Abstract：
BACKGROUND: University students are an at-risk group for the development of eating disorders (EDs); however, many college campuses lack sufficient resources to provide ED specialty care. Students report unique reasons for not seeking ED treatment, including the desire to solve the problem on their own (eg, seeking help from friends, self-medicating, or waiting to see if their problems improve), inability to afford treatment, lack of time to participate in the treatment, fear of seeing their primary care physician, and lack of recognition of their issues as an ED. Mobile health (mHealth) apps may be a cost-effective, helpful adjunctive tool to overcome personal and systemic barriers and encourage help seeking.
OBJECTIVE: This paper describes the development, usability, and acceptability of the Building Healthy Eating and Self-Esteem Together for University Students (BEST-U) mHealth smartphone app, which is designed to fill critical gaps in access to ED treatment on college campuses.
METHODS: We undertook a 4-phase iterative development process that focused on user-centered design. The 4 phases included needs assessment based on literature reviews, prototype development and initial evaluation in a pilot trial, redesign, and further pilot-testing to assess the usability and acceptability of the final version of the mHealth app. Acceptability and user satisfaction were assessed using an ad hoc survey that ranged from 1 (strongly disagree) to 7 (strongly agree).
RESULTS: Our needs assessment identified a lack of accessible and affordable treatments for university students. To help meet this need, the BEST-U prototype was designed as an 11-week program that provided interactive, weekly modules that focused on second- and third-wave cognitive behavioral skills. The modules focused on topics such as psychoeducation, reducing thought distortions and body checking, improving body image, interpersonal effectiveness, and behavior chain analysis. The content included interactive quizzes, short answer questions, daily and weekly logs, and surveys completed in the app. BEST-U was paired with brief 25-30 minutes of weekly telehealth coaching sessions provided by a licensed provider or supervised trainee. Pilot-testing revealed minor issues with one module of the app content, which some participants viewed as having low relevance to their experience and therapist concerns about the organization of the app content. These issues were addressed through the removal, addition, and reorganization of BEST-U modules, with the help of therapists-in-training across 2 workshops. The revised version of the BEST-U app had a grand mean acceptability rating of 5.73 out of 7. The participants completed 90.1% (694/770) of the BEST-U modules, indicating high compliance.
CONCLUSIONS: BEST-U is a new, acceptable, and user-friendly mHealth app to help therapists deliver brief, evidence-based cognitive behavioral interventions. Owing to its acceptability and user-friendly nature, BEST-U has high user compliance and holds promise for future implementation and dissemination in university mental health settings.
OBJECTIVE: This paper describes the development, usability, and acceptability of the Building Healthy Eating and Self-Esteem Together for University Students (BEST-U) mHealth smartphone app, which is designed to fill critical gaps in access to ED treatment on college campuses.
METHODS: We undertook a 4-phase iterative development process that focused on user-centered design. The 4 phases included needs assessment based on literature reviews, prototype development and initial evaluation in a pilot trial, redesign, and further pilot-testing to assess the usability and acceptability of the final version of the mHealth app. Acceptability and user satisfaction were assessed using an ad hoc survey that ranged from 1 (strongly disagree) to 7 (strongly agree).
RESULTS: Our needs assessment identified a lack of accessible and affordable treatments for university students. To help meet this need, the BEST-U prototype was designed as an 11-week program that provided interactive, weekly modules that focused on second- and third-wave cognitive behavioral skills. The modules focused on topics such as psychoeducation, reducing thought distortions and body checking, improving body image, interpersonal effectiveness, and behavior chain analysis. The content included interactive quizzes, short answer questions, daily and weekly logs, and surveys completed in the app. BEST-U was paired with brief 25-30 minutes of weekly telehealth coaching sessions provided by a licensed provider or supervised trainee. Pilot-testing revealed minor issues with one module of the app content, which some participants viewed as having low relevance to their experience and therapist concerns about the organization of the app content. These issues were addressed through the removal, addition, and reorganization of BEST-U modules, with the help of therapists-in-training across 2 workshops. The revised version of the BEST-U app had a grand mean acceptability rating of 5.73 out of 7. The participants completed 90.1% (694/770) of the BEST-U modules, indicating high compliance.
CONCLUSIONS: BEST-U is a new, acceptable, and user-friendly mHealth app to help therapists deliver brief, evidence-based cognitive behavioral interventions. Owing to its acceptability and user-friendly nature, BEST-U has high user compliance and holds promise for future implementation and dissemination in university mental health settings.
