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Do Recovery Apps Even Exist?: Why College Women with Eating Disorders Use (But Not Recommend) Diet and Fitness Apps Over Recovery Apps

Part of the Lecture Notes in Computer Science book series (LNISA,volume 11420)

Abstract

Getting individuals to adopt condition-specific apps over general health apps remains an issue. Using eating disorders (EDs) as an example, we explored (1) if users recommend the general diet and fitness apps they repurpose for ED recovery and (2) if they use condition-specific apps intended for recovery. We used semi-structured interviews and four questionnaires to investigate use and perceptions of diet and fitness apps and recovery apps with 24 college women with self-identified and clinically-diagnosed EDs. Using inductive coding, we generated themes to address their lack of use of recovery apps. We found the majority (n = 13) would not recommend using general diet and fitness apps for recovery (compared to only 3 who would), yet most participants did not seek out a condition-specific app even when their objective was recovery. Four themes emerged around the non-use of recovery apps: lack of awareness, unpopularity or unfamiliarity, unwillingness, and lack of features or poor usability. In order to improve awareness as well as perceived popularity and familiarity of condition-specific apps, we suggest researchers and clinicians develop approved app lists, primary care clinicians become expert recommenders for evidence-based apps, and clinicians and educators leverage social media and college settings to reach these “hard to reach” populations.

Keywords

  • Eating disorder recovery app
  • Diet and fitness app
  • Mental health
  • mHealth
  • Personal informatics
  • Self-tracking

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Notes

  1. 1.

    For more details about these measures, please see [13].

  2. 2.

    https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

  3. 3.

    https://nccd.cdc.gov/dnpabmi/calculator.aspx.

  4. 4.

    2 participants did not provide an answer for this question.

  5. 5.

    23 of 24 participants answered questions related to ED recovery apps.

References

  1. CDC Mental Illness Surveillance Fact Sheet. Centers Dis. Control Prev. (2011). https://www.cdc.gov/mentalhealthsurveillance/fact_sheet.html

  2. Nicholas, J., Larsen, M.E., Proudfoot, J., Christensen, H.: Mobile apps for bipolar disorder: a systematic review of features and content quality. J. Med. Internet Res. 17 (2015). https://doi.org/10.2196/jmir.4581

  3. Juarascio, A.S., Manasse, S.M., Goldstein, S.P., Forman, E.M., Butryn, M.L.: Review of smartphone applications for the treatment of eating disorders. Eur. Eat. Disord. Rev. 23, 1–11 (2015). https://doi.org/10.1002/erv.2327

    CrossRef  Google Scholar 

  4. Fairburn, C.G., Rothwell, E.R.: Apps and eating disorders: a systematic clinical appraisal. Int. J. Eat. Disord. 48, 1038–1046 (2015). https://doi.org/10.1002/eat.22398

    CrossRef  Google Scholar 

  5. Bakker, D., Kazantzis, N., Rickwood, D., Rickard, N.: Mental health smartphone apps: review and evidence-based recommendations for future developments. JMIR Ment. Heal. 3, e7 (2016). https://doi.org/10.2196/mental.4984

    CrossRef  Google Scholar 

  6. Leigh, S., Flatt, S.: App-based psychological interventions: friend or foe? Evid. Based Ment. Health 18(4), 97–99 (2015)

    CrossRef  Google Scholar 

  7. Eisenberg, D., Nicklett, E.J., Roeder, K., Kirz, N.E.: Eating disorder symptoms among college students: prevalence, persistence, correlates, and treatment-seeking. J. Am. Coll. Heal. 59, 700–707 (2011). https://doi.org/10.1038/nature13314.A

    CrossRef  Google Scholar 

  8. Berg, K.C., Frazier, P., Sherr, L.: Change in eating disorder attitudes and behavior in college women: prevalence and predictors. Eat. Behav. 10, 137–142 (2009). https://doi.org/10.1016/j.eatbeh.2009.03.003

    CrossRef  Google Scholar 

  9. Woodruff, S.J., Hanning, R.M., Lambraki, I., Storey, K.E., McCargar, L.: Healthy Eating Index-C is compromised among adolescents with body weight concerns, weight loss dieting, and meal skipping. Body Image 5, 404–408 (2008). https://doi.org/10.1016/j.bodyim.2008.04.006

    CrossRef  Google Scholar 

  10. Gillen, M.M., Markey, C.N., Markey, P.M.: An examination of dieting behaviors among adults: Links with depression. Eat. Behav. 13, 88–93 (2012). https://doi.org/10.1016/j.eatbeh.2011.11.014

