Using the Person-Based Approach to design novel Virtual Reality treatments for eating disorders

Research Question: Can novel Virtual Reality treatments be developed for eating disorders, and are such treatments acceptable to young people with ED? A person-based approach Background: Eating disorders are serious mental illnesses with significant associated mortality and morbidity. Most eating disorders begin during adolescence, and they affect 1 in 20 adolescent girls and 1 in 50 adolescent boys. Rates of hospital admission with an eating disorder have more than doubled since 2016. However existing treatments do not work for as many as half of those with an eating disorder, and people often relapse following treatment, particularly if they have residual symptoms of dissatisfaction with their weight and shape. Aims and objectives: The overarching aim is to use the Person-Based Approach to co-design a suite of novel Virtual Reality interventions for use alongside the usual treatment of 14-25-year-olds with eating disorders for whom an overvaluation of shape and weight is a key part of their illness(Anorexia Nervosa, Bulimia Nervosa, and the related Other Specified Feeding and Eating Disorders). As part of the Fellowship, I will then design a study protocol and apply for funding for a feasibility trial of their use. Ultimately, the aim is to test effectiveness of the intervention in real-world settings, and working alongside experienced therapists will ensure that the resulting interventions will be appropriate for use within the NHS. Specific Objectives: Use the Person-Based Approach to co-develop the following interventions within Virtual Reality: a graded-exposure scenarioto practice a challenging real-life situation, of ordering in a café. a gamified attentional re-training taskto train attention away from underweight bodies. an intervention to explore inhabiting and viewing different versions of one's body in Virtual Reality, to address the overvaluation of shape and weight. Bring together the most successful aspects of Objectives 1(i) to 1(iii) into a single novel intervention and test its acceptabilityin a separate group. Design a study protocol and apply for further funding for a feasibility studyof this novel treatment. Methods: I will use the Person-Based Approach (a methodology developed by my research mentor Prof Yardley) to enable the existing evidence base to be combined with qualitative work with people with lived experience. The iterativeintervention design and optimisation process that is central to the Person-Based Approach will ensure that the resulting interventions are engaging and acceptable for people with eating disorders, as well as drawing on the existing evidence base. Timelines for delivery: The process of iterative co-design is necessary but time-intensive, and I envisage that Objectives 1(i, ii and iii) will be complete around 3.5 years into the project. Objective 2 will draw the most successful elements together over the following year. The final six months will be spent applying for funding and IRAS to conduct a feasibility study. Anticipated impact and dissemination: This work will result in a novel intervention as an adjunctive treatment for eating disorders which has potential for a significant positive impact on patients. It will be widely disseminated including via peer-reviewed literature, conferences social media and via charity collaborators.