The aim of this proposal is to use personal digital assistants (PDAs) to integrate psychosocial assessments and interventions (based on Social Cognitive Theory) for disordered eating prevention for at-risk college women. PDAs have been used in two distinct capacities: (a) an assessment device employing Ecological Momentary Assessment (EMA);(b) a device for delivering interventions. The proposed work is innovative because it combines the assessment and intervention capacities of PDAs. Participants will complete EMA reports, and micro-interventions (Mis) will be administered on PDAs based on concurrent EMA responses. Mis are brief treatment extensions delivered on portable devices. The Ml will be targeted to three specific experiences (eating, media exposure, negative mood) when women are most vulnerable to body image dissatisfaction (identified in preliminary research). Undergraduate women at-risk of developing disordered eating (n=144) will be randomly assigned to a CD-ROM intervention and EMA reports (EMA+CD), CD, EMA and micro-interventions (EMA+CD+MI), or EMA only (EMA) groups. All participants will complete baseline assessments of body image dissatisfaction, disordered eating, and psychological well-being. Six times daily for the following 1 week, participants will complete EMA surveys (including body image dissatisfaction, eating behavior, media exposure, and mood items) on PDAs. The EMA+CD and EMA+CD+MI groups will receive the Food, Mood, and Attitude CD-ROM intervention. One week later all participants will receive the PDAs again and complete the same EMA survey. The EMA+CD+MI group will also receive targeted. Mis consist of reminders to use skills learned in the CD-ROM and will be administered on the PDA immediately following the survey, and then 10 to 20 minutes following the EMA. All participants will complete 1- and 3-month follow-up assessments of disordered eating, body image dissatisfaction, and psychological well-being. The EMA only group will receive the CD-ROM intervention after completing the 3-month assessment. All participants will be given referral information if they wish to seek additional care. The public health significance of this research includes the innovative development of a methodology to increase the efficacy of eating pathology prevention programs (i.e., micro-interventions). These prevention programs will prove useful in reducing the incidence of eating disorders and have implications for other treatments and prevention strategies, by informing the development and implementation of treatment extensions more broadly.
