JMIR Publications

ABSTRACT

Background:

Guided cognitive behavioural self-help is a recommended first line treatment for eating disorders, such as bulimia nervosa (BN) or binge eating disorder(BED). Online versions of such self-help programmes are increasingly being studied in randomised controlled trials (RCTs), with some evidence that they can reduce eating disorder symptoms, although intervention drop-out is typically high. However, in-depth research into participants’ experience and views on acceptability of online interventions is limited.

Objective:

This study is a qualitative process evaluation of participants’ experiences of everyBody Plus, an online cognitive-behavioural intervention, integrated into a large RCT to aid the interpretation of the results of the main trial. This is the first such study in digital intervention for eating disorders research to include real-time feedback into the qualitative analysis. The aim of this study is to build upon the emerging literature by qualitatively exploring participants’ experience of an online intervention for BN and BED.

Methods:

Participants were those who took part in the UK arm of a larger RCT investigating the efficacy of the everyBody Plus intervention. Reflexive thematic analysis was completed on two sources of data from the online platform; real-time feedback quotes provided at the end of completing a module on the platform (N=104), and semi-structured telephone interview transcripts (N=12).

Results:

Four main themes were identified. The first theme identified positive and negative user experiences (UX), with a desire for a more customised and personalised intervention. Another theme positively reflected on how flexible and easy the intervention was to embed into daily life, compared to the ‘silo’ of face-to-face therapy. The third theme identified how the intervention had a holistic impact cognitively, emotionally, interpersonally and behaviourally. The final theme related to how the intervention was not a ‘one-size-fits-all’ and that the perceived usefulness and relevance was often dependant on participant demographic and clinical characteristics.

Conclusions:

Overall, participants reported positive experiences of the use of the everybody Plus online intervention, including flexibility of use and the potential to holistically impact people’s lives. Participants also provided valuable suggestions for how similar future online interventions could be improved and in the context of eating disorders, how programmes can be designed to be more inclusive of people by encompassing different demographic and clinical characteristics. Clinical Trial: ISRCTN12608780