. 2022 Oct 31;6(10):e38387.

doi: 10.2196/38387.

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

Hannah K Jarman^{1

2}, Siân A McLean³, Rachel Rodgers^{4

5}, Matthew Fuller-Tyszkiewicz^{1

2}, Susan Paxton³, Beth O'Gorman⁶, Emily Harris⁶, Adrian Shatte⁷, Katie Bishop¹, Tahlia Baumann⁸, Danielle Mahoney⁸, Melissa-Claire Daugelat^{9

10}, Zali Yager¹¹

Affiliations

¹ School of Psychology, Deakin University, Geelong, Australia.
² Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Melbourne, Australia.
³ School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
⁴ Applied Psychology Program for Eating and Appearance Research, Department of Applied Psychology, Northeastern University, Boston, MA, United States.
⁵ Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Centre Hospitalier Regional Universitaire Montpellier, Montpellier, France.
⁶ Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
⁷ Department of Planning, Performance & Analytics, James Cook University, Townsville, Australia.
⁸ School of Psychology, University of Queensland, Brisbane, Australia.
⁹ Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
¹⁰ Centre of Excellence for Eating Disorders, University of Tübingen, Tübingen, Germany.
¹¹ Institute for Health and Sport, Victoria University, Melbourne, Australia.

PMID: 36315225
PMCID: PMC9664336
DOI: 10.2196/38387

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

Hannah K Jarman et al. JMIR Form Res. 2022.

. 2022 Oct 31;6(10):e38387.

doi: 10.2196/38387.

Authors

Affiliations

¹ School of Psychology, Deakin University, Geelong, Australia.
² Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Melbourne, Australia.
³ School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
⁴ Applied Psychology Program for Eating and Appearance Research, Department of Applied Psychology, Northeastern University, Boston, MA, United States.
⁵ Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Centre Hospitalier Regional Universitaire Montpellier, Montpellier, France.
⁶ Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
⁷ Department of Planning, Performance & Analytics, James Cook University, Townsville, Australia.
⁸ School of Psychology, University of Queensland, Brisbane, Australia.
⁹ Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
¹⁰ Centre of Excellence for Eating Disorders, University of Tübingen, Tübingen, Germany.
¹¹ Institute for Health and Sport, Victoria University, Melbourne, Australia.

PMID: 36315225
PMCID: PMC9664336
DOI: 10.2196/38387

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.

Keywords: app-based intervention; co-design; design thinking; eating disorders; interviews; lived experience; mHealth; mobile health; young women.

©Hannah K Jarman, Siân A McLean, Rachel Rodgers, Matthew Fuller-Tyszkiewicz, Susan Paxton, Beth O'Gorman, Emily Harris, Adrian Shatte, Katie Bishop, Tahlia Baumann, Danielle Mahoney, Melissa-Claire Daugelat, Zali Yager. Originally published in JMIR Formative Research (https://formative.jmir.org), 31.10.2022.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

**Figure 1**
An example empathy map, which identifies the lived experience of 1 participant.

See this image and copyright information in PMC

Cited by

Enhanced recovery support for people with eating disorders during the COVID-19 pandemic: quality improvement using a web-based, stepped-care programme in Canada.
Wood MD, Smith JL, Healey H, Görges M, Lokker C. Wood MD, et al. BMJ Open Qual. 2023 Nov;12(4):e002366. doi: 10.1136/bmjoq-2023-002366. BMJ Open Qual. 2023. PMID: 37935516 Free PMC article.
Enhancing Distress Tolerance Skills in Adolescents With Anorexia Nervosa Through the BALANCE Mobile App: Feasibility and Acceptability Study.
Miranda C, Matheson B, Datta N, Whyte A, Yang HJ, Schmiedmayer P, Ravi V, Aalami O, Lock J. Miranda C, et al. JMIR Form Res. 2025 Feb 28;9:e70278. doi: 10.2196/70278. JMIR Form Res. 2025. PMID: 40019817 Free PMC article.
User Experiences of and Preferences for Self-Guided Digital Interventions for the Treatment of Mild to Moderate Eating Disorders: Systematic Review and Metasynthesis.
Cheung LG, Thomas PC, Brvar E, Rowe S. Cheung LG, et al. JMIR Ment Health. 2025 Jan 3;12:e57795. doi: 10.2196/57795. JMIR Ment Health. 2025. PMID: 39752210 Free PMC article.
Two identical twin pairs discordant for longstanding anorexia nervosa and OSFED: lived experience accounts of eating disorder and recovery processes.
Elwyn R, Williams M, Smith E, Smith S. Elwyn R, et al. J Eat Disord. 2024 Sep 2;12(1):127. doi: 10.1186/s40337-024-01078-w. J Eat Disord. 2024. PMID: 39223672 Free PMC article.
An in-depth understanding of stakeholders' experiences about their participation in the co-production of 'Maze Out': a serious game for the treatment of eating disorders.
Guala MM, Bikic A, Bul K, Clinton D, Nielsen AS, Nielsen HN, Scarpelli M, Schneider L, Christiansen R. Guala MM, et al. J Eat Disord. 2024 Nov 14;12(1):178. doi: 10.1186/s40337-024-01136-3. J Eat Disord. 2024. PMID: 39543730 Free PMC article.

See all "Cited by" articles

References

1. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr. 2019 May 01;109(5):1402–13. doi: 10.1093/ajcn/nqy342.5480601 - DOI - PubMed
1. Cooper M, Reilly EE, Siegel JA, Coniglio K, Sadeh-Sharvit S, Pisetsky EM, Anderson LM. Eating disorders during the COVID-19 pandemic and quarantine: an overview of risks and recommendations for treatment and early intervention. Eat Disord. 2022;30(1):54–76. doi: 10.1080/10640266.2020.1790271. - DOI - PMC - PubMed
1. Griffiths S, Hay P, Mitchison D, Mond JM, McLean SA, Rodgers B, Massey R, Paxton SJ. Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress. Aust N Z J Public Health. 2016 Dec;40(6):518–22. doi: 10.1111/1753-6405.12538. - DOI - PubMed
1. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011 Jul;68(7):724–31. doi: 10.1001/archgenpsychiatry.2011.74.68/7/724 - DOI - PubMed
1. van Hoeken D, Hoek HW. Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden. Curr Opin Psychiatry. 2020 Nov;33(6):521–7. doi: 10.1097/YCO.0000000000000641. https://europepmc.org/abstract/MED/32796186 00001504-202011000-00003 - DOI - PMC - PubMed

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

LinkOut - more resources

Full Text Sources

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Related information

LinkOut - more resources

Full Text Sources