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Symposia

Adult- Health Psychology / Behavioral Medicine

Opening Doors: Innovative Digital or Mobile ACT Interventions for Behavioral Medicine Populations

3 - (SYM 99) A Randomized Controlled Trial of Iact: A Hybrid Intervention for Eating Disorders in Type 1 Diabetes

Saturday, November 16, 2024
2:30 PM – 3:30 PM EST
Location: Regency Ballroom A, Second Floor Mezzanine, Loews Hotel
Abstract Body

Type 1 diabetes (T1D) is an autoimmune disorder that requires close monitoring of eating and exercise and administration of life-saving insulin to maintain near euglycemia. Studies indicate up to 32% of young women with T1D have an eating disorder (ED)(Colten et al., 2015), increasing risk for early and severe diabetes-related complications and early mortality (a nearly 6-fold increase relative to their peers without an ED)(Gibbings et al., 2021). Conventional ED treatments for anorexia and bulimia nervosa are less effective among individuals with T1D indicating the need for more tailored approaches. We have conducted several studies to identify multi-level, multi-dimensional contextual factors associated with ED symptoms in individuals with T1D, such as the presence of low blood sugar (Merwin et al., 2014) or specific times of day behaviors are most likely to occur (Merwin et al., 2018), as well as general and momentary cognitive and emotional precipitants to ED behaviors (Merwin et al. 2015; Moskovich et al., 2019). We translated findings from this body of work into iACT, a novel hybrid in-person and digital intervention for EDs in T1D that uses mobile phones to deliver interventions at the time and place they are most needed and facilitate skills practice. Our initial open trial demonstrated iACT was acceptable and feasible, with preliminary evidence of improvements in ED behaviors, diabetes management and glycemic control (Merwin et al., 2021). We are currently testing a modified version of iACT, following feedback from key stakeholders, in a multi-site randomized control trial (Target N=128) for individuals with T1D (ages 16-50) with an ED characterized by binge eating or purging (including withholding insulin to lose weight). We will present the results from our community engagement studios (Joosten et al., 2015; NIH), and an in-depth overview of the clinical trial and progress to date (N=20; 75% Female-identifying, Age M=32.25, SD=8.02, 55% White, 20% Black, 5% Asian, 20% More than one race; 10% Hispanic/Latinx). This will include discussion of how we translated study findings into digital interventions tailored to the needs of this population, with mobile text messaging to recontextualize T1D, shape awareness of thoughts/feelings and associated needs (e.g., need for acceptance, defusion, values, grounding or centering), and deliver intervention targeting identified struggles and needs in real-time (e.g., interventions to increase acceptance of diabetes distress to support adaptive eating and diabetes management).