Development of a transdiagnostic digital interactive application for eating disorders: psychometric properties, satisfaction, and perceptions on implementation in clinical practice

J Eat Disord. 2023 Aug 29;11(1):146. doi: 10.1186/s40337-023-00871-3.

Abstract

Background: Given limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application.

Methods: The content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application's development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann-Whitney U tests.

Results: The digital application showed excellent validity (mean i-CVI: .93, range: .86-.96) and internal reliability (all Cronbach alpha's > .88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice.

Conclusions: Findings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment.

Several digital self-help applications have been developed to help people overcome their eating disorders. Many available interventions are limited to a specific type of eating disorder or assume that participants are ready to change. We developed a new digital self-help application (called ASTrA) that was designed for different types of eating disorders to help increase people’s motivation to recover. The aim of the present study was to describe the development and to study the psychometric properties, user satisfaction and potentials for practical use of our application. The application was developed by a group of clinicians, researchers, experts in digital health, and people who had an eating disorder in the past. We then tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of people receiving treatment for their eating disorder and of clinicians specialized in eating-disorder treatment. We found that the application has excellent psychometric properties. Patients and clinicians alike were satisfied with the application and found the application feasible for use in clinical practice. Our next step is to study the effect of the application on symptoms and motivation in people currently on the waitlist for specialized eating-disorder treatment.

Keywords: Digital interventions; Eating disorders; Remote self-help; Study implementation; Transdiagnostic; Validation study; Webtool.