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Objective: Fraudulent participation is an escalating concern for online clinical trials and research studies and can have a significant negative impact on findings. We aim to shed light on the risk and to provide practical recommendations for detecting and managing such instances. Methods: The FREED‐Mobile (FREED‐M) study is an online, randomized controlled feasibility trial to assess a digital early intervention for young people (aged 16–25) in England or Wales with eating problems. The trial involved baseline (week 0), post‐intervention (week 4), and follow‐up (week 12) surveys, alongside weekly modules provided over 4 weeks on the study website. Study completers were compensated with £20 shopping vouchers. Despite the complexity of the trial design, two instances of fraudulent sign‐ups occurred in January and March 2023. To counter this, we developed a "fraudulent participants protocol" following internal investigations and discussions with collaborators. Results: The implementation of prevention measures such as reCAPTCHA updates, IP address review, and changes in reimbursement effectively halted further fraudulent sign‐ups. Our protocol facilitated the systematic identification and withdrawal of suspected or clear fraudsters and was demonstrably robust at distinguishing between fraudsters and genuine responders. Discussion: All remote, online trials or studies are at risk of fraudulent participation. Drawing from our experience and existing literature, we offer practical recommendations for researchers considering online recruitment and data collection. Vigilance and the integration of deterrents, and data quality checks into the study design from the outset are advised to safeguard research integrity. Public Significance: Fraudulent participation in digital research can have asignificant impact on research findings, potentially leading to biased resultsand misinformed decisions. We developed an effective protocol for theprevention, identification, and management of fraudulent participants. Bysharing our insights and recommendations, we hope to raise awareness of thisissue and provide other researchers with the knowledge and strategies necessaryto safeguard research integrity moving forward. [ABSTRACT FROM AUTHOR]

A sample of 14-year-old boys and girls were studied using previously collected biomedical, familial, antenatal, demographic, and social data to identify prospective predictors of eating disorders. Findings suggest that parents' perceptions on their child's weight were more powerful predictors of the development of eating disorders compared to objective child body weight.

Objective: This paper outlines the evidence base for early intervention for eating disorders; provides a global overview of how early intervention for eating disorders is provided in different regions and settings; and proposes policy, service, clinician and research recommendations to progress early intervention for eating disorders. Method and Results: Currently, access to eating disorder treatment often takes many years or does not occur at all. This is despite neurobiological, clinical and socioeconomic evidence showing that early intervention may improve outcomes and facilitate full sustained recovery from an eating disorder. There is also considerable variation worldwide in how eating disorder care is provided, with marked inequalities in treatment provision. Despite these barriers, there are existing evidence‐based approaches to early intervention for eating disorders and progress is being made in scaling these. Conclusions: We propose action steps for the field that will transform eating disorder service provision and facilitate early detection, treatment and recovery for everyone affected by eating disorders, regardless of age, socioeconomic status and personal characteristics. Highlights: Early intervention for eating disorders is in its infancy.We summarise existing early intervention approaches for eating disorders from around the globe.We propose key policy, service, clinician, and research recommendations to progress early intervention for eating disorders. [ABSTRACT FROM AUTHOR]

Aim: First Episode Rapid Early Intervention for Eating Disorders (FREED) is an early intervention model for young people with recent‐onset eating disorders (ED). Promising results from a previous single‐centre study and a four‐centre study (FREED‐Up) have led to the rapid national scaling of FREED to ED services in England (FREED‐4‐All). Our aim was to evaluate duration of an untreated ED (DUED), wait time target adherence, and clinical outcomes in FREED‐4‐All and compare these to the (benchmark) findings of the earlier FREED‐Up study. Method: FREED services submit de‐identified data to the central FREED team quarterly. The current study covers the period between September 2018 and September 2021. This FREED‐4‐All dataset includes 2473 patients. These were compared to 278 patients from the FREED‐Up study. Results: DUED was substantially shorter in the FREED‐4‐All dataset relative to the FREED‐Up study (15 vs. 18 months). Adherence to the wait time targets was comparable in both cohorts (~85% of engagement calls attempted in <2 days, ~50%–60% of assessments offered in <14 days, ~40% of treatment offered in <28 days). Patients in the FREED‐4‐All dataset experienced significant improvements in ED and general psychological symptoms from pre‐ to post‐treatment that were comparable to the FREED‐Up study. These findings should be interpreted cautiously as only 6% of FREED‐4‐All patients had post‐treatment data. Conclusions: Data from the FREED‐4‐All evaluation suggest that FREED is replicating at scale. However, these data are flawed, uncertain, proximate, and sparse and should therefore be used carefully alongside other evidence and clinical experience to inform decision making. [ABSTRACT FROM AUTHOR]

Objective: First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway which aims to provide timely, well‐coordinated, developmentally informed and evidence‐based care for young people with eating disorders (EDs). This article investigates the impact of the COVID‐19 pandemic on FREED patient presentations and service provision in England. Method: Data from three services spanning the pre‐ to post‐pandemic period were included (January 2019–September 2021; n = 502 patients). Run charts were created to analyze changes in monthly baseline patient data (e.g., referral numbers, duration of an untreated ED, diagnostic mix, and average body mass index for patients with anorexia nervosa [AN]). Results: Significant increases in referral numbers were found from September 2020 onward, coinciding with the end of the first UK national lockdown. The percentage of AN presentations significantly increased after the onset of the first national lockdown (April 2020–December 2020). No other significant change patterns were identified. Discussion: There have been substantial increases in referral numbers and presentations of AN to FREED services whereas illness severity seems largely unchanged. Together, this suggests that increased referrals cannot be attributed to milder presentations being seen. Implications for the implementation, funding, and sustainability of the model are discussed. Public Significance: Our research suggests that early intervention eating disorder services across England faced significant increases in patient referrals and presentations of anorexia nervosa over the COVID‐19 pandemic. This increase in referrals is not due to a rise in milder eating disorder cases, as baseline symptom severity remained stable across the pandemic. Investment in early intervention for eating disorders must therefore match increased referral trends. [ABSTRACT FROM AUTHOR]