Author ORCID Identifier

https://orcid.org/0000-0002-9105-0817

Date Available

5-1-2025

Year of Publication

2025

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Leslie Scott

Committee Member

Dr. Ashton Dixon

Faculty

Dr. Elizabeth Tovar

Abstract

Background: The incidence of eating disorders has been on the rise, often beginning in adolescence and continuing well into adulthood. Consequences of untreated disrupted eating patterns can affect multiple body systems and are responsible for thousands of deaths annually. Despite these facts, research and data regarding eating disorders in adolescent patients are severely deficient. There is also a lack of standardization regarding assessing eating disorders in the pediatric primary care setting, as there are no specific guidelines or screening processes recommended by the American Academy of Pediatrics for the detection of eating disorders.

Purpose: The purpose of this project is to pilot an eating disorder protocol to a pediatric primary care clinic in Jasper, Indiana. The target population for this project were adolescents ages 12-17 years presenting for routine wellness exams.

Design: A quasi-experimental design was used for this project to evaluate interventions.

Methods: A pretest-posttest quasi-experimental design was used to evaluate intervention strategies’ impact on eating disorder screening rates in the pediatric primary care setting. A 4-week retrospective chart review was conducted prior to implementing the eating disorder protocol. The protocol consisted of administrating the EDE-QS to all patients 12 to 17 years of age who presented for a wellness examination. The protocol also included education to participating providers, which consisted of eating disorder significance, consequences, the importance and current data that exists in favor of routine screening, treatment recommendations set forth by the American Academy of Pediatrics, and resources for further information. Current practices in relation to referrals were utilized, including psychiatrists and counselors, nutritionists and dieticians, feeding clinics, and inpatient treatment at outside facilities. A 4-week prospective chart review was conducted to understand the change in screening rates and the prevalence of eating disorder behaviors among this age group. Data was analyzed using Pearson’s Correlation Coefficient to discover strengths of relationships between patient responses and age, as well as patient responses and BMI.

Results: Zero patients out of 37 were screened in the retrospective chart review. Twenty patients were screened using the EDE-QS in the 4-week prospective review. Nine responded with a score of 0, while 11 scored with a 1 or higher. The overall mean score was 3.45. Five patients scored above the EDE-Q mean global score of 1.4 and five patients reported behaviors specific for eating disorder behaviors. The Weight Concern subscale yielded the highest scores, with all 11 patients who responded with a 1 or greater on the EDE-QS revealing some degree of weight concern, despite majority of participants being considered “healthy weight,” per their BMI. There were positive correlations between age and EDE-QS scores and BMI and EDE-QS scores, but relationships were weak (p=.653, p=.698 respectively) and not clinically significant given sample size and other limitations.

Conclusion: The EDE-QS has proven to have the potential to be a useful tool in the primary care setting, as it is brief and requires a shorter recall from patients when compared to other versions. There were no clinically significant patterns or trends in data to suggest that patients with specific demographics are at risk due to limited sample size and lack of diversity. Further research is needed for accurate conclusions to be made regarding eating disorders in adolescents.

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