An RCT of an Internet Intervention for Pediatric Encopresis With One-Year Follow-Up

Encopresis is a significant medical problem for millions of children. Despite its prevalence, poor treatment success rates indicate that it is often difficult to treat. The goal of this study was to evaluate an Internet intervention for encopresis (UCanPoopToo) with children from across the US. A 2 (Group) × 3 (Time) RCT was used to evaluate the efficacy of UCanPoopToo. Participants were randomized to a treatment-as-usual (TAU) or TAU + UCanPoopToo group. Assessments were completed at baseline (Pre), 4–6 weeks following baseline (Post), and one year follow-up (Post12). At baseline, the TAU and TAU + UCanPoopToo retrospectively reported a median 9 and 8 accidents, respectively, over the previous two weeks. Using prospective online diary data, the TAU group reported a median 8 accidents at Post and 3 accidents at Post12, compared to the TAU + UCanPoopToo group report of a median 4.5 accidents at Post and 1 accident at Post12. At Post12, a significant difference was found between success rates (≤1 accident/2 weeks) of 28% for the TAU group and 64% for the TAU + UCanPoopToo group. At Post12, a significant difference was also found between cure rates (0 accidents/2 weeks) of 20% for the TAU group and 50% for the TAU + UCanPoopToo group. This study supports the use of an Internet intervention for encopresis. Increasing the ability for clinicians to refer their patients to evidence-based Internet interventions has meaningful implications for clinical practice as it extends the reach of treatment options for patients and enables provision of interventions otherwise unavailable.