Effectiveness of Peer-Led Eating Disorder Groups

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Program Evaluation Design

Eating Disorder Program

The university hospital in our city has developed a strong program focused on a spectrum of eating disorders. Disorders addressed include anorexia, bulimia nervosa, compulsive eating, obesity, and a variety of non-traditional eating disorders. Our hospital approaches these issues on many levels, and our staff includes highly trained psychiatrists and psychologists, as well as skilled nutritionists to develop personalized eating plans tailored to each patient. Gastroenterologists, endocrinologists, and other specialists are also part of our team, since the severity of eating disorders can lead to serious and life-threatening conditions.

We also recognize the value of peer support and have incorporated two peer-led groups that focus on eating disorders education as well as prevention. The groups have been meeting weekly for nearly six months. The meetings for each group are structured in the same way, and the length of each meeting is 90 minutes. The larger group contains 13 members; the second group contains 7. All group members are female and they range in age from 13 to 18. All have significant eating disorders that have disrupted their normal lives, affected family members, and in some cases threatened their health. Before being admitted to the group, however, each member was physically and psychologically assessed to determine their readiness to be in a group setting. All members have been treated at our clinic and have joined the group voluntarily, although they received encouragement from staff to join. No one who was asked to join the group refused to become a member, and other than one member relocating out-of-state, membership has been fairly consistent over the six-month period. By design, each group receives the same intervention. Our program director has requested that we design a study to evaluate the effectiveness of the groups and to make recommendations as needed. Her concern is the overall effectiveness of the groups; a secondary concern is the type of intervention that seems to have the most positive impact on group members.

1. List at least one research question that you would like address in your study.

One research question I would like to address in this study is: which of the three interventions offered seems to be the most effective in each group setting. Three are currently in use. Dialectical Behavioral Therapy (DBT) focuses on emotions and triggers. Acceptance and Commitment Therapy (ACT) is empirically based and guides group members to accept negative and deal with negative feelings and unwelcome thoughts rather than resort to their disorder. The Food & Mood Program, as it sounds, explores the complex relationships between different types of foods and their effects on blood sugar, energy levels, and other physical and/or emotional reactions. One type of intervention is used at each meeting as a way of structuring the group's time together.

2. Operationally define your dependent variable(s). How will you measure your dependent variable(s)? The dependent variable here is the success rate of each of the three types of interventions: which seems to have a stronger and more positive impact: DBT, ACT, or the Food & Mood Program? To measure this, we will rely to a large extent on the group members themselves, who will be asked a series of questions at the end of each session. These questions are designed to measure emotional states and feelings of satisfaction and have been used successfully in earlier studies. Other than questionnaires, observation will elicit additional data. Participants will also be observed over time to determine whether there are any identifiable patterns to be explored.

3. Describe your research design and your method for collecting data. The method for collecting data will be limited to weekly questionnaires for a three-month period as well as ongoing observation. Measurements such as amounts of weight gained or lost, or episodes of bulimia of compulsive eating, will not be considered as part of the study. Because of the wide spectrum of eating disorders that group members have been diagnosed with, this type of data collection would render little of value for purposes of this study.

4. Describe how you plan to create your sample. Because of the limited number of participants in the groups, and because of the sensitive nature of the disorders they suffer from, we will be dealing with a very small sample. The purpose of the program evaluation is first of all, to assess its overall effectiveness. Next, we will try to determine the type of intervention that seems to be most successful with the members. For example, are there identifiable patterns? Do some individuals respond positively to a particular treatment, and if so, are there any correlating factors to explain this response? Another possibility, of course, is timing: is it too soon to extract valid data from these groups?