Optimising Digital Mindfulness-Based Interventions to Reduce Risk Factors for Disordered Eating

: (Alternative Format Thesis)

Abstract

Disordered eating refers to maladaptive behaviours and related cognitions around eating, weight, and shape, regardless of whether diagnostic criteria for an eating disorder are met. Given its high prevalence and harmful consequences, reducing the occurrence and impact of disordered eating is a global mental health priority. Digital mindfulness-based interventions (MBIs) offer a promising and scalable approach to addressing risk factors for disordered eating; however, engagement is often low, and outcomes are variable. Involving end users in development can improve engagement by ensuring interventions are relevant and usable, while identifying active components may enhance both effectiveness and engagement by streamlining content to focus on what matters most. Therefore, this thesis aimed to develop our understanding of how MBIs can be optimised to reduce key psychological risk factors for disordered eating. Chapter 1 introduces two guiding frameworks for intervention development – the Person-Based Approach (PBA) and the Multiphase Optimisation Strategy (MOST) – and begins applying MOST in this context through the identification and selection of promising intervention components. Chapter 2 evaluates emotion regulation as a mediator of the relationship between mindfulness and disordered eating risk factors, supporting its selection as a candidate component to be examined alongside self-compassion. Chapter 3 lays the groundwork for intervention development within the PBA by systematically mapping qualitative evidence on user experiences with digital MBIs and identifying key barriers and facilitators to engagement. Chapter 4 builds on this PBA groundwork to develop a theory-, evidence-, and user-informed prototype intervention ready for optimisation. Chapter 5 assesses the feasibility of the intervention and factorial optimisation trial designed to evaluate the added effects of emotion regulation and self-compassion components to mindfulness, supporting progression to a full-scale optimisation trial. Chapter 6 synthesises findings, critically evaluates the work, outlines implications, and provides recommendations for future research. Together, this work provides the theoretical, empirical, and methodological foundation for optimising digital MBIs and developing effective, engaging, and scalable interventions capable of reducing the onset, experience, and burden of disordered eating.

Date of Award	18 Feb 2025
Original language	English
Awarding Institution	University of Bath
Supervisor	Melissa Atkinson (Supervisor), Paul Chadwick (Supervisor), Ben Ainsworth (Supervisor) & Nic Hooper (Supervisor)