scholarly journals Technology-Enabled Reform in a Nontraditional Mental Health Service for Eating Disorders: Participatory Design Study (Preprint)

2020 ◽  
Author(s):  
Alyssa Clare Milton ◽  
Ashlea Hambleton ◽  
Mitchell Dowling ◽  
Anna Elizabeth Roberts ◽  
Tracey Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Body Image ◽  
Participatory Design ◽  
Technological Solution ◽  
Web Based ◽  
Design Processes ◽  
The Right ◽  
Body Image Issues ◽  
Technology Solution

BACKGROUND The recent Australian National Agenda for Eating Disorders highlights the role technology can play in improving accessibility and service development through web-based prevention, early access pathways, self-help, and recovery assistance. However, engagement with the eating disorders community to co-design, build, and evaluate these much-needed technology solutions through participatory design processes has been lacking and, until recently, underresourced. OBJECTIVE This study aims to customize and configure a technology solution for a nontraditional (web-based, phone, email) mental health service that provides support for eating disorders and body image issues through the use of participatory design processes. METHODS Participants were recruited chiefly through the Butterfly National Helpline 1800 ED HOPE (Butterfly’s National Helpline), an Australian-wide helpline supporting anyone concerned by an eating disorder or body image issue. Participants included individuals with lived experience of eating disorders and body image issues, their supportive others (such as family, health professionals, support workers), and staff of the Butterfly Foundation. Participants took part in participatory design workshops, running up to four hours, which were held nationally in urban and regional locations. The workshop agenda followed an established process of discovery, evaluation, and prototyping. Workshop activities included open and prompted discussion, reviewing working prototypes, creating descriptive artifacts, and developing user journeys. Workshop artifacts were used in a knowledge translation process, which identified key learnings to inform user journeys, user personas, and the customization and configuration of the InnoWell Platform for Butterfly’s National Helpline. Further, key themes were identified using thematic techniques and coded in NVivo 12 software. RESULTS Six participatory design workshops were held, of which 45 participants took part. Participants highlighted that there is a critical need to address some of the barriers to care, particularly in regional and rural areas. The workshops highlighted seven overarching qualitative themes: identified barriers to care within the current system; need for people to be able to access the right care anywhere, anytime; recommendations for the technological solution (ie, InnoWell Platform features and functionality); need for communication, coordination, and integration of a technological solution embedded in Butterfly’s National Helpline; need to consider engagement and tone within the technological solution; identified challenges and areas to consider when implementing a technological solution in the Helpline; and potential outcomes of the technological solution embedded in the Helpline relating to system and service reform. Ultimately, this technology solution should ensure that the right care is provided to individuals the first time. CONCLUSIONS Our findings highlight the value of actively engaging stakeholders in participatory design processes for the customization and configuration of new technologies. End users can highlight the critical areas of need, which can be used as a catalyst for reform through the implementation of these technologies in nontraditional services.

scholarly journals Technology-Enabled Reform in a Nontraditional Mental Health Service for Eating Disorders: Participatory Design Study

10.2196/19532 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e19532
Author(s):  
Alyssa Clare Milton ◽  
Ashlea Hambleton ◽  
Mitchell Dowling ◽  
Anna Elizabeth Roberts ◽  
Tracey Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Body Image ◽  
Participatory Design ◽  
Technological Solution ◽  
Web Based ◽  
Design Processes ◽  
The Right ◽  
Body Image Issues ◽  
Technology Solution

Background The recent Australian National Agenda for Eating Disorders highlights the role technology can play in improving accessibility and service development through web-based prevention, early access pathways, self-help, and recovery assistance. However, engagement with the eating disorders community to co-design, build, and evaluate these much-needed technology solutions through participatory design processes has been lacking and, until recently, underresourced. Objective This study aims to customize and configure a technology solution for a nontraditional (web-based, phone, email) mental health service that provides support for eating disorders and body image issues through the use of participatory design processes. Methods Participants were recruited chiefly through the Butterfly National Helpline 1800 ED HOPE (Butterfly’s National Helpline), an Australian-wide helpline supporting anyone concerned by an eating disorder or body image issue. Participants included individuals with lived experience of eating disorders and body image issues, their supportive others (such as family, health professionals, support workers), and staff of the Butterfly Foundation. Participants took part in participatory design workshops, running up to four hours, which were held nationally in urban and regional locations. The workshop agenda followed an established process of discovery, evaluation, and prototyping. Workshop activities included open and prompted discussion, reviewing working prototypes, creating descriptive artifacts, and developing user journeys. Workshop artifacts were used in a knowledge translation process, which identified key learnings to inform user journeys, user personas, and the customization and configuration of the InnoWell Platform for Butterfly’s National Helpline. Further, key themes were identified using thematic techniques and coded in NVivo 12 software. Results Six participatory design workshops were held, of which 45 participants took part. Participants highlighted that there is a critical need to address some of the barriers to care, particularly in regional and rural areas. The workshops highlighted seven overarching qualitative themes: identified barriers to care within the current system; need for people to be able to access the right care anywhere, anytime; recommendations for the technological solution (ie, InnoWell Platform features and functionality); need for communication, coordination, and integration of a technological solution embedded in Butterfly’s National Helpline; need to consider engagement and tone within the technological solution; identified challenges and areas to consider when implementing a technological solution in the Helpline; and potential outcomes of the technological solution embedded in the Helpline relating to system and service reform. Ultimately, this technology solution should ensure that the right care is provided to individuals the first time. Conclusions Our findings highlight the value of actively engaging stakeholders in participatory design processes for the customization and configuration of new technologies. End users can highlight the critical areas of need, which can be used as a catalyst for reform through the implementation of these technologies in nontraditional services.

