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Pursey KM, Burrows TL, Barker D, Hart M, Paxton SJ. Disordered eating, body image concerns, and weight control behaviors in primary school aged children: A systematic review and meta-analysis of universal-selective prevention interventions. Int J Eat Disord 2021; 54:1730-1765. [PMID: 34245459 DOI: 10.1002/eat.23571] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Body image concerns and extreme weight control behaviors frequently develop in childhood indicating an important age group for the implementation of universal-selective prevention approaches. This systematic review aimed to evaluate the effect of universal-selective prevention interventions addressing disordered eating, body image concerns, and/or extreme weight control behaviors in children aged 6-12 years. METHOD Nine databases were searched up to April 2021. Studies were included if they delivered a universal-selective prevention intervention to children aged 6-12 years and reported outcomes relating to body image, disordered eating, or weight control behaviors. The review was conducted in line with the PRISMA Guidelines. RESULTS A total of 42 articles describing 39 studies included in the review, with most (n = 24; 57%) classified as neutral quality. Thirty studies implemented an eating disorder specific universal-selective program and nine implemented lifestyle interventions plus content to address disordered eating risk factors. Meta-analysis (n = 16 studies) revealed an improvement in body image-related outcomes across all studies (standardized mean difference [SMD] 0.26 [95%CI 0.01, 0.51]); with a high level of heterogeneity (Î2 = 89.9%; p < .01). Meta-analysis according to gender revealed a general improvement in body image-related outcomes for girls (SMD 0.40 [95%CI 0.07, 0.73]), but not boys (SMD 0.23 [95%CI -0.24, 0.70]). DISCUSSION By investigating child, parental and teaching interventions and including outcomes such as weight control and disordered eating behaviors, a trend toward a reduction in eating disorder risk factors was observed, particularly body image-related outomes in girls. Future directions include embedded disordered eating prevention materials within existing lifestyle interventions and inclusion of more diverse samples.
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Affiliation(s)
- Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Melissa Hart
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Hunter New England Mental Health, Waratah, New South Wales, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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da Silva SU, Alves MDA, de Vasconcelos FDAG, Gonçalves VSS, Barufaldi LA, de Carvalho KMB. Association between body weight misperception and dietary patterns in Brazilian adolescents: Cross-sectional study using ERICA data. PLoS One 2021; 16:e0257603. [PMID: 34555063 PMCID: PMC8460023 DOI: 10.1371/journal.pone.0257603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/04/2021] [Indexed: 01/13/2023] Open
Abstract
The association between body image and eating behaviors or weight control strategies has been demonstrated in the scientific literature, but there is a lack of evidence on the association between weight misperception and food consumption indicators in adolescents. This study aimed to evaluate the association between weight misperception and dietary patterns (DPs) in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). It was a national school-based cross-sectional study conducted among students aged 12-17 years. Data were collected in the form of anthropometric measurements, responses in self-answered questionnaires, and 24-h dietary recall. The following variables were assessed: weight underestimation and overestimation (independent variables), which were defined as the presence of a disagreement between nutritional status and self-perceived weight; dietary patterns (dependent variables), defined by a posteriori method using principal component factor analysis; and individual and demographic variables (covariates). Data analysis was performed using the Poisson regression models method, stratified by sex. A total of 52,038 adolescents with normal weights were evaluated. The weight misperception prevalence was 34.0% (95% confidence interval [CI]: 33.0, 35.0). Three DPs were identified: "Traditional Brazilian," "Processed meat sandwiches and coffee," and "Ultra-processed and sweet foods." In girls, weight underestimation was directly associated with the "Traditional Brazilian" (1.24; 95% CI: 1.08, 1.43) and "Ultra-processed and sweet foods" DPs (1.29; 95% CI: 1.09, 1.54), and overestimation was inversely associated with all the DPs. In boys, a direct association between underestimation and the "Ultra-processed and sweet foods" DP (1.29; 95% CI: 1.10, 1.51) was found. Overestimation was inversely associated with the "Traditional Brazilian" DP (0.79; 95% CI: 0.63, 0.99). The inverse association between overestimation and the "Traditional Brazilian" DP, and the direct association between underestimation and the "Ultra-processed and sweet foods" DP indicated that weight misperception was related to unhealthy eating habits in Brazilian adolescents.
