Melanie Sowa

Screening riskanten Essverhaltens bei 12-jährigen Mädchen und Jungen: psychometrischer Vergleich der deutschsprachigen Versionen von SCOFF und EAT-26

To detect eating disorders and risky eating behaviour at an early stage, screening tests should be economic, i. e. as short as possible but at the same time they should fulfil the psychometric quality criteria. We compared the German version of the Eating Attitudes Test (EAT-26D, which comprises 26 items) and the German version of the SCOFF test (which contains only 5 Yes-no questions) in a community sample of 425 12-year-old girls and 382 boys from Thuringia, Germany. Although the EAT-26D reached higher psychometric properties, the SCOFF has been proved as a useful screening tool with a test-retest reliability of r (tt)=0.73 and a maximum accuracy of 82% (area under the ROC curve). With the EAT-26D (20 point cut-off) as a reference the sensitivity of the SCOFF was 79%, specificity 74%, positive predictive value 25%, and the negative predictive value, which is more relevant for screenings, was 97%. The criterion validity reached r=0.53.

Primary prevention of eating-related problems in the real world

AimAs known from meta-analyses, prevention programs for eating disorders yield significant effects under ideal conditions. However, it is still unclear how these programs can be more widely disseminated. Since 2004 in Thuringia, Germany, several programs for preadolescent girls and boys (aged 10 to 15 years) covering a wide geographical range have been developed in order to prevent eating-related problems.Subjects and MethodsOver 3,500 pupils and more than 100 schools participated in the internal evaluation following the three-step standard of the Society of Prevention Research (SPR). To examine the program efficacy (step 1) and effectiveness (step 2), we conducted pre-post design studies with control groups. In order to describe the implementation process and the program dissemination (step 3), the Health Promoting School Approach (HEPS) was applied.ResultsGirls (6th grade) showed significant improvements in eating attitudes and self esteem about their bodies, whereas boys only improved their knowledge about eating and physical activity. The evaluations of the programs for 7th and 8th graders are still pending. On the HEPS checklist, our health promotion concept fulfilled 64 points out of a maximum of 74, which indicates a high intervention quality.ConclusionBroad dissemination of prevention programs requires methodological compromises and organizational flexibility. Quality assurance should be considered to be as important as the optimal level of evidence, which depends on the needs of all stakeholders and could not be derived from the standards for clinical studies. Furthermore, health promotion needs political support that is independent of legislative periods and the turnover of institutional staff.

Essstörungen wirksam vorbeugen mit den Schulprogrammen „PriMa“ und „Torera“ für Jugendliche in Klasse 6 und 7

The aim of this study was to assess the effects of 2 German school-based primary prevention programmes for (pre)adolescents, aged 11-13 years, with 9 manual-guided lessons. 92 (PriMa, n=1,553 girls) and 22 (Torera, n=256 boys, 277 girls) Thuringian secondary schools participated in controlled trials with pre-post assessment. Girls and students at risk showed significant improvements of conspicuous eating behaviour and body self-esteem with small to medium effect sizes. Implementation costs were € 2.50 per student.