Understanding body image from a psychosocial stance: how this connects with patients requesting cosmetic procedures

2020 ◽  
Vol 9 (3) ◽  
pp. 128-131 ◽  
Author(s):  
Deborah Auer
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Body Image ◽  
Depression And Anxiety ◽  
Health Issues ◽  
Health It ◽  
Additional Training ◽  
Mental Health Issues ◽  
Body Dysmorphia

There are many patients requesting cosmetic procedures who also struggle with mental health issues. These can include body dysmorphia, eating disorders, depression and anxiety. If aesthetic practitioners are able to recognise mental health, it will go some way to protect those for whom cosmetic procedures may not be the most appropriate course of treatment. This article will discuss the factors that contribute to the development of body image. The hope is that it will help practitioners question their own knowledge and understanding of mental health and how it can be connected with requests for cosmetic procedures. Practitioners may also identify areas where they need additional training and or understanding.

scholarly journals Involving End Users in Adapting a Spanish Version of a Web-Based Mental Health Clinic for Young People in Colombia: Exploratory Study Using Participatory Design Methodologies

10.2196/15914 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e15914
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey A Davenport ◽  
Alvaro Andres Navarro-Mancilla ◽  
Vanessa Wan Sze Cheng ◽  
Andrés Camilo Cardozo Alarcón ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Health Professionals ◽  
Participatory Design ◽  
Self Report ◽  
User Testing ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries

Background Health information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties. Objective Using participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C). Methods This study involved the utilization of a research and development (R&D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions. Results A total of 2 co-design workshops were held with 18 users—young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions—young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context. Conclusions The application of an R&D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R&D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C—a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time.

scholarly journals Development of a Web-Based Acceptance and Commitment Therapy Intervention to Support Lifestyle Behavior Change and Well-Being in Health Care Staff: Participatory Design Study

10.2196/22507 ◽  
2020 ◽  
Vol 4 (11) ◽  
pp. e22507
Author(s):  
Menna Brown ◽  
Nic Hooper ◽  
Parisa Eslambolchilar ◽  
Ann John
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Design Process ◽  
Acceptance And Commitment Therapy ◽  
Participatory Design ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Web Based ◽  
Acceptance And Commitment

Background Positive emotional well-being is associated with healthier lifestyle choices and overall health function, whereas poor mental health is associated with significant economic and psychological costs. Thus, the development of effective interventions that improve emotional well-being is crucial to address the worldwide burden of disease. Objective This study aims to develop a web-based emotional well-being intervention for use by health care staff using participatory design to consider adherence and engagement from a user perspective. Methods A 3-staged iterative participatory design process was followed, including multiple stakeholders: researchers, computer scientists, mental health experts, and health care staff. Stage 1 used document analyses, direct observation, and welcome interviews; stage 2 used focus group discussions, rapid prototyping, and usability tasks; and stage 3 evaluated a high-fidelity prototype. Results Different health care staff (N=38) participated during a sustained period. A structured, sequential, automated, 12-week, web-based emotional well-being intervention based on acceptance and commitment therapy was developed. Freely navigated psychoeducational resources were also included. Conclusions The iterative and collaborative participatory design process successfully met its objectives. It generated an in-depth understanding of well-being within the workplace and identified barriers to access. The 3-staged process ensured that participants had the opportunity to explore and articulate criteria relevant to their roles over time and reflect on decisions made at each stage.

scholarly journals The effect of body image preoccupation on decision making in eating disorders