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Affiliation(s)
- Simoni Urbano da Silva
- Faculty of Health Sciences, Graduate Program of Public Health, University of Brasilia, Brasilia, Federal District, Brazil
| | - Mariane de Almeida Alves
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | | | | | - Laura Augusta Barufaldi
- Population Research Division, Brazilian National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Rio de Janeiro, Brazil
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Linardon J, Greenwood CJ, Fuller-Tyszkiewicz M, Macdonald JA, Spry E, Hutchinson DM, Youssef GJ, Sanson A, Wertheim EH, McIntosh JE, Le Grange D, Letcher P, Olsson CA. Young adult mental health sequelae of eating and body image disturbances in adolescence. Int J Eat Disord 2021; 54:1680-1688. [PMID: 34240437 DOI: 10.1002/eat.23575] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There has been interest in the antecedents and mental health impacts of eating and body image disturbances in adolescence. Less is known about longer-term mental health impacts into young adulthood, as longitudinal studies with data spanning this developmental period are rare. We capitalize on mental health data collected across adolescence and young adulthood from a population-based cohort study that has been following >2000 Australian children and their families from infancy to young adulthood. METHOD This sample comprised 1,568 participants who completed the Eating Disorder Inventory drive for thinness and bulimic behavior (the severity of binge-purge patterns) subscales, and a modified version of the body dissatisfaction subscale in mid-adolescence (15-16 years), or the Depression Anxiety Stress Scales in young adulthood (19-20, 23-24, and 27-28 years). RESULTS After adjusting for baseline demographic and prior mental health factors (<13 years of age), all three indices of eating and body image disturbances in adolescence predicted each mental health outcome in young adulthood. Mental health risks associated with adolescent body dissatisfaction and bulimic behavior scores remained stable across young adulthood, with men having more pronounced problems associated with bulimic behavior scores than women. In contrast, mental health risks associated with adolescent drive for thinness scores diminished across this period similarly for men and women. DISCUSSION Findings suggest that adolescent eating and body image disturbances may have long-term mental health impacts that extend into young adulthood. This underscores the need for early preventative intervention, and longer-term monitoring and support for body image and eating disturbances.
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Affiliation(s)
- Jake Linardon
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Elizabeth Spry
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Delyse M Hutchinson
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia.,National Drug and Alcohol Research Centre, The University of New South Wales, Randwick, New South Wales, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Ann Sanson
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Eleanor H Wertheim
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer E McIntosh
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, Eating Disorders Program, University of California, San Francisco, San Francisco, California, USA
| | - Primrose Letcher
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
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54
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Jarman HK, Treneman-Evans G, Halliwell E. "I didn't want to say something and them to go outside and tell everyone": The acceptability of a dissonance-based body image intervention among adolescent girls in the UK. Body Image 2021; 38:80-84. [PMID: 33836350 DOI: 10.1016/j.bodyim.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
Cognitive dissonance-based interventions (CDIs) have been well established as effective programs for the prevention of eating disorders. However, limited research has qualitatively explored adolescent girls experience of such interventions. The present study examined the acceptability of a cognitive dissonance-based body image intervention among adolescent girls in UK secondary schools. Adolescent girls aged 14-18 years (N = 99; Mage = 14.87, SD = 0.97) who opted to participate in the intervention were invited to provide intervention feedback via open-ended questions and small focus groups. The findings suggest that the intervention was largely acceptable among adolescent girls. Peers played an important role. Despite initial concerns about sharing within the group, the groups provided a sense of belonging and participants no longer felt alone in their experience of body dissatisfaction. Participants discussed a transition from negative to positive body image following the intervention. Although acceptability was generally high, the data provides some interesting insights into potential considerations and modifications which may be advantageous in future CDIs. These include enhancing authenticity through reduced reliance on the script, inclusion of more personal content from the peer-leaders, and more interactive activities and physical movement.
