Preventing Eating Disorders by Improving Mental Health Literacy in Chinese Adolescents

Preventing Eating Disorders by Improving Mental Health Literacy in Chinese Adolescents: A Non-randomized Cluster Controlled Trial

Mental health literacy (MHL) is necessary for the prevention, detection, and treatment of eating disorders, whereas the MHL about eating disorders is inadequate in China. Thus, the current study aimed to improve the MHL for eating disorders among Chinese adolescents via a brief online intervention.

The current MHL intervention is a brief online intervention and comprises two modules. The first module is a short video introducing a teenage girl with bulimia nervosa. The second module is an online lecture comprising information about eating disorders including the prevalence, symptoms, type, cause, treatment, a related symptom checker, and sources of help. The above two modules are implemented in a single session lasting approximately 2 hours.

Participants assigned to the waiting list group will not receive any intervention until the end of the 12 weeks follow-up. They received the same intervention as the MHL intervention group after the 12 weeks follow-up test.

The vignette for eating disorders mental health literacy was developed for the current study. The vignette describes a 14-year old girl who has bulimia nervosa. We also conducted a 5-point Likert scale to assess the knowledge, attitude, and help-seeking behaviors of eating disorders. Higer scores indicating a higer level of eating disorders mental health literacy.

The social distance scale was used to assess the level of social rejection that participants were likely to impose on people with eating disorders. The lower the score, the greater the desire for social distancing and the more negative the attitude toward people with eating disorders.

The Weight Concerns Scale was used to assess weight concern and shape concern, with a higher score indicating more concerns.

The SCOFF (Sick, Control, One, Fat, Food) was used to detect the existence of eating disorder symptoms. Scores of 2 or greater were originally set a cut-off point for maximum sensitivity to detect anorexia and Bulimia nervosa (Morgan et al, 1999).

We conducetd three items to assess the actual help-seeking behavior, including, "In the last 6 months, have you come into contact with someone who you think may have the same problems as Lily?","Have you offered help to them?", "How you helped him/her?".

The Patient Health Questionnaire-4 was used to assess any negative impact on participant's well-being. Scores are rated as normal (0-2), mild (3-5), moderate (6-8), and severe (9-12). Total score ≥3 for first 2 questions suggests anxiety. Total score ≥3 for last 2 questions suggests depression.