Harrison, Amy;
Zaremba, Natalie;
Brown, Jennie;
Pillay, Divina;
Allan, Jacqueline;
Tan, Rachael;
Treasure, Janet;
... Stadler, Marietta; + view all
(2025)
A quantitative process evaluation of a feasibility randomised controlled trial of a co-designed cognitive behavioural therapy intervention for people with type 1 diabetes and disordered eating (steady trial): Auditing treatment integrity and delivery.
Diabetic Medicine
, Article e70124. 10.1111/dme.70124.
(In press).
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Abstract
Aims: Safe management of people with Type 1 diabetes and Eating Disorders study (STEADY), a complex psychological intervention, defined by the Medical Research Council as involving multiple interacting components and individualised delivery, is a treatment designed for people with Type 1 diabetes and mild-to-moderate disordered eating (T1DE) which integrates cognitive behavioural therapy (CBT) with diabetes education. STEADY was previously tested in a feasibility randomised controlled trial (RCT), and the purpose of this work was to maximise trial learning to support future scaling up of STEADY in a multi-site RCT. // Methods: This study addressed three research questions: (1) Which STEADY toolkit tools were used in the intervention, and at which point? (2) To what extent was treatment delivered as intended, reflecting the minimum competency (≥3) on the Cognitive Therapy Rating Scale (Revised; CTS-R)? (3) How long did it take to deliver the STEADY intervention? // Results: A range of STEADY tools were used during the trial; the five most frequent tools were CBT formulation (72 uses), behavioural experiments (47 uses), thought records (43 uses), goal setting (40 uses) and understanding emotions and ‘riding the wave’ (40 uses). The CTS-R mean score was 3.81 ± 0.74, indicating competent adherence to CBT. Mean time to completion was 153.3 days (SD = 73). // Conclusions: When scaling up for a multi-site RCT, some participants may need greater flexibility regarding timing to access all STEADY sessions. STEADY can be personalised through its toolkit-based approach, and therapists should be mindful and trained in the range of tools available.
| Type: | Article |
|---|---|
| Title: | A quantitative process evaluation of a feasibility randomised controlled trial of a co-designed cognitive behavioural therapy intervention for people with type 1 diabetes and disordered eating (steady trial): Auditing treatment integrity and delivery |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/dme.70124 |
| Publisher version: | https://doi.org/10.1111/dme.70124 |
| Language: | English |
| Additional information: | Copyright © 2025 The Author(s). Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Cognitive behavioural therapy, disordered eating, eating disorders, process evaluation, randomised controlled trial, Type 1 diabetes |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Psychology and Human Development |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213942 |
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