Stakeholders’ perspectives on online interventions to improve mental health in eating disorder patients and carers in Germany
Open accessAbstract
Background: Eating disorders are causing severe consequences for those affected as well as a high burden for their carers. Although there is a substantial need for psychological assistance, different factors are hindering access to support. Internet-based interventions can help to overcome these barriers. To date, there is only little knowledge on attitudes of potential users, facilitators (e.g. psychologists) and decision makers (e.g. health insurances) regarding these interventions. Methods: We conducted focus groups with potential users (N = 30) and semi-structured interviews with potential decision makers (N = 4). Potential facilitators (N = 41) participated in an online survey. Stakeholders’ experiences, attitudes, and their needs regarding Internet-based interventions for eating disorder patients and carers were assessed. Furthermore, hindering and fostering factors related to reach, adoption, implementation and maintenance were analyzed. Results: About two-thirds of the participating facilitators have heard or read about Internet-based interventions in general. In contrast, the other stakeholders mentioned to have no or little experience with such interventions. Factors like anonymity, availability and cost-effectiveness were seen as major advantages. Also disadvantages, e.g. lack of personal contact, limitations by disease severity and concerns on data safety, were mentioned. Stakeholders stated the need for interventions which are usable, evidence-based, tailored and provide personal support. Conclusion: Stakeholders considered Internet-based programmes to have more advantages than disadvantages. Effort should be put in providing systematic education to address prejudices. When offering an online intervention, stakeholders’ needs, as well as a continuous evaluation and adaptation, have to be taken into account.
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Smartphone-delivered interventions are flexible in terms of time and place.
“Such interventions are flexible in terms of time and place, can be offered in different languages, thus reaching a high number of people, and their anonymous usage might reduce the fear of mental health stigma (Hilty et al., 2018; Burchert et al., 2019; Schmidt-Hantke et al., 2021).”
From Smartphone-delivered mental health care interventions for refugees: A systematic review of the literature (2023) · cites this paper as Schmidt-Hantke et al., 2021
The Results (Attitudes; page unavailable) report that stakeholders considered Internet-based interventions flexible in location and time. The paper mentions mobile-phone use, but it does not specifically establish this finding for smartphone-delivered interventions. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSmartphone-delivered interventions have the potential to directly address some of the strongest barriers to help-seeking in refugee populations.
“Smartphone-delivered interventions like applications (‘apps’) or internet-based interventions that can be implemented on smartphones have the potential to directly address some of the strongest barriers to help-seeking in refugee populations.”
From Smartphone-delivered mental health care interventions for refugees: A systematic review of the literature (2023) · cites this paper as Schmidt-Hantke et al., 2021
The Introduction says Internet-delivered interventions may reduce barriers such as limited access, stigma and long waits; the Discussion notes their accessibility and potential to reach underserved people. The paper concerns eating-disorder patients and carers in Germany, however, and does not establish that these are the strongest help-seeking barriers in refugee populations. It discusses Internet-based programmes suitable for mobile devices, not specifically smartphone apps. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSmartphone-delivered interventions can be offered in different languages, thus reaching a high number of people.
“Such interventions are flexible in terms of time and place, can be offered in different languages, thus reaching a high number of people, and their anonymous usage might reduce the fear of mental health stigma (Hilty et al., 2018; Burchert et al., 2019; Schmidt-Hantke et al., 2021).”
From Smartphone-delivered mental health care interventions for refugees: A systematic review of the literature (2023) · cites this paper as Schmidt-Hantke et al., 2021
The Results (Attitudes) describe internet-based interventions as using widely available technology, and the Discussion (Principal Findings) says they can reach underserved populations. The paper also discusses a mobile version in Results (Characteristics), but the passages do not say interventions can be offered in different languages or that this is why they reach more people. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAnonymous usage of smartphone-delivered interventions might reduce the fear of mental health stigma.
“Such interventions are flexible in terms of time and place, can be offered in different languages, thus reaching a high number of people, and their anonymous usage might reduce the fear of mental health stigma (Hilty et al., 2018; Burchert et al., 2019; Schmidt-Hantke et al., 2021).”
From Smartphone-delivered mental health care interventions for refugees: A systematic review of the literature (2023) · cites this paper as Schmidt-Hantke et al., 2021
In Results > Attitudes (page not provided), stakeholders described anonymity as an advantage of Internet-based interventions because it could help overcome fear of stigmatization. The source supports the proposed stigma benefit, but it does not establish that benefit specifically for smartphone-delivered interventions. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- Schmidt-Hantke, J., Vollert, B., Hagner, F., Beintner, I., Hütter, K., Nitsch, M., Jacobi, C., & Waldherr, K.
- Affiliations
- Technische Universität Dresden (DE)
- Fachhochschule Wiener Neustadt (AT)
- Corresponding author
- Schmidt-Hantke, Juliane
- ORCID
- Venue
- European Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-07-01
- Volume
- 31
- Issue
- Supplement_1
- Pages
- i80-i87
- ISSN
- 1101-1262 (ISSN-L)
- 1464-360X
- PMC
- PMC8266537
- OpenAlex
- W3181207793
- Cited by
- 29
- References
- 37
- Citations by year
- 2026: 3 · 2024: 11 · 2023: 2 · 2022: 11 · 2021: 2
- FWCI
- 5.84
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- European Union’s Horizon 2020 (634757)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- eating disorders, online intervention, online psychological intervention, caregivers, stakeholder perspectives, access barriers, facilitators, data privacy, cost-effectiveness, anonymity, mental health
- MeSH terms
- Internet-Based Intervention, Feeding and Eating Disorders, Humans, Mental Health, Caregivers, Focus Groups
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