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Affiliation(s)
- Hannah K Jarman
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia.
| | - Georgia Treneman-Evans
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, United Kingdom
| | - Emma Halliwell
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, United Kingdom
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55
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Campbell SM. Expanding notions of equity: Body diversity and social justice. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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56
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Bell BT, Taylor C, Paddock D, Bates A. Digital Bodies: A controlled evaluation of a brief classroom-based intervention for reducing negative body image among adolescents in the digital age. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2021; 92:280-298. [PMID: 34350594 DOI: 10.1111/bjep.12449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND A growing body of research has linked social media use to negative body image. AIMS The present research aimed to evaluate the efficacy of Digital Bodies, a brief classroom-based intervention that aims to improve adolescents' body image. METHODS British adolescents (N = 290; Age M = 12.81; SD = 0.40; Range = 12-13; Female = 151) were cluster randomized to intervention or waiting list control groups. Measures of body satisfaction, appearance ideal internalization (thin and athletic ideal internalization) and self-objectification were completed at baseline (T1), 1-week post-intervention (T2) and 8-week follow-up (T3). RESULTS Multi-level modelling showed adolescents in the intervention group reported improved body satisfaction at T2, in comparison to the control, and crucially this effect was sustained at T3. Additionally, girls reported less thin ideal internalization at T2 relative to the control, but this effect was not sustained at T3. No other intervention effects were found. CONCLUSIONS Overall, the findings provide initial support for the efficacy of Digital Bodies as an intervention for improving adolescents' body satisfaction.
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Affiliation(s)
- Beth T Bell
- School of Education, Languages and Psychology, York St John University, UK
| | - Caitlin Taylor
- School of Education, Languages and Psychology, York St John University, UK
| | - Danielle Paddock
- School of Education, Languages and Psychology, York St John University, UK
| | - Adam Bates
- College of Social Sciences and Arts, Sheffield Hallam University, UK
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57
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Atkinson MJ, Diedrichs PC. Assessing the impact of body image concerns on functioning across life domains: Development and validation of the Body Image Life Disengagement Questionnaire (BILD-Q) among British adolescents. Body Image 2021; 37:63-73. [PMID: 33581387 DOI: 10.1016/j.bodyim.2021.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 12/20/2022]
Abstract
Assessing the impact of body image on engagement in a range of life domains is important; however, there is a lack of validated measures for adolescents. The current research developed the Body Image Life Disengagement Questionnaire (BILD-Q) and validated it among four samples of British adolescents. Study 1 (N = 1707; 11-13 years) indicated a 9-item unidimensional scale based on Exploratory Factory Analysis. In Study 2 (N = 1403; 11-13 years), Confirmatory Factor Analysis (CFA) showed an acceptable fit overall, but better among girls than boys. Further exploration with CFA in Study 3 (N = 2034; 13-14 years) showed a good to excellent fit overall, and acceptable among both boys and girls. The scale showed good internal consistency and test-retest reliability, and gender invariance indicated the scale can be used comparatively. In Study 4 (N = 288; 13-14 years), convergent validity was supported via expected relationships with body image and related constructs. Concurrent and predictive incremental validity were also evidenced via explaining significant unique variance in well-being. These studies provide support for the BILD-Q as a reliable and valid measure of broader impacts of body image among adolescents, which may benefit intervention evaluation and policy change efforts.
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Affiliation(s)
- Melissa J Atkinson
- Department of Psychology, University of Bath, UK; Centre for Appearance Research, University of the West of England, UK.
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58
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De Coen J, Verbeken S, Goossens L. Media influence components as predictors of children's body image and eating problems: A longitudinal study of boys and girls during middle childhood. Body Image 2021; 37:204-213. [PMID: 33711766 DOI: 10.1016/j.bodyim.2021.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 01/15/2023]
Abstract
Body image problems are reported during middle childhood and are associated with exposure to appearance-focused media. This longitudinal study investigated the extent to which three media influence components, Awareness, Pressure, and Internalization of media ideals, predict body image and eating problems in children and whether gender moderates this effect. A total sample of N = 688 participants (46 % girls, aged 8-11 at T1) was studied. Self-report questionnaires were administered on the media influence components, body image and eating problems at T1 and T2 (1 year later). After controlling for age, adjusted body mass index and baseline levels of body image and eating problems, results show that media influence components significantly predicted Restraint and Concerns about Eating, Weight, and Shape one year later. Awareness, however, uniquely predicted increases in Eating Concerns in boys, while Pressure predicted increases in Concerns on Eating, Weight, and Shape in girls only. The current results indicate that media influences, some of which may be gender-specific risk factors, predict subsequent body image concerns of girls and boys during middle childhood. Thus, both boys and girls should be addressed in future research and prevention programs.
