Trial, Error, and Insight: Using the Pilot Study of the HOPE Program to Inform Next Steps for Digital Single-Session Research for Eating Disorders.

Abstract

Digital single-session interventions (D-SSIs) are emerging as promising tools for bridging treatment gaps in youth mental health. Negi and Forbush's recent pilot study introduces "Help for Overcoming Problem Eating" (HOPE), a D-SSI targeting binge-spectrum eating disorders in university students. Their findings suggest preliminary acceptability, feasibility, and symptom improvements, contributing to the growing evidence-base for D-SSIs in disordered eating. This commentary outlines five key challenges that must be addressed to translate pilot findings into real-world impact. First, the uptake of D-SSIs is often low, likely due to help-seeking barriers and septicism towards this approach. Peer-led, promotional campaigns may boost engagement of D-SSIs in young people. Second, despite their brevity, D-SSI completion is not assured. Strategies such as automated reminders, peer or AI-guided support, and youth co-design may improve adherence. Third, economic evaluations are rare but critical for determining whether D-SSIs offer cost-effective support within resource-limited student services. Fourth, trials should examine mechanisms and durability of change, with complementary D-SSIs offering promising directions. Finally, meaningful integration into care pathways is critical. D-SSIs may serve as stand-alone supports, early engagement tools, or components of stepped-care models. Lack of response could signal the need for intensive care, while successful use may increase openness to further help-seeking. Addressing these challenges with informative, implementation-ready trials will be key to realizing the full potential of D-SSIs in addressing eating disorders in university students and advancing youth mental health care more broadly.