Implementation of a Waitlist Intervention and Clinical Care Pathway for Families Awaiting at Eating Disorders Program

Overview

The COVID-19 pandemic has resulted in several challenges in service delivery for the eating disorders program at McMaster Children's Hospital. Long waiting lists prior to the pandemic (6-9 month wait time) have been made worse by an interruption in service during the initial stages of the pandemic. New routine assessments were placed on hold for many months, while only the most urgently ill children were seen. This, in combination with a dramatic increase in new referrals has resulted in a long waitlist. Now families are waiting 12-18 months for service. The resulting waitlist is now unmanageable and unsafe. Investigators wish to study the implementation of a waitlist intervention which will educate parents on how to start to renourish their children and interrupt eating disordered behaviors. The intervention will consist of a series of educational videos and a book on how to help their children. It is hoped that this intervention can lessen the need for hospitalization and can change the trajectory of symptoms while waiting for service. A clinical care pathway will also be developed to ensure those waiting receive the most appropriate treatment.

Investigators would like to study the implementation of an adapted FBT model in which there is no therapist involvement and the intervention is delivered to families on the waitlist of Eating Disorder program at McMaster Children's Hospital. The intervention would involve a series of prerecorded videos and reading material. This, in combination with the development of a clinical care pathway, would help to manage the extraordinary volumes of referrals recently been received. The need to social distance brought on by the pandemic presents the opportunity to consider the value of this waitlist intervention as a structured program for parents who have a child waiting for service. A model such as this could dramatically improve parental abilities to begin to re-feed their children, thereby reducing acuity and time spent in treatment. Similarly, some parents on the waitlist may decide that the proposed treatment model is not suitable after they have received the proposed waitlist intervention, and may wish to seek treatment elsewhere. Alternatively, parents may be able to shift the pattern of weight loss and/or binge purge behavior in children so that the severity of illness is decreased by the time of assessment. If successful, this intervention and clinical care pathway for waitlisted patients and their families could be disseminated to other tertiary care centers, thereby reducing mounting pressures on these centers.