{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:46:56Z","timestamp":1769046416810,"version":"3.49.0"},"reference-count":37,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec id=\"S205647242100051X_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The 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.<\/jats:p><\/jats:sec><jats:sec id=\"S205647242100051X_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>This study evaluated fidelity to the FREED service model during the multicentre FREED-Up study.<\/jats:p><\/jats:sec><jats:sec id=\"S205647242100051X_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Participants were 259 emerging adults (aged 16\u201325 years) with an eating disorder of &lt;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.<\/jats:p><\/jats:sec><jats:sec id=\"S205647242100051X_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>There were significant increases (16\u201340%) 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.<\/jats:p><\/jats:sec><jats:sec id=\"S205647242100051X_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>This 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.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjo.2021.51","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T08:16:04Z","timestamp":1620375364000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Assessing implementation fidelity in the First Episode Rapid Early Intervention for Eating Disorders service model"],"prefix":"10.1192","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3826-6317","authenticated-orcid":false,"given":"Katie L.","family":"Richards","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Flynn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia","family":"Austin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Lang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina L.","family":"Allen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjeet","family":"Bassi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Brady","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Connan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Franklin-Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Glennon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William Rhys","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuda","family":"Kali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Koskina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Mahony","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria A.","family":"Mountford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Nunes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique","family":"Schelhase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Serpell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"S205647242100051X_ref21","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.12.2.123"},{"key":"S205647242100051X_ref13","article-title":"Assessing the impact of First Episode Rapid Early Intervention for Eating Disorders on duration of untreated eating disorder: a multi-centre quasi-experimental study","author":"Flynn","year":"2020","journal-title":"Eur Eat Disord Rev"},{"key":"S205647242100051X_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s10464-008-9165-0"},{"key":"S205647242100051X_ref37","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-014-0548-2"},{"key":"S205647242100051X_ref4","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23265"},{"key":"S205647242100051X_ref12","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00064"},{"key":"S205647242100051X_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033656"},{"key":"S205647242100051X_ref26","doi-asserted-by":"publisher","DOI":"10.1080\/03610918.2017.1295152"},{"key":"S205647242100051X_ref27","doi-asserted-by":"publisher","DOI":"10.1037\/mot0000127"},{"key":"S205647242100051X_ref36","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2695"},{"key":"S205647242100051X_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2012.02766.x"},{"key":"S205647242100051X_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000641"},{"key":"S205647242100051X_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-020-01165-0"},{"key":"S205647242100051X_ref33","unstructured":"33 Academic Health Science Network. Early Intervention Eating Disorders: Supporting Mental Health Teams Across England to Speed Up Diagnosis and Treatment of Eating Disorders in Young People. NHS England, 2020 (https:\/\/www.ahsnnetwork.com\/about-academic-health-science-networks\/national-programmes-priorities\/early-intervention-eating-disorders)."},{"key":"S205647242100051X_ref11","unstructured":"11 RE-AIM Workgroup. Welcome to RE-AIM.org . 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