This preprint is under consideration at Journal of Eating Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research Article
Rebecca Spigel
Boston Childrens Hospital: Boston Children's Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8116-9144
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Shelter-in-place orders and social distancing guidelines, in response to the COVID-19 pandemic, have limited traditional face-to-face interactions and led to many clinical providers transitioning to the use of videoconferencing platforms. The present study aims to assess how the COVID-19 pandemic has impacted adolescents’/young adults’ (AYA) eating disorder (ED)-related care, and how access to, changes in, perceived disruptions to, and quality of care are associated with ED thoughts and behaviors.
Methods
AYA enrolled in the RECOVERY study, a pre-existing web-based longitudinal study, completed a COVID-19-specific survey (n=89). We examined bivariate associations of four markers of care: access to and changes in care as well as perceived disruption to and quality of care. Using multiple logistic regression, we examined the associations of our pandemic-related markers of care with changes in ED thoughts and behaviors. We excluded those not engaged in treatment pre-pandemic (n=16).
Results
In the remaining 73 participants, reported access to care was high, with 92% of respondents continuing to see at least one ED provider during the pandemic; however, 47% stopped some treatment during the pandemic. Nearly one-third (32%) perceived a disruption in treatment. Quality of care remained high with 67% reporting care to be better than or as good as pre-pandemic. Respondents acknowledged heightened symptomatology: 81% reported increased ED thoughts and 81% reported increased ED behaviors due to COVID-19-related factors. However, none of the markers of care described were significantly associated with ED thoughts or behaviors in regression analyses adjusting for demographic variables and baseline characteristics, except our quality of care measure which was approaching significance (p=0.07).
Conclusions
Our findings show the majority of AYA who had care prior to the pandemic are still receiving some element of their multi-disciplinary ED treatment and perceive their care as high quality. Although none of the markers of care described were statistically associated with increased ED thoughts and behaviors, our results may indicate that continued access to care may be protective against increased ED behaviors and patients who perceive their quality of care as worse than usual might be more likely to have intrusive ED thoughts.
Keywords
COVID-19, Eating disorders, adolescents, access, telemedicine
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CURRENT STATUS: Under Revision
Version 1
Posted 16 Mar, 2021
No community comments so far
Editorial decision: Minor Revision
On 02 Apr, 2021
Review #3 received
Received 27 Mar, 2021
Review #2 received
Received 25 Mar, 2021
Review #1 received
Received 25 Mar, 2021
Reviewer #3 agreed
On 23 Mar, 2021
Reviewer #2 agreed
On 22 Mar, 2021
Review #? received
Received 22 Mar, 2021
Reviewer #1 agreed
On 22 Mar, 2021
Reviewers invited
Invitations sent on 13 Mar, 2021
Editor assigned
On 11 Mar, 2021
Submission checks complete
On 11 Mar, 2021
Editor invited
On 11 Mar, 2021
First submitted
On 02 Mar, 2021
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Allergy & Immune Disorders
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This preprint is under consideration at Journal of Eating Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Rebecca Spigel
Boston Childrens Hospital: Boston Children's Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8116-9144
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 16 Mar, 2021
No community comments so far
Editorial decision: Minor Revision
On 02 Apr, 2021
Review #3 received
Received 27 Mar, 2021
Review #2 received
Received 25 Mar, 2021
Review #1 received
Received 25 Mar, 2021
Reviewer #3 agreed
On 23 Mar, 2021
Reviewer #2 agreed
On 22 Mar, 2021
Review #? received
Received 22 Mar, 2021
Reviewer #1 agreed
On 22 Mar, 2021
Reviewers invited
Invitations sent on 13 Mar, 2021
Editor assigned
On 11 Mar, 2021
Submission checks complete
On 11 Mar, 2021
Editor invited
On 11 Mar, 2021
First submitted
On 02 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Allergy & Immune Disorders
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Shelter-in-place orders and social distancing guidelines, in response to the COVID-19 pandemic, have limited traditional face-to-face interactions and led to many clinical providers transitioning to the use of videoconferencing platforms. The present study aims to assess how the COVID-19 pandemic has impacted adolescents’/young adults’ (AYA) eating disorder (ED)-related care, and how access to, changes in, perceived disruptions to, and quality of care are associated with ED thoughts and behaviors.
Methods
AYA enrolled in the RECOVERY study, a pre-existing web-based longitudinal study, completed a COVID-19-specific survey (n=89). We examined bivariate associations of four markers of care: access to and changes in care as well as perceived disruption to and quality of care. Using multiple logistic regression, we examined the associations of our pandemic-related markers of care with changes in ED thoughts and behaviors. We excluded those not engaged in treatment pre-pandemic (n=16).
Results
In the remaining 73 participants, reported access to care was high, with 92% of respondents continuing to see at least one ED provider during the pandemic; however, 47% stopped some treatment during the pandemic. Nearly one-third (32%) perceived a disruption in treatment. Quality of care remained high with 67% reporting care to be better than or as good as pre-pandemic. Respondents acknowledged heightened symptomatology: 81% reported increased ED thoughts and 81% reported increased ED behaviors due to COVID-19-related factors. However, none of the markers of care described were significantly associated with ED thoughts or behaviors in regression analyses adjusting for demographic variables and baseline characteristics, except our quality of care measure which was approaching significance (p=0.07).
Conclusions
Our findings show the majority of AYA who had care prior to the pandemic are still receiving some element of their multi-disciplinary ED treatment and perceive their care as high quality. Although none of the markers of care described were statistically associated with increased ED thoughts and behaviors, our results may indicate that continued access to care may be protective against increased ED behaviors and patients who perceive their quality of care as worse than usual might be more likely to have intrusive ED thoughts.
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