal bearbeitet. Zur Konstruktvalidierung wurden parallel die Symptom Checklist 90, das Inventar Interpersoneller Probleme sowie die Fragebogen zur sozialen Integration und zur Lebenszufriedenheit vorgelegt. Ergebnisse: Fur die interne Konsistenz wurden Werte von .59 bis .93 und fur die Retest-Reliabilitaten von .71 bis .87 geschatzt. Die Korrelationen mit den zur Validierung hinzugezogenen Instrumenten lagen zwischen .45 und .76. Schlusfolgerungen: Die Standardisierung rechtfertigt es, den EB-45 in der Evaluation und Qualitatssicherung einzusetzen; die Beschrankungen der Stichprobe erm...