Perceived Facilitators and Barriers to Engaging with a Digital Intervention among Those with Food Insecurity, Binge Eating, and Obesity

Abstract

Interventions that address binge eating and food insecurity are needed. Engaging people with lived experience to understand their needs and preferences could yield important design considerations for such interventions. In this study, people with food insecurity, recurrent binge eating, and obesity completed an interview-based needs assessment to learn facilitators and barriers that they perceive would impact their engagement with a digital intervention for managing binge eating and weight. Twenty adults completed semi-structured interviews. Responses were analyzed using thematic analysis. Three themes emerged. Participants shared considerations that impact their ability to access the intervention (e.g., cost of intervention, cost of technology, accessibility across devices), ability to complete intervention recommendations (e.g., affordable healthy meals, education to help stretch groceries, food vouchers, rides to grocery stores, personalized to budget), and preferred intervention features for education, self-monitoring, personalization, support, and motivation/rewards. Engaging people with lived experiences via user-centered design methods revealed important design considerations for a digital intervention to meet this population’s needs. Future research is needed to test whether a digital intervention that incorporates these recommendations is engaging and effective for people with binge eating and food insecurity. Findings may have relevance to designing digital interventions for other health problems as well.

Patient perceptions of the relationship between food insecurity and eating disorder treatment: A qualitative exploration

“…For those with current FI, logistical concerns surrounding the availability of food may inhibit this intervention, perpetuating dietary restraint and subsequent binge eating. This is consistent with the findings of Venkatesh et al (2021), in which participants cited cost as a perceived barrier to a digital intervention for managing binge eating and weight concerns. Furthermore, for those with a history of FI, learned behaviors related to the presence or absence of food may also interfere with treatment.…”

“…A recent study conducted an assessment to identify perceived facilitators and barriers to digital treatment engagement in those with binge eating and FI, however, these individuals were not enrolled in or undergoing treatment at the time the interviews were conducted (Venkatesh et al, 2021), precluding an understanding of how FI may impact treatment. FI may be a barrier to successful treatment outcomes for several reasons.…”

Integrating a web-based intervention into routine care of binge-eating disorder: Study protocol for a randomized controlled trial

“…Web-based interventions can reduce these barriers and facilitate access to evidence-based treatment for patients with BED ( Aardoom et al, 2013 ; Dölemeyer et al, 2013 ; Venkatesh et al, 2021 ). However, despite the increasing number of empirical studies investigating web-based self-help for depression and anxiety symptoms (for a meta-analysis, see Spek et al, 2007 ), there is still a scarcity of high-quality studies on the effectiveness of online interventions for BED ( Haderlein, 2022 ).…”

“…Web-based self-help interventions can help overcome these barriers by making treatments for BED more available ( Aardoom et al, 2013 ; Dölemeyer et al, 2013 ; Venkatesh et al, 2021 ). Empirical evidence suggests that web-based interventions can effectively reduce BED symptoms with medium to large effect sizes when investigating symptom changes after completing online self-help programs (e.g., Beintner et al, 2014 ; de Zwaan et al, 2017 ; Haderlein, 2022 ; Wyssen et al, 2021 ).…”

“…They are cost-effective, easy to implement, have a low threshold, and are permanently accessible while allowing a flexible treatment adaptation based on individualized therapy goals ( Aardoom et al, 2013 ; Dölemeyer et al, 2013 ; Linardon et al, 2020 ). Therefore, online programs for BED could be used to bridge waiting times for face-to-face therapy, facilitate transfers from inpatient to outpatient care, or may serve as an alternative treatment for patients who perceive the barriers of face-to-face therapy as too high ( Beintner et al, 2014 ; Venkatesh et al, 2021 ).…”