Currently submitted to: JMIR Mental Health
Date Submitted: Feb 27, 2024
Open Peer Review Period: Feb 29, 2024 - Apr 25, 2024
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User Experiences and Preferences of Self-Guided Digital Interventions for the Treatment of Mild to Moderate Eating Disorders: A Systematic Review and Meta-Synthesis
ABSTRACT
Background:
Digital interventions typically involve using smartphones or personal computers to access online or downloadable self-help, and may offer a more accessible and convenient option than face-to-face for some people with mild to moderate eating disorders. They have been shown to reduce eating disorder symptoms significantly, but treatment dropout rates can be high. We need to understand user experiences and preferences for digital interventions to support the design and development of user-centred digital interventions which are engaging and meet users’ needs.
Objective:
To understand user experiences and user preferences for digital interventions that aim to reduce mild to moderate eating disorder symptoms in adults.
Objective:
To understand user experiences and user preferences for digital interventions that aim to reduce mild to moderate eating disorder symptoms in adults.
Methods:
We conducted a meta-synthesis of qualitative studies. We searched six databases for published and unpublished literature from 2013 to 2023. We searched for studies conducted in naturalistic or outpatient settings, using primarily unguided digital self-help interventions designed to reduce eating disorder symptoms in adults with mild to moderate eating disorders. We conducted a thematic synthesis using line-by-line coding of the results and findings from each study to generate themes.
Results:
Eight studies were included after screening 2,435 search results. Eight meta-themes were identified. Meta-themes include (1) Appeal of digital interventions, (2) Role of digital interventions in treatment, (3) Value of support in treatment, (4) Communication at the right level, (5) Importance of engagement, (6) Flexibility of digital interventions, (7) Shaping knowledge to improve eating disorder behaviours, and (8) Design of the digital intervention. Users had positive experiences with digital interventions and perceived them as helpful for self-reflection and mindfulness. Users found digital interventions to be convenient and flexible to fit with their lifestyle. Overall, users noticed reduced eating disorder thoughts and behaviours. However, digital interventions were not generally perceived as a sufficient treatment that could replace traditional face-to-face treatment. Users have individual needs, so an ideal intervention would offer personalised content and functions. Users preferred an intervention that offered diary functions to log their food, moods and binges as these supported engagement.
Conclusions:
Users found digital interventions for eating disorders to be a practical and effective method of intervention. However, users emphasised the importance of an intervention that recognises the range of eating disorder symptoms and severity and meets their language, lifestyle and engagement needs. An ideal intervention would allow users to tailor content, functions, appearance, and format of content. Increased personalisation may increase adherence to digital interventions for people with mild to moderate eating disorders. Future studies should investigate more diverse samples and include populations that are often overlooked in mental health research (for example, older adults and men). Future studies may also investigate the use of artificial intelligence and machine learning to further improve digital interventions. Clinical Trial: PROSPERO (CRD42023426932)
Citation
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