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Behavior Change Techniques Within Digital Interventions for the Treatment of Eating Disorders: Systematic Review and
Pamela Carien Thomas1, Kristina Curtis2, Henry W W Potts3
1Department of Epidemiology & Applied Clinical Research, Division of Psychiatry, University College London, London, United Kingdom.
JMIR Mental Health
|August 1, 2024
Summary
Digital interventions for eating disorders are effective, with common behavior change techniques (BCTs) like self-monitoring. Interventions strongly informed by theory showed greater symptom improvement.
Area of Science:
- Digital health interventions
- Behavioral science
- Clinical psychology
Background:
- Systematic reviews show digital interventions improve eating disorder symptoms.
- Understanding the mechanisms and contributing factors of these interventions remains limited.
- Identifying behavior change techniques (BCTs) and theoretical grounding is crucial for optimizing digital interventions.
Purpose of the Study:
- To define BCTs in digital self-management/minimally guided interventions for adults with eating disorders.
- To assess the theoretical grounding and modes of delivery for these interventions.
- To evaluate the impact of BCTs, theory, and delivery modes on eating disorder outcomes.
Main Methods:
- Literature search for randomized controlled trials of digital interventions for adult eating disorders with minimal therapist support.
- Coding interventions for BCTs (BCT Taxonomy v1), theoretical application (TCS), and modes of delivery (Mode of Delivery Ontology).
- Meta-analysis to assess if individual BCTs, theory application, or delivery modes moderated effect size.
Main Results:
- Effective interventions included an average of 14 BCTs, with self-monitoring, problem-solving, and action planning being common.
- Web-based delivery was most common (88%), with an average of 4 modes used.
- Interventions with higher theoretical grounding (TCS score) showed significantly greater effect sizes (χ²=9.7, P=.002).
Conclusions:
- While common BCTs were consistent, no single BCT proved uniquely effective.
- Digital interventions for eating disorders that are strongly informed by theory yield better outcomes.
- Findings can guide the development of more effective future digital interventions for eating disorders.
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