    CrossRef  Google Scholar 

  11. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th edn. American Psychiatric Publishing, Washington, D.C., London, England (2013)

    Google Scholar 

  12. Eikey, E.V., Reddy, M.C.: “It’s Definitely Been a Journey”: a qualitative study on how women with eating disorders use weight loss apps. In: ACM CHI Conference on Human Factors in Computing Systems (CHI 2017), Denver, CO, pp. 1–13. ACM (2017)

    Google Scholar 

  13. Eikey, E.V., Booth, K.M., Chen, Y., Zheng, K.: The use of general health apps among users with specific conditions: why college women with disordered eating adopt food diary apps. In: AMIA, San Francisco, CA (2018)

    Google Scholar 

  14. Levinson, C.A., Fewell, L., Brosof, L.C.: My fitness pal calorie tracker usage in the eating disorders. Eat. Behav. 27, 14–16 (2017). https://doi.org/10.1016/j.eatbeh.2017.08.003

    CrossRef  Google Scholar 

  15. Simpson, C.C., Mazzeo, S.E.: Calorie counting and fitness tracking technology: associations with eating disorder symptomatology. Eat. Behav. 26, 89–92 (2017). https://doi.org/10.1016/j.eatbeh.2017.02.002

    CrossRef  Google Scholar 

  16. Eikey, E.V.: Providers’ perceptions of the impact of weight loss apps on users with eating disorders. In: Proceedings of the 2016 ACM SIGMIS Conference on Computers and People Research, pp. 19–20. ACM, New York (2016)

    Google Scholar 

  17. Tan, T., Kuek, A., Goh, S.E., Lee, E.L., Kwok, V.: Internet and smartphone application usage in eating disorders: a descriptive study in Singapore. Asian J. Psychiatr. 19, 50–55 (2016). https://doi.org/10.1016/j.ajp.2015.11.007

    CrossRef  Google Scholar 

  18. Eikey, E.V., et al.: Desire to be underweight: an exploratory study on a weight loss app community and user perceptions of the impact on disordered eating behaviors. JMIR mHealth uHealth 5 (2017). https://doi.org/10.2196/mhealth.6683

  19. Fairburn, C.G., Beglin, S.: EDE-Q. In: Cognitive Behavior Therapy and Eating Disorders, pp. 1–5. Guilford Press, New York (2008)

    Google Scholar 

  20. Garner, D.M., Olmsted, M.P., Bohr, Y., Garfinkel, P.E.: The eating attitudes test: psychometric features and clinical correlates. Psychol. Med. 12, 871–878 (1982)

    CrossRef  Google Scholar 

  21. Bohn, K., Fairburn, C.G.: The clinical impairment assessment questionnaire (CIA 3.0). In: Fairburn, C.G (ed.) Cognitive Behavior Therapy and Eating Disorders. Guilford Press, New York (2008)

    Google Scholar 

  22. Bohn, K., Doll, H.A., Cooper, Z., O’Connor, M., Palmer, R.L., Fairburn, C.G.: The measurement of impairment due to eating disorder psychopathology. Behav. Res. Ther. 46, 1105–1110 (2008). https://doi.org/10.1016/j.brat.2008.06.012

    CrossRef  Google Scholar 

  23. Berg, K.C., Peterson, C.B., Frazier, P., Crow, S.J.: Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int. J. Eat. Disord. 45, 428–438 (2012). https://doi.org/10.1002/eat.20931

    CrossRef  Google Scholar 

  24. Marshall, M.N.: Sampling for qualitative research. Fam. Pract. 13, 522–526 (1996)

    MathSciNet  CrossRef  Google Scholar 

  25. Thomas, D.R.: A general inductive approach for analyzing qualitative evaluation data. Am. J. Eval. 27, 237–246 (2006). https://doi.org/10.1177/1098214005283748

    CrossRef  Google Scholar 

  26. CDC Centers for Disease Control and Prevention About Child & Teen BMI. Heal. Weight CDC. https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

  27. Fox, S., Duggan, M.: Mobile Health 2012. Pew Internet Am. Life Proj. 1–29 (2012). Accessed http://pewinternet.org/Reports/2012/Mobile-Health.aspx

  28. Smith, A.: The Smartphone Difference. Pew Research Center, April 2015. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/

  29. Quick, V.M., Byrd-Bredbenner, C.: Eating disorders examination questionnaire (EDE-Q): norms for US college students. Eat. Weight Disord. 18, 29–35 (2013). https://doi.org/10.1007/s40519-013-0015-1

