This project aims to develop, validate, and assess a digital education tool, called TRIPS, to facilitate effective service transitions in eating disorder (ED) care.
Background
Transitions from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) present great challenge for ED patients. Typically occurring at 18 years of age, these transitions coincide with peak ED onset (15–19 years), as well as decreased family contact and support. Many patients are therefore lost to follow-up after discharge from CAMHS, with only 25% of those requiring ongoing care making the transition to AMHS. A small body of qualitative (n=8), cross-sectional (n=2), and longitudinal (n=3) studies has further shown that service transitions are problematic for ED patients, caregivers, and providers alike. These results point to various—often intersecting—temporal (e.g., developmental stage), stakeholder (e.g., provider knowledge), and systemic (e.g., service alliance) factors that contribute to loss of care and poor transitions.
Project Aims
This project aims to: (1) identify any new strategies to include in the TRIPS tool; (2) determine which strategies predict service transition outcomes; and (3) evaluate the feasibility, acceptability, and utility of the TRIPS tool. Lastly, we will develop a public-facing website that houses the TRIPS tool.
Project Activity
- For Aim 1, we will conduct three PPIE advisory groups with patients (n=6), caregivers (n=6), and providers (n=6), who have lived experience of EDs, caring for those with EDs, or transferring patients with EDs, respectively. We will present the TRIPS tool and obtain PPIE feedback on the proposed strategies.
- For Aim 2, we will develop and validate the TRIPS tool, using regression analysis to determine which strategies significantly predict service transition outcomes, namely ED psychopathology. Patients with EDs (n=200) who have transitioned in the past year, will be recruited directly via Prolific, an online recruitment platform, or directed to Prolific via ED charities. Patients will complete the TRIPS tool regarding their recent transition experience and report current ED symptoms (e.g., EDE-Q).
- For Aim 3, we will conduct three qualitative focus groups with patients (n=10), caregivers (n=10), and providers (n=10). Here, we will probe the feasibility, acceptability, and utility of the TRIPS tool. Findings will inform future implementation and effectiveness studies.
- Lastly, we will develop a public-facing website that houses the TRIPS tool, available to patients, caregivers, and providers online.
Anticipated or actual outputs
This project has potential to improve service transitions for patients with EDs, a population that suffers from both psychological and physical impairments, which become chronic and more severe over time, and are associated with significant morbidity and mortality.
Papers/resources associated with this project
Ragnhildstveit, A., Tuteja, N., Seli, P. et al. Transitions from child and adolescent to adult mental health services for eating disorders: an in-depth systematic review and development of a transition framework. J Eat Disord 12, 36 (2024). https://doi.org/10.1186/s40337-024-00984-3
Who is involved?
- Dr Sharon Neufeld (PI, correspondant), University of Cambridge, Psychiatry
- Ms. Anya Ragnhildstveit, University of Cambridge, Psychiatry
- Prof Tamsin Ford, University of Cambridge, Psychiatry
