Experts’ views on the implementation of digital interventions for eating disorders: A Delphi study

Abstract

Background Eating disorders (EDs) constitute a considerable burden for individuals and society, but adequate and timely professional treatment is rare. Evidence-based Digital Mental Health Interventions (DMHIs) have the potential both to reduce this treatment gap and to increase treatment effectiveness. However, their integration into routine care is lacking. Understanding practitioners' attitudes towards DMHIs for EDs is crucial for their effective use.Aims To investigate the consensus among German ED treatment experts on the relevance of different influencing factors for DMHI use in EDs.Methods Semi-structured qualitative telephone interviews with N = 24 ED experts (Mage=41.96, SDage=9.92, n = 22 female) were conducted to explore attitudes, experiences, and expectations towards DMHIs. Ten interviews were used for this Delphi study. Content analysis identified 63 influencing factors, grouped into three main categories: contextual conditions, design, and content of DMHIs. In two rounds, participants rated the factors’ importance on 10-point scales. Group percentages and individual ratings of the first round (n = 23) were presented in the second round (n = 21). Consensus was calculated for each item (defined as IQR ≤ 2).Results Importance ratings were high across items (M = 7.88, SD = 2.07, Mdn = 8). In the first round, a consensus rate of 48% was reached, with its most important (Mdn = 10) factors referring to data security, evidence base, technical requirements, usability, and to specific DMHI content (psychoeducation, crisis intervention). In the second Delphi round, consensus was reached for 73% of the items. No consensus was reached for 17 items.Conclusions The findings on practitioners' attitudes and priorities have relevant implications for subsequent DMHI development, dissemination, and implementation strategies, indicating that the highest-rated factors should be highlighted in the process.