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Usability evaluation of a cognitive-behavioral app-based intervention for binge eating and related psychopathology : a qualitative study

- Linardon, Jake, King, Teagan, Shatte, Adrian, Fuller-Tyszkiewicz, Matthew

  • Authors: Linardon, Jake , King, Teagan , Shatte, Adrian , Fuller-Tyszkiewicz, Matthew
  • Date: 2022
  • Type: Text , Journal article
  • Relation: Behavior Modification Vol. 46, no. 5 (2022), p. 1002-1020
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  • Description: Despite their promise as a scalable intervention modality for binge eating and related problems, reviews show that engagement of app-based interventions is variable. Issues with usability may account for this. App developers should undertake usability testing so that any problems can be identified and fixed prior to dissemination. We conducted a qualitative usability evaluation of a newly-developed app for binge eating in 14 individuals with a diagnostic- or subthreshold-level binge eating symptoms. Participants completed a semi-structured interview and self-report measures. Qualitative data were organized into six themes: usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance. Qualitative and quantitative results indicated that the app demonstrated good usability. Key advantages reported were its flexible content-delivery formats, level of interactivity, easy-to-understand information, and ability to track progress. Concerns with visual aesthetics and lack of professional feedback were raised. Findings will inform the optimal design of app-based interventions for eating disorder symptoms. © The Author(s) 2021.

Efficacy of a transdiagnostic cognitive-behavioral intervention for eating disorder psychopathology delivered through a smartphone app: a randomized controlled trial

- Linardon, Jake, Shatte, Adrian, Rosato, John, Fuller-Tyszkiewicz, Matthew

  • Authors: Linardon, Jake , Shatte, Adrian , Rosato, John , Fuller-Tyszkiewicz, Matthew
  • Date: 2022
  • Type: Text , Journal article
  • Relation: Psychological Medicine Vol. 52, no. 9 (2022), p. 1679-1690
  • Full Text: false
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  • Description: Abstract Background Although effective treatments exist for diagnostic and subthreshold-level eating disorders (EDs), a significant proportion of affected individuals do not receive help. Interventions translated for delivery through smartphone apps may be one solution towards reducing this treatment gap. However, evidence for the efficacy of smartphones apps for EDs is lacking. We developed a smartphone app based on the principles and techniques of transdiagnostic cognitive-behavioral therapy for EDs and evaluated it through a pre-registered randomized controlled trial. Methods Symptomatic individuals (those who reported the presence of binge eating) were randomly assigned to the app ( n = 197) or waiting list ( n = 195). Of the total sample, 42 and 31% exhibited diagnostic-level bulimia nervosa and binge-eating disorder symptoms, respectively. Assessments took place at baseline, 4 weeks, and 8 weeks post-randomization. Analyses were intention-to-treat. The primary outcome was global levels of ED psychopathology. Secondary outcomes were other ED symptoms, impairment, and distress. Results Intervention participants reported greater reductions in global ED psychopathology than the control group at post-test ( d = −0.80). Significant effects were also observed for secondary outcomes ( d 's = −0.30 to −0.74), except compensatory behavior frequency. Symptom levels remained stable at follow-up. Participants were largely satisfied with the app, although the overall post-test attrition rate was 35%. Conclusion Findings highlight the potential for this app to serve as a cost-effective and easily accessible intervention for those who cannot receive standard treatment. The capacity for apps to be flexibly integrated within current models of mental health care delivery may prove vital for addressing the unmet needs of people with EDs.
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