title: Decreasing the duration of untreated illness for individuals with anorexia nervosa: study protocol of the evaluation of a systemic public health intervention at community level.
abstract: BACKGROUND
  Anorexia nervosa (AN) is a mental disorder with grave burdens for affected individuals as well as for the healthcare system. One of the strongest predictors of a poor outcome is a long Duration of Untreated Illness (DUI), which is defined as the time between the onset of the disease and treatment initiation. Reducing the DUI is an important step to optimize care of individuals with AN. In order to achieve this aim, systemic public health interventions are necessary. Objective of this study is to evaluate a systemic public health intervention at Community level aiming to reduce the DUI in individuals with AN.
  
  
  METHODS
  The intervention includes the establishment of a network of health care professionals within the area of eating disorders (EDs), the development of an internet-based treatment guide, the presentation of informative short-films about EDs in cinemas and a corresponding poster campaign as well as a special outpatient clinic. For the evaluating study a pre-post between-subject design is chosen. The DUI, and the duration until first contact (DUC) with a health care professional, ED pathology as well as comorbidity are assessed before and after the systemic intervention is carried out.
  
  
  CONCLUSIONS
  The study attempts to provide evidence of the effectiveness of an ED-related systematic public health intervention. Additionally, the study will lead to a better understanding of the DUI, which is essential in order to improve care of individuals with AN.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN44979231 ; Registered 11 November 2011.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany. a.gumz@uke.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Gumz
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany. n.uhlenbusch@uke.de.
authors.forename: Natalie
authors.initials: N
authors.lastname: Uhlenbusch
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany. a.weigel@uke.de.
authors.forename: Angelika
authors.initials: A
authors.lastname: Weigel
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. k.wegscheider@uke.de.
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.affiliation: Department of Children and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Münster, Germany, Schmeddingstr 50, Münster, 48149, Germany. Georg.Romer@ukmuenster.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Romer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany. b.loewe@uke.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D006801:Humans; D011634:Public Health / Q000379:methods*; D012111:Residence Characteristics; D013997:Time Factors