2020 ◽  
Author(s):  
Jakub Onysk ◽  
Peggy Seriès
Keyword(s):  
Decision Making ◽  
Eating Disorders ◽  
Body Image ◽  
Eating Disorder ◽  
The Body ◽  
Body Image Disturbance ◽  
Model Based ◽  
Healthy Control ◽  
Body Image Issues ◽  
Reinforcement Learning Model

AbstractEating disorders are associated with one of the highest mortality rates among all mental disorders, yet there is very little research about them within the newly emerging and promising field of computational psychiatry. As such, we focus on investigating a previously unexplored, yet a core aspect of eating disorders – body image preoccupation. We continue a freshly opened debate about model-based learning in eating disorders and perform a study that utilises a two-step decision-making task and a reinforcement learning model to understand the effect of body image preoccupation on model-based learning in a subclinical eating disorder population, as recruited using Prolific. We find a significantly reduced model-based contribution in the body image disturbance task condition in the eating disorder group as compared to a healthy control. We propose a new digital biomarker that significantly predicts disordered eating, and body image issues.

scholarly journals Technology-Enabled Mental Health Service Reform for Open Arms – Veterans and Families Counselling: Participatory Design Study (Preprint)

2019 ◽  
Author(s):  
Haley M LaMonica ◽  
Tracey A Davenport ◽  
Jane Burns ◽  
Shane Cross ◽  
Stephanie Hodson ◽  
...  
Keyword(s):  
Mental Health ◽  
Participatory Design ◽  
New Technologies ◽  
Personal Health Information ◽  
Department Of Veterans Affairs ◽  
Web Based ◽  
South Wales ◽  
Australian Defence Force ◽  
The Individual ◽  
The Impact

BACKGROUND The impact of mental ill-health on every aspect of the lives of a large number of Australian Defence Force (ADF) personnel, their partners, and their families is widely recognized. Recent Senate inquiries have highlighted gaps in service delivery as well as the need for service reform to ensure appropriate care options for individuals who are currently engaged with mental health and support services as well as for those who, for a variety of reasons, have not sought help. To that end, successive Australian governments generally and the Department of Veterans’ Affairs specifically have prioritized veteran-centric reform. Open Arms is an Australia-wide service that provides counseling and support to current and former ADF personnel, and their family members, for mental health conditions. OBJECTIVE The aim of this study was to develop and configure a prototypic Web-based platform for Open Arms—Veterans & Families Counselling (formerly Veterans and Veterans Families Counselling Service) with the Open Arms community to enhance the quality of mental health services provided by Open Arms. METHODS The study aimed to recruit up to 100 people from the Open Arms community (current and former ADF personnel and their families, health professionals, service managers, and administrators) in regions of New South Wales, including Sydney, Canberra, Maitland, Singleton, and Port Stephens. Participants were invited to participate in 4-hour participatory design workshops. A variety of methods were used within the workshops, including prompted discussion, review of working prototypes, creation of descriptive artifacts, and group-based development of user journeys. RESULTS Seven participatory design workshops were held, including a total of 49 participants. Participants highlighted that the prototype has the potential to (1) provide the opportunity for greater and better-informed personal choice in relation to options for care based on the level of need and personal preferences; (2) ensure transparency in care by providing the individual with access to all of their personal health information; and (3) improve collaborative care and care continuity by allowing information to be shared securely with current and future providers. CONCLUSIONS Our findings highlight the value of actively engaging stakeholders in participatory design processes for the development and configuration of new technologies.

scholarly journals Recognising and managing eating disorders in the emergency department

2021 ◽  
pp. postgradmedj-2021-140253
Author(s):  
Anisa Jabeen Nasir Jafar ◽  
Wisam Jalal Jawad Jafar ◽  
Emma Kathleen Everitt ◽  
Ian Gill ◽  
Hannah Maria Sait ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Healthcare Professionals ◽  
Good Recovery ◽  
Acute Medicine ◽  
Electrolyte Disturbances ◽  
Risk Patients ◽  
Self Harm ◽  
New Perspective ◽  
The Right

Compared with other mental health conditions or psychiatric presentations, such as self-harm, which may be seen in emergency departments, eating disorders can seem relatively rare. However, they have the highest mortality across the spectrum of mental health, with high rates of medical complications and risk, ranging from hypoglycaemia and electrolyte disturbances to cardiac abnormalities. People with eating disorders may not disclose their diagnosis when they see healthcare professionals. This can be due to denial of the condition itself, a wish to avoid treatment for a condition which may be valued, or because of the stigma attached to mental health. As a result their diagnosis can be easily missed by healthcare professionals and thus the prevalence is underappreciated. This article presents eating disorders to emergency and acute medicine practitioners from a new perspective using the combined emergency, psychiatric, nutrition and psychology lens. It focuses on the most serious acute pathology which can develop from the more common presentations; highlights indicators of hidden disease; discusses screening; suggests key acute management considerations and explores the challenge of mental capacity in a group of high-risk patients who, with the right treatment, can make a good recovery.

