title: Process evaluation of the MOSAIC trial: treatment experience of two psychological therapies for out-patient treatment of Anorexia Nervosa.
abstract: BACKGROUND
  This study is part of a series of process evaluations within the MOSAIC Trial (Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions). This randomised controlled trial (RCT) compared two psychological treatments, the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM) for adult outpatients with Anorexia Nervosa. The present process study integrates quantitative (treatment acceptability and credibility) and qualitative (written) feedback to evaluate patients' treatment experiences.
  
  
  METHODS
  All 142 MOSAIC participants were asked to (a) rate treatment acceptability and credibility on visual analogue scales (VAS) at six and 12 months post-randomisation, and (b) provide written feedback regarding their views on their treatment at 12 months. Transcripts were first analysed thematically and then rated according to the global valence of feedback (positive, mixed/negative).
  
  
  RESULTS
  114/142 (80.3 %) MOSAIC participants provided VAS data and 82 (57.7 %) provided written feedback. At 12 months, MANTRA patients gave significantly higher acceptability and credibility ratings compared to SSCM patients. A significantly higher proportion of MANTRA patients provided written feedback. MANTRA patients also tended to write in more detail and to give globally more positive feedback when compared to individuals receiving SSCM. Qualitative themes suggest that patients experienced the two treatments differently in terms of characteristics and outcomes.
  
  
  CONCLUSIONS
  This study highlights the benefits of incorporating qualitative and quantitative data into RCT process evaluations. MANTRA patients were more willing to express their views on treatment and generally felt more positively about this than those receiving SSCM.
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Kelly Ann
authors: KA
authors: Zainal
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Beth
authors: B
authors: Renwick
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Alexandra
authors: A
authors: Keyes
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Anna
authors: A
authors: Lose
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Martha
authors: M
authors: Kenyon
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Hannah
authors: H
authors: DeJong
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Hannah
authors: H
authors: Broadbent
authors: Hope Wing, Porters Avenue Health Centre, North East London Foundation Trust, Dagenham, Essex UK.|Eating Disorders Research Group, Research Dept. of Clinical, Educational & Health Psychology, University College London, London, UK.
authors: Lucy
authors: L
authors: Serpell
authors: The Phoenix Wing, St Ann's Hospital, Barnett, Enfield and Haringey Mental Health Trust, Tottenham, London, UK.
authors: Lorna
authors: L
authors: Richards
authors: The Phoenix Wing, St Ann's Hospital, Barnett, Enfield and Haringey Mental Health Trust, Tottenham, London, UK.
authors: Eric
authors: E
authors: Johnson-Sabine
authors: Oxford Adult Eating Disorder Service, Cotswold House, Warneford Hospital, Oxford NHS Foundation Trust, Oxford, UK.
authors: Nicky
authors: N
authors: Boughton
authors: Oxford Adult Eating Disorder Service, Cotswold House, Warneford Hospital, Oxford NHS Foundation Trust, Oxford, UK.
authors: Linette
authors: L
authors: Whitehead
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Janet
authors: J
authors: Treasure
authors: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO Box 59, SE5 8AF London, UK.
authors: Ulrike
authors: U
authors: Schmidt
keywords: Anorexia nervosa; MANTRA; Process evaluation; Randomised–controlled trial; Specialist supportive clinical management