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Affiliation(s)
- Jolien De Coen
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Sandra Verbeken
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Lien Goossens
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium
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Acceptability and preliminary efficacy of a school-based body image intervention in urban India: A pilot randomised controlled trial. Body Image 2021; 37:282-290. [PMID: 33813345 DOI: 10.1016/j.bodyim.2021.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/19/2021] [Accepted: 02/25/2021] [Indexed: 01/27/2023]
Abstract
This pilot study evaluated the acceptability and preliminary efficacy of a culturally adapted school-based body image intervention, Dove Confident Me, for use in urban India. Two private schools in New Delhi were randomly assigned at the school level to receive either the five-session intervention facilitated by trained psychologists or lessons-as-usual (control). Participants were Year 7 students (N = 166; Mage = 11.9 years). Students, facilitators, and observing teachers, provided acceptability feedback. Fidelity was assessed. Body image and related measures were completed by students in a classroom setting at pre-intervention, post-intervention, and two-month follow-up. Most students enjoyed (73.7 %) and understood (84.2 %) the intervention. Facilitators (90 %) and observing teachers (70 %) reported that the learning objectives were achieved. Adherence and facilitator competence were rated as very good. Body esteem improved significantly among intervention students at post-intervention and follow-up (Cohen's ds = .45-.46), relative to control students. Positive affect also improved at post-intervention (d = .58). No significant effects on internalisation, life engagement, eating pathology, self-esteem, or negative affect emerged. This study provides evidence for the acceptability and preliminary efficacy of Dove Confident Me in urban India. Intervention refinements to increase acceptability and efficacy are recommended.
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60
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Bell BT, Taylor C, Paddock DL, Bates A, Orange ST. Body talk in the digital age: A controlled evaluation of a classroom-based intervention to reduce appearance commentary and improve body image. Health Psychol Open 2021; 8:20551029211018920. [PMID: 34104461 PMCID: PMC8165851 DOI: 10.1177/20551029211018920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research evaluates the efficacy of a classroom-based intervention - Body Talk in the Digital Age (BTIDA) - in reducing adolescents' appearance commentary and improving body image. British adolescents (N = 314; Age Range = 12-14) were cluster randomised to intervention or waiting-list control groups. Measures of appearance commentary, appearance ideal internalisation, self-objectification and body satisfaction were completed at baseline (T1), then one-week (T2) and eight-week (T3) post-intervention. Multi-level modelling showed girls who received BTIDA reported less appearance commentary engagement and thin ideal internalisation at T2 and T3, than the control, supporting the partial efficacy of BTIDA for girls. No intervention effects were found among boys.
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61
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Zimmer-Gembeck MJ, Rudolph J, Pariz J. A cascade of rejection and appearance preoccupation: Adolescents' body dysmorphic symptoms and appearance rejection sensitivity over 4 years. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2021; 40:17-34. [PMID: 33891314 DOI: 10.1111/bjdp.12377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/06/2021] [Indexed: 10/21/2022]
Abstract
Adolescence is a high-risk period for body image disturbance and appearance concerns. In a cascade model, we examined interrelations of body dysmorphic symptoms (BDS) with appearance rejection sensitivity (ARS) and tested gender moderation. Participants were 397 Australian adolescents (T1 Mage = 11.7, SD = 0.91; 56% girls) who completed six surveys over 4 years. In a random-intercept cross-lag model, two (of five possible) paths showed ARS predicted higher subsequent BDS, and three (of five possible) paths showed BDS predicted higher subsequent ARS. Girls reported more BDS and ARS than boys, and random intercepts of BDS and ARS were correlated with the correlation stronger in girls than boys. Cross-lag BDD-ARS associations over the six waves were not significantly moderated by gender. Overall, girls are at higher risk of appearance concerns than boys, but BDD-ARS cascade effects do not differ between girls and boys.
