King's College London, London, United Kingdom.
South London and Maudsley NHS Foundation Trust, London, United Kingdom.
J Med Internet Res. 2020 Sep 23;22(9):e17880. doi: 10.2196/17880.
Guided cognitive behavioral self-help is a recommended first-line treatment for eating disorders (EDs) such as bulimia nervosa (BN) or binge eating disorder (BED). Online versions of such self-help programs are increasingly being studied in randomized controlled trials (RCTs), with some evidence that they can reduce ED symptoms, although intervention dropout is variable across interventions. However, in-depth research into participants' experiences and views on the acceptability of web-based interventions is limited.
This is a qualitative process study of participants' experiences of everyBody Plus, a web-based cognitive behavioral intervention, integrated into a large RCT to aid the interpretation of the main trial's results. To our knowledge, this is the first such study in digital intervention for EDs research to include real-time feedback into the qualitative analysis. This study aims to build upon the emerging literature by qualitatively exploring participants' experiences of a web-based intervention for BN and BED.
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 2 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 semistructured telephone interview transcripts (n=12).
Four main themes were identified. The first theme identified positive and negative user experiences, with a desire for a more customized and personalized intervention. Another theme positively reflected on how flexible and easy the intervention was to embed into daily life, compared with the silo of face-to-face therapy. The third theme identified how the intervention had a holistic impact cognitively, emotionally, interpersonally, and behaviorally. The final theme was related to how the intervention was not a one size fits all and how the perceived usefulness and relevance were often dependent on participants' demographic and clinical characteristics.
Overall, participants reported positive experiences with the use of the everyBody Plus web-based intervention, including flexibility of use and the potential to holistically impact people's lives. The participants also provided valuable suggestions for how similar future web-based interventions could be improved and, in the context of EDs, how programs can be designed to be more inclusive of people by encompassing different demographic and clinical characteristics.
引导认知行为自助是治疗饮食失调（ED）如神经性贪食症（BN）或暴食障碍（BED）的一线推荐治疗方法。此类自助计划的在线版本越来越多地在随机对照试验（RCT）中进行研究，有一些证据表明它们可以减轻 ED 症状，尽管干预措施的辍学率因干预措施而异。然而，对于参与者对基于网络的干预措施的可接受性的体验和观点的深入研究是有限的。
这是一项对 everyBody Plus 的参与者体验的定性过程研究，everyBody Plus 是一种基于网络的认知行为干预措施，已整合到一项大型 RCT 中，以帮助解释主要试验的结果。据我们所知，这是 ED 研究中首个将实时反馈纳入定性分析的此类研究。本研究旨在通过定性探索参与者对 BN 和 BED 的基于网络的干预措施的体验，对新兴文献进行补充。
参与者是参加更大 RCT 英国部分的参与者，该 RCT 调查了 everyBody Plus 干预措施的疗效。对来自在线平台的 2 个数据源完成了反思性主题分析：在完成平台上的一个模块后提供的实时反馈报价（N=104）和半结构化电话访谈记录（n=12）。
确定了四个主要主题。第一个主题确定了积极和消极的用户体验，希望有一个更定制化和个性化的干预措施。另一个主题积极地反映了干预措施在日常生活中的灵活性和易用性，与面对面治疗的孤立相比。第三个主题确定了干预措施如何在认知、情感、人际关系和行为方面产生全面影响。最后一个主题与干预措施并非一刀切的方式有关，以及感知到的有用性和相关性往往取决于参与者的人口统计学和临床特征。
总体而言，参与者报告了对使用 everyBody Plus 基于网络的干预措施的积极体验，包括使用的灵活性和对人们生活产生整体影响的潜力。参与者还为如何改进类似的未来基于网络的干预措施提供了有价值的建议，并且在 ED 的背景下，如何设计程序以更包容不同人口统计学和临床特征的方式来容纳更多人。
