597 - Spotting the Signs: Current Barriers and Future Opportunities in School-Based Eating Disorder Detection

Publication Number: 597.6557

Nina Shevzov-Zebrun, Lucile Packard Children's Hospital Stanford, Redwood City, CA, United States; Anagha Dogiparthi, Stanford University School of Medicine, Santa Clara, CA, United States; Bonnie Halpern-Felsher, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Early detection of eating disorders (ED) facilitates effective treatment and improves outcomes. Due to frequent and longitudinal interactions with youth, school faculty/staff may be uniquely poised to detect early signs of ED in students. Limited extant research examines the role of schools in ED identification.

Objective: To (1) describe the current state of policies/practices around ED detection in California (CA) middle and high schools, and (2) identify barriers to, and possible future roles for, school-based ED screening in CA and beyond.

Design/Methods: This descriptive study consisted of a demographic Qualtrics survey followed by 90-minute semi-structured focus groups (FG). Participants were either a) educators/staff at CA public middle or high schools, or b) caregivers of 6th-12th grade students in CA. Discussion covered four general domains: 1) background knowledge of ED, 2) status quo of school practices around ED, 3) barriers to/facilitators of school involvement regarding ED, and 4) potential future school roles and/or policies. Surveys were evaluated using SPSS Statistics 29. FG transcriptions were thematically coded and analyzed.

Results: 10 caregivers (ages 39-58; 7 F) and 5 educators (ages 38-73; 4 F) participated across 5 FG. Several key themes emerged from FG analysis: 1) caregivers and educators alike were unaware of any ED-related guidelines at schools; 2) while educators suspecting ED may seek assistance from school wellness teams, caregivers were uncertain how schools approach ED concerns; 3) barriers to ED detection included factors that are school-specific (e.g., overburdened system), intrinsic disease-specific (e.g., secretive nature), and social (e.g., stigma); 4) despite mixed views on the feasibility and ideal nature of school involvement in ED detection, there was broad support for establishment of formal guidelines/policies.

Conclusion(s): Despite policies around suicide prevention and other mental health issues, CA schools appear to lack policies regarding ED. This gap is concerning given the diverse and life-threatening nature of ED. While the ideal role for schools in ED detection appears controversial, this study suggests robust support for general establishment of ED-related guidelines. Barriers include school-specific, disease-specific, and social factors; cutting across is stark lack of training on ED, ED detection and counseling for educators. Future efforts should thus focus on: 1) enhancing educator knowledge about ED, and 2) concretely delineating ideal roles for schools to support ED detection, including any prerequisite practical and/or ideological reforms.