Informing mHealth and Web-Based Eating Disorder Interventions: Combining Lived Experience Perspectives With Design Thinking Approaches

Abstract

Background App-based interventions designed to prevent and treat eating disorders have considerable potential to overcome known barriers to treatment seeking. Existing apps have shown efficacy in terms of symptom reduction; however, uptake and retention issues are common. To ensure that apps meet the needs and preferences of those for whom they were designed, it is critical to understand the lived experience of potential users and involve them in the process of design, development, and delivery. However, few app-based interventions are pretested on and co-designed with end users before randomized controlled trials. Objective To address the issue, this study used a highly novel design thinking approach to provide the context and a lived experience perspective of the end user, thus allowing for a deeper level of understanding. Methods In total, 7 young women (mean age 25.83, SD 5.34, range 21-33 years) who self-identified as having a history of body image issues or eating disorders were recruited. Participants were interviewed about their lived experience of body image and eating disorders and reported their needs and preferences for app-based eating disorder interventions. Traditional (thematic analysis) and novel (empathy mapping; visually depicting and empathizing with the user’s personal experience) analyses were performed, providing a lived experience perspective of eating disorders and identifying the needs and preferences of this population in relation to app-based interventions for eating disorders. Key challenges and opportunities for app-based eating disorder interventions were also identified. Results Findings highlighted the importance of understanding and identifying problematic eating disorder symptoms for the user, helpful practices for recovery that identify personal values and goals, the role of social support in facilitating hope, and aspects of usability to promote continued engagement and recovery. Conclusions Practical guidance and recommendations are described for those developing app-based eating disorder interventions. These findings have the potential to inform practices to enhance participant uptake and retention in the context of app-based interventions for this population.

Barriers and facilitators affecting treatment uptake behaviours for patients with eating disorders: A systematic review synthesising patient, caregiver and clinician perspectives

“…Among the most prevalent barriers reported were concerns regarding technological requirements and data privacy, as well as the accessibility of digital interventions. These results mirror those of prior studies, in which the accessibility, usability and visual design of digital interventions were among the key factors in the decision to engage with services (Jarman et al., 2022). Among the included studies in the current systematic review, the use of digital interventions was associated with significantly less stigma than face‐to‐face therapies.…”

Lived experience perspectives on eating disorder research: The use of adaptive trials and research priorities

“…Since the publication of this synthesis, two additional studies have been published. Jarman et al (2022) sought feedback from seven young women with self‐identified body image issues or eating disorders on the use of app‐based eating disorder interventions. Key themes emerged around the importance of recognizing symptoms and help‐seeking attitudes, the effectiveness of the content and alignment with full recovery and personal values, social connection and instilling hope, and ensuring apps are accessible and appealing (Jarman et al, 2022).…”

“…Jarman et al (2022) sought feedback from seven young women with self‐identified body image issues or eating disorders on the use of app‐based eating disorder interventions. Key themes emerged around the importance of recognizing symptoms and help‐seeking attitudes, the effectiveness of the content and alignment with full recovery and personal values, social connection and instilling hope, and ensuring apps are accessible and appealing (Jarman et al, 2022). Most recently, Papastavrou Brooks et al (2023) co‐designed principles to guide research in their lived experience eating disorder clinic.…”

“…been published Jarman et al (2022). sought feedback from seven young women with self-identified body image issues or eating disorders on the use of app-based eating disorder interventions.…”

Adolescents’ perspectives on a novel digital treatment targeting eating disorders: a qualitative study

“…Results from the present study address the importance of personalisation to meet the adolescents’ individual needs. Personalisation of treatment is viewed positively by individuals with eating disorders [ 70 – 72 ] and is especially highlighted as important for adolescents [ 73 ].…”