Evaluation of Web-Based Health Information From the Perspective of Women With Eating Disorders: Thematic Analysis.

BACKGROUND: Users with experience of eating disorders use the internet as a source of information, whether for prorecovery activities (such as web-based treatment, looking for information, support, and sharing) or activities that promote eating disorder behavior as a desirable lifestyle choice (such as pro-eating disorder communities and reading and creating pro-eating disorder posts). Their assessment of web-based eating disorder-related information is crucial for understanding the context of the illness and for health professionals and their web-based interventions. OBJECTIVE: This study aimed to understand the criteria young women with the experience of eating disorders use in evaluating eating disorder-related web-based information and what eating disorder-related characteristics of these women are involved in their evaluation. METHODS: We analyzed 30 semistructured individual interviews with Czech women aged 16 to 28 years with past or present eating disorder experience using a qualitative approach. Thematic analysis was adopted as an analytical tool. RESULTS: The specifics of eating disorder phases (the disorder stage and the treatment process) emerged as important aspects in the process of information assessment. Other specific characteristics of respondents (eg, motivation, abilities, and resources) addressed how the respondents arrived at certain web-based information and how they evaluated it. In addition, the respondents described some content cues as features of information (eg, novelty and social information pooling). Another finding is that other users' attitudes, experiences, activities, and personal features are involved in the information evaluation of these users and the information presented by them. Finally, the respondents evaluated the websites' visual look and graphic components. CONCLUSIONS: This study shows that web-based information evaluation reported by women with experience of eating disorders is a complex process. The assessment is influenced by current personal characteristics related to the illness (mainly the motivation for maintaining or curing the eating disorder) using cues associated with information content, other users, and website look. The study findings have important implications for health professionals, who should ask their clients questions about web-based communities and their needs to understand what information and sources they choose.

Advantages and Disadvantages of Internet Use: The Perspective of Women with Eating Disorders Experience.

Even though the internet is a common source of information and treatment for people with eating disorder (ED) experience, the motives for illness-related searches have rarely been investigated beyond the perceived negatives. This study explores how women with ED experience reflect upon the advantages and disadvantages of their ED-related internet use. We expand the framework of the Uses and Gratifications Theory (U&G) into the context of users with ED experience through 30 semi-structured interviews with women with ED experience, aged 16 to 28, who live in the Czech Republic. Thematic analysis revealed four themes related to the pros and cons of their internet usage: ED-related Information Content; Internet Features Important to Users; Body Image; and Social Interaction. The results challenge the binary view of ED-related internet use and question some presumptions of U&G Theory within the specific context of users with ED experience.

Feasibility of Real-time Behavior Monitoring Via Mobile Technology in Czech Adults Aged 50 Years and Above: 12-Week Study With Ecological Momentary Assessment.

BACKGROUND: Czech older adults have lower rates of physical activity than the average population and lag behind in the use of digital technologies, compared with their peers from other European countries. OBJECTIVE: This study aims to assess the feasibility of intensive behavior monitoring through technology in Czech adults aged ≥50 years. METHODS: Participants (N=30; mean age 61.2 years, SD 6.8 years, range 50-74 years; 16/30, 53% male; 7/30, 23% retired) were monitored for 12 weeks while wearing a Fitbit Charge 2 monitor and completed three 8-day bursts of intensive data collection through surveys presented on a custom-made mobile app. Web-based surveys were also completed before and at the end of the 12-week period (along with poststudy focus groups) to evaluate participants' perceptions of their experience in the study. RESULTS: All 30 participants completed the study. Across the three 8-day bursts, participants completed 1454 out of 1744 (83% compliance rate) surveys administered 3 times per day on a pseudorandom schedule, 451 out of 559 (81% compliance rate) end-of-day surveys, and 736 episodes of self-reported planned physical activity (with 29/736, 3.9% of the reports initiated but returned without data). The overall rating of using the mobile app and Fitbit was above average (74.5 out of 100 on the System Usability Scale). The majority reported that the Fitbit (27/30, 90%) and mobile app (25/30, 83%) were easy to use and rated their experience positively (25/30, 83%). Focus groups revealed that some surveys were missed owing to notifications not being noticed or that participants needed a longer time window for survey completion. Some found wearing the monitor in hot weather or at night uncomfortable, but overall, participants were highly motivated to complete the surveys and be compliant with the study procedures. CONCLUSIONS: The use of a mobile survey app coupled with a wearable device appears feasible for use among Czech older adults. Participants in this study tolerated the intensive assessment schedule well, but lower compliance may be expected in studies of more diverse groups of older adults. Some difficulties were noted with the pairing and synchronization of devices on some types of smartphones, posing challenges for large-scale studies.