摘要：
背景：大学生是饮食失调（ED）发展的高危人群；然而，许多大学校园缺乏足够的资源来提供ED专业护理。学生报告不寻求ED治疗的独特原因，包括自己解决问题的愿望(例如，寻求朋友的帮助，自我用药,或等着看他们的问题是否有所改善)，无力负担治疗费用，没有时间参与治疗，害怕见到他们的初级保健医生，并且缺乏对他们作为ED的问题的认识。移动健康（mHealth）应用程序可能具有成本效益，有用的辅助工具，以克服个人和系统的障碍，并鼓励寻求帮助。
目的：本文描述了发展，可用性，以及为大学生（BEST-U）mHealth智能手机应用程序共同构建健康饮食和自尊的可接受性，旨在填补大学校园获得ED治疗的关键空白。
方法：我们进行了一个四阶段的迭代开发过程，重点是以用户为中心的设计。这4个阶段包括基于文献综述的需求评估，在试点试验中进行原型开发和初步评估，重新设计,以及进一步的试点测试，以评估mHealth应用程序最终版本的可用性和可接受性。可接受性和用户满意度使用临时调查进行评估，范围从1（强烈不同意）到7（强烈同意）。
结果：我们的需求评估发现，大学生缺乏可获得和负担得起的治疗方法。为了满足这种需求，BEST-U原型设计为一个为期11周的程序，提供互动，每周模块，专注于第二波和第三波认知行为技能。这些模块侧重于诸如心理教育，减少思想扭曲和身体检查，改善身体形象，人际有效性，和行为链分析。内容包括交互式测验，简短回答问题，每日和每周日志，并在应用程序中完成调查。BEST-U与由有执照的提供者或受监督的受训者提供的每周25-30分钟的简短的远程健康辅导课程配对。试点测试表明，应用程序内容的一个模块存在一些小问题，一些参与者认为这与他们的经验和治疗师对应用程序内容组织的担忧相关性很低。这些问题通过移除得到了解决，addition,以及BEST-U模块的重组，在2个讲习班的培训中，治疗师的帮助下。BEST-U应用程序的修订版的平均可接受性评分为7分之5.73。参与者完成了90.1%（694/770）的BEST-U模块，表明高度合规。
结论：BEST-U是一种新的，可接受,和用户友好的mHealth应用程序，以帮助治疗师提供简报，基于证据的认知行为干预。由于其可接受性和用户友好性，BEST-U具有很高的用户合规性，并有望在大学心理健康环境中进行未来的实施和传播。
目的：本文描述了发展，可用性，以及为大学生（BEST-U）mHealth智能手机应用程序共同构建健康饮食和自尊的可接受性，旨在填补大学校园获得ED治疗的关键空白。
方法：我们进行了一个四阶段的迭代开发过程，重点是以用户为中心的设计。这4个阶段包括基于文献综述的需求评估，在试点试验中进行原型开发和初步评估，重新设计,以及进一步的试点测试，以评估mHealth应用程序最终版本的可用性和可接受性。可接受性和用户满意度使用临时调查进行评估，范围从1（强烈不同意）到7（强烈同意）。
结果：我们的需求评估发现，大学生缺乏可获得和负担得起的治疗方法。为了满足这种需求，BEST-U原型设计为一个为期11周的程序，提供互动，每周模块，专注于第二波和第三波认知行为技能。这些模块侧重于诸如心理教育，减少思想扭曲和身体检查，改善身体形象，人际有效性，和行为链分析。内容包括交互式测验，简短回答问题，每日和每周日志，并在应用程序中完成调查。BEST-U与由有执照的提供者或受监督的受训者提供的每周25-30分钟的简短的远程健康辅导课程配对。试点测试表明，应用程序内容的一个模块存在一些小问题，一些参与者认为这与他们的经验和治疗师对应用程序内容组织的担忧相关性很低。这些问题通过移除得到了解决，addition,以及BEST-U模块的重组，在2个讲习班的培训中，治疗师的帮助下。BEST-U应用程序的修订版的平均可接受性评分为7分之5.73。参与者完成了90.1%（694/770）的BEST-U模块，表明高度合规。
结论：BEST-U是一种新的，可接受,和用户友好的mHealth应用程序，以帮助治疗师提供简报，基于证据的认知行为干预。由于其可接受性和用户友好性，BEST-U具有很高的用户合规性，并有望在大学心理健康环境中进行未来的实施和传播。