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Affiliation(s)
- Melanie J Zimmer-Gembeck
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Julia Rudolph
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Juliane Pariz
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
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'Everybody's Different: The Appearance Game'. A randomised controlled trial evaluating an appearance-related board game intervention with children aged 9-11 years. Body Image 2021; 36:34-44. [PMID: 33160256 DOI: 10.1016/j.bodyim.2020.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 11/22/2022]
Abstract
This study evaluated the effectiveness of an educational board game aimed at increasing knowledge of appearance-related issues, positive body image, media literacy, and acceptance of appearance diversity with British school children. Two hundred and fifty-nine children, aged 9-11 (Mage = 10.26), from three primary schools in South-West England participated in a two-arm matched cluster randomised controlled trial. Outcome measures were collected pre-, post- and at two-week follow-up. Knowledge of appearance-related issues significantly increased in the intervention group, compared to the control group post-intervention, but was not maintained at follow-up. There were no significant differences between groups for body appreciation, media literacy or acceptance of visible difference. Of the intervention arm, 78 % (n=117) they would like to play again and 85.3 % (n=128) thought other children would like to play. Qualitative data suggests participants learned the key messages of the game. The findings suggest 'Everybody's Different: The Appearance Game' is an enjoyable way to increase knowledge of appearance-related issues. In future, researchers should consider how to increase body appreciation, media literacy and acceptance of appearance diversity, for example by increasing the dosage of the game or using it in conjunction with discussions and lessons surrounding appearance diversity and appearance-altering conditions.
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63
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Torres S. School-Based Body Image Intervention: Overcoming Challenges to Dissemination. J Adolesc Health 2021; 68:229-230. [PMID: 33541597 DOI: 10.1016/j.jadohealth.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Sandra Torres
- Faculty of Psychology and Education Sciences, Center for Psychology at University of Porto, University of Porto, Porto, Portugal
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64
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Diedrichs PC, Atkinson MJ, Garbett KM, Leckie G. Evaluating the "Dove Confident Me" Five-Session Body Image Intervention Delivered by Teachers in Schools: A Cluster Randomized Controlled Effectiveness Trial. J Adolesc Health 2021; 68:331-341. [PMID: 33243723 DOI: 10.1016/j.jadohealth.2020.10.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/05/2020] [Accepted: 10/04/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Body dissatisfaction is common during adolescence and predicts poor psychological and physical health. Interventions have traditionally overrelied on delivery by external providers (e.g., researchers and psychologists), preventing scalability. This study evaluated the acceptability and effectiveness of a school-based body image intervention delivered by schoolteachers. METHODS Six British schools participated in a pragmatic cluster randomized controlled trial. Girls and boys aged 11-13 years received the five-session intervention delivered by their teachers (n = 848) or lessons-as-usual control (n = 647) and were assessed at baseline, postintervention, and 2-, 6-, 12-, 24- and 36-month follow-up. The primary outcome was body image (body esteem), secondary outcomes included risk factors for body image (internalization of appearance ideals, sociocultural pressures, social comparisons, appearance-related teasing, and conversations), and tertiary outcomes included psychosocial well-being (negative affect, self-esteem, dietary restraint, and life engagement). RESULTS Compared with the control group, intervention students demonstrated improvements in the primary outcome of body esteem at postintervention (Cohen's d = .15), 2-month (d = .26), and 6-month follow-up (d = .15). For girls, there was also a significant reduction in experienced appearance-related teasing at 6-month (d = .24) and 12-month (d = .30) follow-up. No other significant intervention effects were observed. The intervention was acceptable to students. CONCLUSIONS These findings present the longest sustained improvements in a cognitive-affective body image outcome observed among girls and boys during a teacher-led universal body image program to date. Intervention refinement and improved teacher training may further improve outcomes. Task-shifting intervention delivery to community providers to scale up interventions is a promising strategy.
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Affiliation(s)
- Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
| | - Melissa J Atkinson
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom; Department of Psychology, University of Bath, Bath, United Kingdom
| | - Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - George Leckie
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
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Kwag KH, Han SW, Cho JY, Ko M, Park EJ, Kim YR. A school-based eating disorder prevention program (Me, You & Us) for young adolescents in Korea: A 3-year follow-up study. Int J Eat Disord 2021; 54:168-173. [PMID: 33348424 DOI: 10.1002/eat.23447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The study aimed to examine the feasibility and long-term effects of a school-based eating disorder prevention program for young adolescents in Korea. METHOD We followed up the students (n = 133) who had participated in the prevention program at 3 years ago to evaluate changes in body esteem and self-esteem between postintervention and 3-year follow-up, with investigating whether gender moderated the effect of time. RESULTS Boys showed no decline in body esteem and self-esteem from postintervention to 3-year follow-up, indicating that the prevention program alleviated decreases in body esteem and self-esteem over time. Girls showed decreases in body esteem and self-esteem from postintervention to 3-years follow-up. DISCUSSION This study provides evidence supporting the feasibility of the school-based eating disorder prevention program targeting mixed-sex, young adolescents in Korea. Given the developmental trajectories of decrease in body esteem and self-esteem during adolescence, the program may be efficient for boys over time. Boosters and/or complementary prevention approaches across gender are needed.
