OBJECTIVE Independent trials have found that the dissonance-based Body Project eating disorder prevention program is efficacious and effective; the present trial provided the first test of whether delivery could be task-shifted from clinician-delivery to peer educator-delivery or Internet-delivery without loss of effectiveness through 4-year follow-up. METHOD Young women at high-risk for eating disorders because of body image concerns (N = 680, Mage = 22.2) recruited at 3 colleges were randomized to clinician-led Body Project groups, peer-led Body Project groups, the Internet-based eBody Project, or educational video control. RESULTS Participants in clinician- and peer-led Body Project groups and the eBody Project generally showed larger reductions in risk factors and eating disorder symptoms versus controls through 1- and 2-year follow-up (d = .16-.59), with some effects persisting through 3- and 4-year follow-ups (d = .28-.58). Peer-led Body Project participants showed greater reductions in some risk factors than eBody Project participants (d = .18-.19), but no other contrasts between Body Project interventions differed. Eating disorder onset over 4-year follow-up was significantly lower for peer-led Body Project participants (8.1%) than control participants (17.6%) and clinician-led Body Project participants (19.3%), and marginally lower than eBody Project participants (15.5%). CONCLUSIONS The evidence that all three Body Project interventions outperformed educational video controls, peer-led groups outperformed the Internet-based intervention, and peer-led groups showed lower eating disorder onset over 4-year follow-up than the other conditions are novel. Results imply that it might be optimal to task-shift Body Project delivery to peer-leaders to address implementation barriers associated with clinician-led delivery. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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临床医生主导、同行主导和互联网提供的基于失调的饮食失调预防计划：这些提供方式通过 4 年随访的有效性。


目的 独立试验发现，基于不和谐的身体项目饮食失调预防计划是有效且有效的；本试验首次测试了是否可以将交付任务从临床医生交付转移到同伴教育者交付或互联网交付，并且在四年的随访中不会丧失有效性。方法 在 3 所大学招募的因身体形象问题而处于饮食失调高风险的年轻女性（N = 680，Mage = 22.2）被随机分配到临床医生主导的身体项目组、同伴主导的身体项目组、基于互联网的 eBody项目或教育视频控制。结果 通过 1 年和 2 年的随访，临床医生和同行领导的身体项目小组和 eBody 项目的参与者普遍表现出与对照组相比，风险因素和饮食失调症状有更大程度的减少 (d = 0.16-0.59)，一些影响在 3 年和 4 年的随访中持续存在 (d = .28-.58)。与 eBody 项目参与者相比，同行主导的身体项目参与者在某些风险因素方面表现出更大程度的降低 (d = .18-.19)，但身体项目干预措施之间没有其他对比差异。在 4 年随访中，同伴主导的身体项目参与者 (8.1%) 的饮食失调发病率显着低于对照组参与者 (17.6%) 和临床医生主导的身体项目参与者 (19.3%)，并且略低于 eBody 项目参与者（15.5%）。结论 所有三种身体项目干预措施均优于教育视频控制，同伴主导的小组优于基于互联网的干预，并且同伴主导的小组在 4 年随访中表现出比其他条件更低的饮食失调发病率，这些证据都是新颖的。 结果表明，将身体项目交付任务转移给同行领导者可能是最佳选择，以解决与临床医生主导的交付相关的实施障碍。 （PsycINFO 数据库记录 (c) 2020 APA，保留所有权利）。