Symposia
Health Care System / Public Policy
Julia K. Nicholas, B.S.
PhD Student
University of Louisville
Louisville, Kentucky
Taylor E. Penwell, PhD
Study Coordinator
University of Louisville
Louisville, Kentucky
Caroline Christian, M.S.
Doctoral Student
The University of Louisville
Fort Thomas, Kentucky
Kate Overberg-Wagoner, MSSW
Program Administrator
Kentucky Eating Disorders Council
Frankfort, Kentucky
Nicholas Peiper, PhD, MPH
Associate Professor
University of Louisville
Louisville, Kentucky
Cheri Levinson, Ph.D.
Associate Professor
University of Louisville
Louisville, Kentucky
Objective: Early identification and intervention are critical for eating disorder (ED) recovery, as left untreated, ED symptoms tend to increase in severity and become entrenched (Keel et al., 2003; Zipfel et al., 2000). Early identification is especially important in rural states with fewer ED treatment resources, as patients requiring higher levels of care often need to travel out of state to receive treatment, resulting in additional logistical and financial barriers to care. Primary care presents critical opportunities for early identification and treatment initiation; yet, EDs often go unrecognized in these patient encounters. Using data collected by a state eating disorders council, the current study examines screening and assessment practices among medical and behavioral health providers across a rural U.S. state to identify potential provider-focused barriers to timely ED diagnosis and treatment.
Methods: N = 242 healthcare providers (n = 209 behavioral health, n = 33 medical) practicing in a rural U.S. state completed an online survey about their ED assessment and treatment practices. Medical providers reported their levels of training, knowledge, and confidence in screening for EDs. Response frequencies were calculated to pinpoint potential areas for improved ED detection and intervention.
Results: 35.4% of behavioral health providers and 30.3% of medical providers reported that they do not screen patients for EDs. Just 3.3% of behavioral health providers and 18.2% of medical providers endorsed using an ED-specific screening tool. The most commonly reported reason for not screening was that providers were not sure how to screen (18.6% of behavioral health providers, 6.1% of medical providers). Among medical providers, while 87.9% had formal training on ED assessment and treatment, 39.3% endorsed a lack of knowledge about ED screening, and 39.3% reported being uncomfortable screening for EDs.
Conclusions: Healthcare providers varied widely in their ED assessment practices, with very few using evidence-based, ED-specific screening tools. Medical providers reported low levels of knowledge and comfort with screening for EDs. These findings highlight a need for continuing education focused on evidence-based screening for EDs and stigma-reduction among providers. The current study demonstrates the potential for partnering with legislative bodies to inform data-driven policies that address barriers to care.