Adapting a mobile app to support patients with anorexia nervosa following post-acute care: perspectives from eating disorder treatment center stakeholders

Anneliese Haas; Agatha A Laboe; Claire G McGinnis; Marie-Laure Firebaugh; Jillian Shah; Anna M Bardone-Cone; Kathleen M Pike; C Barr Taylor; Denise E Wilfley; Ellen E Fitzsimmons-Craft

doi:10.3389/fdgth.2023.1099718

Adapting a mobile app to support patients with anorexia nervosa following post-acute care: perspectives from eating disorder treatment center stakeholders

Front Digit Health. 2023 May 19:5:1099718. doi: 10.3389/fdgth.2023.1099718. eCollection 2023.

Affiliations

¹ Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
² Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
³ Department of Psychiatry, Columbia University, New York, NY, United States.
⁴ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
⁵ Center for m2Health, Palo Alto University, Palo Alto, CA, United States.

^# Contributed equally.

Abstract

Introduction: Anorexia nervosa (AN) is a harmful, life-threatening illness. Patients with severe AN often receive acute treatment but, upon discharge, experience high relapse rates. Evidence-based, outpatient treatment following acute care is critical to preventing relapse; however, numerous barriers (e.g., location, financial limitations, low availability of providers) preclude individuals from accessing treatment. mHealth technologies may help to address these barriers, but research on such digital approaches for those with AN is limited. Further, such technologies should be developed with all relevant stakeholder input considered from the outset. As such, the present study aimed to garner feedback from eating disorder (ED) treatment center providers on (1) the process of discharging patients to outpatient services, (2) their experiences with technology as a treatment tool, and (3) how future mHealth technologies may be harnessed to offer the most benefit to patients in the post-acute period.

Methods: Participants (N = 11, from 7 ED treatment centers across the United States) were interviewed. To analyze the data for this study, each interview was manually transcribed and analyzed using components of Braun and Clarke's six-phase thematic analysis framework (Braun & Clarke, 2006).

Results: Participants indicated proactively securing outpatient care for their patients, but mentioned several barriers their patients face in accessing evidence-based ED treatment. All participants had some experience using various technologies for treatment (e.g., teletherapy, self-monitoring apps), and mentioned a high level of interest in the development of a new app to be used by patients recently discharged from acute treatment for AN. Participants also offered suggestions of effective and relevant content for a potential app and adjunctive social networking component for post-acute care of AN.

Discussion: Overall, participants expressed positive attitudes toward the integration of an app into the care flow, suggesting the high potential benefit of harnessing technology to support individuals recovering from AN.

Keywords: anorexia nervosa; eating disorders; mobile intervention; post-acute treatment; social networking; stakeholder engagement.

Grants and funding

This work was supported by R34 MH127203, K08 MH120341, and R01 MH115128-04S1 from the National Institute of Mental Health.