scholarly journals Development of a Web-Based Acceptance and Commitment Therapy Intervention to Support Lifestyle Behavior Change and Well-Being in Health Care Staff: Participatory Design Study (Preprint)

2020 ◽  
Author(s):  
Menna Brown ◽  
Nic Hooper ◽  
Parisa Eslambolchilar ◽  
Ann John
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Design Process ◽  
Acceptance And Commitment Therapy ◽  
Participatory Design ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Web Based ◽  
Acceptance And Commitment

BACKGROUND Positive emotional well-being is associated with healthier lifestyle choices and overall health function, whereas poor mental health is associated with significant economic and psychological costs. Thus, the development of effective interventions that improve emotional well-being is crucial to address the worldwide burden of disease. OBJECTIVE This study aims to develop a web-based emotional well-being intervention for use by health care staff using participatory design to consider adherence and engagement from a user perspective. METHODS A 3-staged iterative participatory design process was followed, including multiple stakeholders: researchers, computer scientists, mental health experts, and health care staff. Stage 1 used document analyses, direct observation, and welcome interviews; stage 2 used focus group discussions, rapid prototyping, and usability tasks; and stage 3 evaluated a high-fidelity prototype. RESULTS Different health care staff (N=38) participated during a sustained period. A structured, sequential, automated, 12-week, web-based emotional well-being intervention based on acceptance and commitment therapy was developed. Freely navigated psychoeducational resources were also included. CONCLUSIONS The iterative and collaborative participatory design process successfully met its objectives. It generated an in-depth understanding of well-being within the workplace and identified barriers to access. The 3-staged process ensured that participants had the opportunity to explore and articulate criteria relevant to their roles over time and reflect on decisions made at each stage.

scholarly journals Co-Designing a Web-Based Decision Aid Tool for Employees Disclosure of Mental Health Conditions: A Participatory Study Design Using Employee and Organizational Preferences (Preprint)

2020 ◽  
Author(s):  
Elizabeth Stratton ◽  
Isabella Choi ◽  
Dorian Peters ◽  
Rafael A Calvo ◽  
Samuel B Harvey ◽  
...  
Keyword(s):  
Mental Health ◽  
Participatory Design ◽  
Decision Aid ◽  
Health Condition ◽  
End Users ◽  
Health Conditions ◽  
Full Time ◽  
Mental Health Condition ◽  
Web Based ◽  
Mental Health Conditions

BACKGROUND Decisions of whether to disclose mental health conditions are extremely personal and require the consideration of multiple factors associated with the disclosure process (eg, weighing the risks and benefits). Decision aid tools help people make these complex decisions. Such an aid needs to be confidential, easily accessible, and easy to use with the potential to access the tool on multiple occasions. Web programs are well suited to meet these requirements and, if properly developed, can provide feasible, accessible, affordable, and effective workplace interventions. OBJECTIVE This study aims to gain insights from potential end users, in this case both employees and organizations, into what type of components including language, style, and content would avoid potential stigma and ensure that elements of clear value for users would be built into a web-based decision aid tool that aims to assist employees in making decisions about the disclosure of their mental health condition at work. METHODS A participatory design approach was used to allow developers, researchers, experts, and end users to collaborate in co-designing the tool. During the user research phase of the development of the web-based tool, a participatory design workshop approach was selected as a part of a larger study of focus groups. Australian employees and managers in rural, suburban, and urban locations participated in an exploratory qualitative study involving participatory workshops designed to elicit their perspectives and preferences for a decision aid tool. RESULTS A total of 2 workshops were conducted with 13 participants. The majority were from a transport company (9/13, 69%), male (8/13, 62%), and employed full time (11/13, 85%). Six employees had previous experience disclosing their own mental health condition, and 7 were in a supervisory role and had previously been disclosed to. In any co-design development, there are certain trade-offs that need to be made between the views of experts, developers, end users, and the available budget. In this specific instance of a very delicate, personal decision, the end users provided valuable design insights into key areas such as language, and they were very antipathetic to a key feature, the avatar, which was thought to be desirable by experts and developers. Findings including aspects of the tool where all stakeholders were in agreement, aspects where some stakeholders disagreed and adaptations were implemented, where disagreements could not be implemented because of financial constraints, and misalignment between stakeholders and how to decide on a balance were shared. CONCLUSIONS The co-design with a lived experience approach is useful for contributing much to the design, language, and features. The key in this study was balancing the needs of the workers and the potential impact for the managers and organizations, while ensuring legislation and regulation requirements were upheld. CLINICALTRIAL

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