OBJECTIVES E-mental health (digital) interventions can help overcome existing barriers that stand in the way of people receiving help for an eating disorder (ED). Although e-mental health interventions for treating and preventing EDs have been met with enthusiasm, earlier reviews brought attention to poor quality of evidence, and offered solutions to enhance their evidence base. To assess developments in the field, we conducted an updated meta-analysis on the efficacy of e-mental health interventions for treating and preventing EDs, paying attention to whether trial quality and outcomes have improved in recent trials. We also assessed whether user-centered design principles have been implemented in existing digital interventions. METHOD Four databases were searched for RCTs of digital interventions for treating and preventing EDs. Thirty-six RCTs (28 prevention- and 8 treatment-focused) were included. RESULTS Some evidence that study quality improved in recent prevention-focused trials was found. Few trials involved the end-user in the design or development stage of the intervention. Issues with intervention engagement were noted, and 1 in 4 participants dropped out from prevention- and treatment-focused trials. Digital interventions were more effective than control conditions in reducing established risk factors and symptoms in prevention- (g's = 0.19 to 0.43) and treatment-focused trials (g's = 0.29 to 0.69), respectively. Effect sizes have not increased in recent trials. Few trials compared a digital intervention with a face-to-face intervention. Whether digital interventions can prevent ED onset is unclear. CONCLUSION Digital interventions are a promising approach to ED treatment and prevention, but improvements are still needed. Three key recommendations are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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用于治疗和预防饮食失调的电子心理健康干预措施：最新的系统评价和荟萃分析。

目标电子心理健康（数字）干预可以帮助克服现有的障碍，阻碍人们获得饮食失调（ED）的帮助。尽管人们对治疗和预防ED的电子心理健康干预措施抱有极大的热情，但较早的评论使人们对不良的证据质量给予了关注，并提供了增强其证据基础的解决方案。为了评估该领域的发展，我们对电子心理健康干预措施用于治疗和预防ED的功效进行了最新的荟萃分析，并关注最近的试验中试验质量和结果是否有所改善。我们还评估了在现有的数字干预措施中是否已经实现了以用户为中心的设计原则。方法在四个数据库中搜索治疗和预防ED的数字干预的RCT。纳入了36项RCT（28项针对预防和8项针对治疗）。结果发现一些证据表明，在最近的针对预防的试验中，研究质量得到了改善。很少有试验使最终用户参与干预的设计或开发阶段。指出了参与干预的问题，并且有四分之一的参与者退出了以预防和治疗为重点的试验。在减少预防（g's = 0.19至0.43）和以治疗为重点的试验（g's = 0.29至0.69）中已确立的危险因素和症状方面，数字干预比控制条件更有效。在最近的试验中，效应的大小并未增加。很少有试验将数字干预与面对面干预进行比较。目前尚不清楚数字干预能否预防ED发作。结论数字干预是治疗和预防ED的有前途的方法，但仍需要改进。提供了三个关键建议。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。