Internet Usage by Women with Eating Disorders during Illness and Recovery.

Internet usage may have both positive and negative impacts on people with eating disorders. In research to date, most of the focus has been put on the harms connected with platforms that support people in continuing their disorder. Less studied have been the benefits of other technology platforms used by people with eating disorders. When these different platforms were investigated, users were rarely interviewed about their experience. To fill this gap, we conducted 30 interviews with participants aged 16 to 28, all female, living in the Czech Republic. The interviews focused on their experiences with the harmful and helpful impacts of the internet on the course of their eating disorders. The data were analyzed via thematic analysis. The results provided insight into the participants' experience with the following online environments: 1) nonprofessional pro-eating disorder platforms; 2) nonprofessional pro-recovery platforms; 3) social networking sites (SNS); 4) platforms for counting calories and setting weight goals; 5) platforms about food, exercise, and lifestyle; and 6) platforms providing professional help. The participants noted many benefits these platforms could provide; however, their ability to achieve the benefits was affected by their motivation for treatment. As a result, even platforms designed to support recovery could be used for illness maintenance. The results are discussed in the context of research on the changing motivations for recovery in people with eating disorders and the theory of different processes connected to the course of the eating disorders according to the differential interactivity of digital platforms.

GPs' perspectives on eHealth use in the Czech Republic: a cross-sectional mixed-design survey study.

BACKGROUND: Digitalisation of health services is among the top priorities of the European Union (EU), yet take-up of eHealth tools is slower in some EU countries than others. AIM: The aim of this study was to evaluate the use of information communication technology (ICT) and eHealth tools by Czech GPs, to elucidate their motivation and barriers to the adoption of eHealth technologies. DESIGN & SETTING: A cross-sectional, mixed-design survey study, administered online and conducted with GPs from seven randomly selected Czech regions. Of the invited 777 GPs, 196 participants responded (25% response rate) and 153 completed the survey. METHOD: Quantitative (measured using, for example, the eHealth readiness scale) and qualitative (thematic analysis) methods were used. RESULTS: Hierarchical multilinear regression (controling for age, sex, and city size) showed that ICT usage in general practice was predicted by eHealth readiness. Among GPs with their own practice, age and practice size also predicted ICT use. Analysis of barriers specific to mobile health tools identified obstacles on the side of GPs (such as low perceived usefulness), patients (such as lack of interest), and contextual barriers (such as lack of time). CONCLUSION: In addition to system-level change, educating Czech GPs about the benefits of eHealth tools for better patient-provider interaction and quality of care is necessary to facilitate eHealth adoption and usage in the Czech Republic.

Is it Important to Talk About Technologies with Eating Disorder Clients? The Health-Care Professional Perspective.

Nowadays, the use of digital technology is an important issue that should be addressed during the treatment of people who have eating disorders. The involvement or absence of this issue reflects the understanding, experience, and atttude of health-care professionals toward their clients' use of technology. The aim of the present study was to investigate the perceptions of health-care professionals and their assessment of their clients' usage of digital technology while developing strategies for treatment. Semistructured interviews with 30 professionals were performed from October 2015 to June 2016 and a thematic analysis was used to analyze the data. The health-care professionals' views could be summarized in three thematic groups: (1) technology use is not relevant for the cooperation; (2) technology use is relevant for the cooperation and addressed generally; and (3) technology use is relevant for the cooperation and addressed specifically. The results are discussed in relation to the theoretical model presented by Rodgers about the impact of technology on disordered eating behaviors and the implications for practice.