ArticleBJPsych open2021
Assessing implementation fidelity in the First Episode Rapid Early Intervention for Eating Disorders service model.
Article in BJPsych open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 21 citations in OpenAlex.
- Recent Innovations in Eating Disorder Prevention and Early Intervention.Current psychiatry reports · 2025Review
- Implementation Fidelity in Early Intervention for Eating Disorders-A Multisite Pilot Study.Behavioral sciences (Basel, Switzerland) · 2025Article
- Recent Advances and Future Directions in Eating Disorder Treatments for Emerging Adults.Current psychiatry reports · 2025Review
- Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study.Journal of eating disorders · 2024Article
- A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope.Journal of eating disorders · 2023Article
- "Early intervention isn't an option, it's a necessity": learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England.Frontiers in health services · 2023Article
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Authors and funding
21 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe First Episode Rapid Early Intervention for Eating Disorders (FREED) service model is associated with significant reductions in wait times and improved clinical outcomes for emerging adults with recent-onset eating disorders. An understanding of how FREED is implemented is a necessary precondition to enable an attribution of these findings to key components of the model, namely the wait-time targets and care package.
aimsThis study evaluated fidelity to the FREED service model during the multicentre FREED-Up study.
methodParticipants were 259 emerging adults (aged 16-25 years) with an eating disorder of <3 years duration, offered treatment through the FREED care pathway. Patient journey records documented patient care from screening to end of treatment. Adherence to wait-time targets (engagement call within 48 h, assessment within 2 weeks, treatment within 4 weeks) and care package, and differences in adherence across diagnosis and treatment group were examined.
resultsThere were significant increases (16-40%) in adherence to the wait-time targets following the introduction of FREED, irrespective of diagnosis. Receiving FREED under optimal conditions also increased adherence to the targets. Care package use differed by component and diagnosis. The most used care package activities were psychoeducation and dietary change. Attention to transitions was less well used.
conclusionsThis study provides an indication of adherence levels to key components of the FREED model. These adherence rates can tentatively be considered as clinically meaningful thresholds. Results highlight aspects of the model and its implementation that warrant future examination.
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