Understanding mHealth Preferences Among Black Women Who Experience Binge and Emotional Eating: A Qualitative Analysis (Preprint)

BACKGROUND Approximately 30% of Black women in the United States experience untreated binge and emotional eating, which may disproportionately increase the risk for obesity and type 2 diabetes. Despite the availability of evidence-based interventions to treat binge and emotional eating, Black women still face several barriers to accessing in-person treatment. With higher smartphone ownership and internet use for health information compared to the general population, utilizing digital health tools may improve treatment access. However, limited evidence exists on the specific digital health needs and preferences of Black women. OBJECTIVE This study uses qualitative inquiry to examine mHealth preferences in black women who experience binge and emotional eating. METHODS Black women who experienced at least 2 binge eating episodes a month and/or emotional eating and regularly used a Bluetooth-enabled smartphone were enrolled (N=23) to use a nutrition monitoring app (Nourishly) for 2 weeks. The app tracked meals, emotions, offered specialized meal plans, and facilitated communication with clinical care teams. Post-app use, participants joined focus groups to describe their experience and perceived cultural relevancy of the app. Thematic analysis was used to identify and analyze data. RESULTS Four themes were identified that captured participants’ experiences with the Nourishly application. Participants reported positive experiences with app features like ease of use, goal setting, rewards, and emotional health tracking. Recommendations included enhancing customization features (e.g., smartwatch connectivity, photo integration, background aesthetics) and community support. Suggestions also included providing grocery shopping recommendations for meal planning and adding culturally relevant health facts (e.g., blood pressure and self-care). CONCLUSIONS Overall feedback was positive, indicating mHealth app acceptance for nutrition monitoring. Enhancing access, customization, and cultural relevance could further enhance mHealth engagement and acceptance among Black women experiencing loss of control and emotional eating. CLINICALTRIAL NCT05741125