    CrossRef  Google Scholar 

  30. Eikey, E.V.: Privacy and weight loss apps: a first look at how women with eating disorders use social features. In: Proceedings of the International Conference on Supporting Group Work (GROUP), pp. 413–415 (2016)

    Google Scholar 

  31. Kawamura, K.Y., Frost, R.O.: Self-concealment as a mediator in the relationship between perfectionism and psychological distress. Cognit. Ther. Res. 28, 183–191 (2004). https://doi.org/10.1023/B:COTR.0000021539.48926.c1

    CrossRef  Google Scholar 

  32. Masuda, A., Latzman, R.D.: Psychological flexibility and self-concealment as predictors of disordered eating symptoms. Sch Words Georg State Univ. (2012)

    Google Scholar 

  33. Hackler, A.H., Vogel, D.L., Wade, N.G.: Attitudes toward seeking professional help for an eating disorder: the role of stigma and anticipated outcomes. J. Couns. Dev. 88, 424–431 (2010). https://doi.org/10.1002/j.1556-6678.2010.tb00042.x

    CrossRef  Google Scholar 

  34. Peng, W., Kanthawala, S., Yuan, S., Hussain, S.A.: A qualitative study of user perceptions of mobile health apps. BMC Public Health 16, 1158 (2016). https://doi.org/10.1186/s12889-016-3808-0

    CrossRef  Google Scholar 

  35. Breton, E.R., Fuemmeler, B.F., Abroms, L.C.: Weight loss-there is an app for that! But does it adhere to evidence-informed practices? Transl. Behav. Med. 1, 523–529 (2011). https://doi.org/10.1007/s13142-011-0076-5

    CrossRef  Google Scholar 

  36. Birnbaum, M.L., Rizvi, A.F., Correll, C.U., Kane, J.M., Confino, J.: Role of social media and the Internet in pathways to care for adolescents and young adults with psychotic disorders and non-psychotic mood disorders. Early Interv. Psychiatry 11, 290–295 (2017). https://doi.org/10.1111/eip.12237

    CrossRef  Google Scholar 

  37. Smith, A., Anderson, M.: Social media use in 2018, pp. 1–17. Pew Research Center. Accessed http://www.pewinternet.org/2018/03/01/social-media-use-in-2018/

  38. Auerbach, R.P., et al.: Mental disorders among college students in the world health organization world mental health surveys. Psychol. Med. 46, 2955–2970 (2016). https://doi.org/10.1017/S0033291716001665

    CrossRef  Google Scholar 

  39. Hunt, J., Eisenberg, D.: Mental health problems and help-seeking behavior among college students. J. Adolesc. Heal. 46, 3–10 (2010). https://doi.org/10.1016/j.jadohealth.2009.08.008

    CrossRef  Google Scholar 

  40. Tregarthen, J.P., Lock, J., Darcy, A.M.: Development of a smartphone application for eating disorder self-monitoring. Int. J. Eat. Disord. 48, 972–982 (2015). https://doi.org/10.1002/eat.22386

    CrossRef  Google Scholar 

  41. Jorm, A.F.: Mental health literacy; empowering the community to take action for better mental health. Am. Psychol. 67, 231–243 (2012). https://doi.org/10.1037/a0025957

    CrossRef  Google Scholar 

  42. Hammer, J.H., Vogel, D.L.: Men’s help seeking for depression: the efficacy of a male-sensitive brochure about counseling. Couns. Psychol. 38, 296–313 (2010). https://doi.org/10.1177/0011000009351937

    CrossRef  Google Scholar 

  43. Finkelstein, J., Lapshin, O.: Reducing depression stigma using a web-based program. Int. J. Med. Inform. 76, 726–734 (2007). https://doi.org/10.1016/j.ijmedinf.2006.07.004

    CrossRef  Google Scholar 

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Acknowledgements

We would like to thank our participants for sharing their experiences. This work was supported by the National Center for Research Resources, the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) under grant UL1 TR001414. It is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Correspondence to Elizabeth V. Eikey .

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Eikey, E.V., Chen, Y., Zheng, K. (2019). Do Recovery Apps Even Exist?: Why College Women with Eating Disorders Use (But Not Recommend) Diet and Fitness Apps Over Recovery Apps. In: Taylor, N., Christian-Lamb, C., Martin, M., Nardi, B. (eds) Information in Contemporary Society. iConference 2019. Lecture Notes in Computer Science(), vol 11420. Springer, Cham. https://doi.org/10.1007/978-3-030-15742-5_69

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  • DOI: https://doi.org/10.1007/978-3-030-15742-5_69

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