Co-design of a single session intervention chatbot for people on waitlists for eating disorder treatment: a qualitative interview and workshop study
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Date
2025
Authors
Sharp, G.
Dwyer, B.
Xie, J.
McNaney, R.
Shrestha, P.
Prawira, C.
Fernando, A.N.
de Boer, K.
Hu, H.
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Journal of Eating Disorders, 2025; 13(1):46-1-46-14
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Gemma Sharp, Bronwyn Dwyer, Jue Xie, Roisin McNaney, Pranita Shrestha, Christopher Prawira, Anne Nileshni Fernando, Kathleen de Boer and Hao Hu
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Abstract
Background: Early treatment is critical to improve eating disorder prognosis. Single session interventions have been proposed as a strategy to provide short term support to people on waitlists for eating disorder treatment, however, it is not always possible to access this early intervention. Conversational artificial intelligence agents or “chatbots” reflect a unique opportunity to attempt to fill this gap in service provision. The aim of this research was to co-design a novel chatbot capable of delivering a single session intervention for adults on the waitlist for eating disorder treatment across the diagnostic spectrum and ascertain its preliminary acceptability and feasibility. Methods: A Double Diamond co-design approach was employed which included four phases: discover, define, develop, and deliver. There were 17 participants in total in Australia; ten adults with a lived experience of an eating disorder and seven registered psychologists working in the field of eating disorders, who participated in online interviews and workshops. Thematic and content analyses were undertaken with interview/workshop transcriptions with findings from the previous phase informing the ideas and development of the next phase. A final prototype of a single session intervention chatbot was presented to the participants in the deliver phase. Results: Thematic and content analyses identified four main themes that were present across the four phases of interviews/ workshops: conversational tone, safety and risk management, user journey and session structure, and content. Conclusions: Overall, the feedback on the single session intervention chatbot was positive throughout the Double Diamond process from both people with a lived experience of an eating disorder and psychologists. Incorporating the feedback across the four themes and four co-design phases allowed for refinement of the chatbot. Further research is required to evaluate the chatbot’s efficacy in early treatment settings.
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© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.