Screening Adolescent Females for Eating Disorders in Primary Care
Abstract
In recent decades, there has been an increased focus on the idealization of thinness and the pressure and expectancy to be thin, which contributes to a rising number of individuals that experience severe body dissatisfaction and body distortion, and in turn, eating disorders. Eating disorders are one of the most common chronic conditions within the youth population, approximately 13% of the adolescent youth population will suffer from at least one eating disorder by age 20, and a majority of those affected will be female. Rural health care providers encounter many health care disadvantages when detecting and treating eating disorders including physical location and distance to nearest healthcare or specialty service, ethnicity, and socioeconomic status. These disadvantages are often responsible for the inability of providers to prevent, screen for, identify, and treat eating disorders.
The focus of this practice improvement project (PIP) was to determine how primary care providers in a rural clinic perceived the implementation of the Screening for Disordered Eating (SDE) in adolescent females ages 11-19. During implementation, the providers were also to identify and refer those scoring 2 or greater to a counselor, mental health specialist, and/or eating disorder specialist. Implementation began with an educational meeting explaining eating disorders and their prevalence, as well as the introduction and explanation of the SDE tool. A survey was then completed by the providers to assess the relevance of the information provided to their practice. During the implementation period, providers were to screen all adolescent females ages 11-19 using the SDE tool and refer those scoring 2 or greater. Participating providers then completed a post-implementation survey assessing their perceptions on the ease, accuracy, and applicability of the SDE tool.
Overall, based on the post-implementation, providers believe screening for eating disorders is important and the SDE tool is easy and applicable to their practice. Screening for Disordered Eating completion rates (14.1%) and referral rates (17.4%) of those scoring 2 or greater were lower than expected. The prevalence of eating disorders continues to rise and continued use of the SDE tool in the primary care setting is strongly recommended.