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Affiliation(s)
- Kyung Hwa Kwag
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Soo Wan Han
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Ji-Yeoun Cho
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Myeong Ko
- Goyang Child & Adolescent Mental Health Welfare Center, Goyang, Republic of Korea
| | - Eun Jin Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea.,Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea
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Duffy F, Sharpe H, Beveridge E, Osborne K, Richards C. Mixed methods pilot evaluation of interpersonal psychotherapy for body image for adolescents. Clin Child Psychol Psychiatry 2021; 26:167-177. [PMID: 33043684 PMCID: PMC7802045 DOI: 10.1177/1359104520963371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Body dissatisfaction is common in adolescence and associated with poor outcomes. The aim of this mixed method pilot evaluation was to determine acceptability, feasibility and preliminary efficacy of Interpersonal Psychotherapy for Body Image (IPT-BI), a school-based group intervention for young people with high levels of body dissatisfaction. Eighteen participants (11-13 years, 78% female) took part in two IPT-BI groups (n = 10; n = 8). Feasibility was measured by recruitment and attrition rates; acceptability using a treatment satisfaction questionnaire and focus groups; and clinical outcomes at baseline, each session and post intervention. The majority of young people (72%, n = 18/25) who were referred or expressed interest went on to take part. Average session attendance was 100% and 89%. Participants expressed high levels of treatment satisfaction with 94% (n = 16/17) rating IPT-BI as 'quite helpful' or 'very helpful' and 94% (n = 16/17) stating they would recommend it to others. Preliminary exploration of efficacy showed significant improvements in body image and significant reductions in interpersonal difficulties and appearance-based conversations. Young people valued specific IPT-BI skills (role play, communication strategies), alongside generic therapeutic factors (therapeutic alliance, group cohesion). IPT-BI is feasible and acceptable with promising provisional clinical outcomes indicating the need for a fully powered randomised controlled trial.
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Affiliation(s)
- Fiona Duffy
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Medical School, Edinburgh, UK
- NHS Lothian CAMHS, Royal Edinburgh Hospital, Edinburgh, UK
| | - Helen Sharpe
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Medical School, Edinburgh, UK
| | - Emily Beveridge
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Medical School, Edinburgh, UK
| | - Kate Osborne
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Medical School, Edinburgh, UK
| | - Cathy Richards
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Medical School, Edinburgh, UK
- NHS Lothian CAMHS, Royal Edinburgh Hospital, Edinburgh, UK
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BATISTA LS, GONÇALVES HVB, BANDONI DH. Relationship of sociodemographic conditions with the formation of body image in Brazilian adolescents. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e210056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To investigate the associations between sociodemographic population conditions and adolescents’ body image Methods This is a cross-sectional study using data from the Pesquisa Nacional de Saúde do Escolar (PeNSE, National School Health Survey), conducted in 2015. The objective was to analyze the relationship between students’ sociodemographic conditions and body image attending public and private schools in Brazil capitals and the Federal District. For the statistical analysis, we conducted the Poisson regression models, generating adjusted prevalence ratios and their respective 95% CI. In the multiple models, sociodemographic variables were included, which were significantly associated with body image variables (p<0.05) or which altered the prevalence ratios by at least 10%. Results The research involved 10,926 adolescentes The analyses showed that the older the adolescents, the greater their dissatisfaction with their body. As for the school administrative status, students from private schools were more unhappy with their image (Girls: 33% and Boys: 17.6%) and, they tend to have more attitudes to lose weight (Girls: 42.8% and Boys: 28%). The mother’s level of education causes daughters to be more dissatisfied with their bodies (33.3%) and sons showing more attitudes of wanting to lose weight (26.6%). Conclusion Sociodemographic conditions are directly and indirectly associated with the adolescents’ body image. Negative deviations in body image can result in binge eating and social disorders hindering the development of these pubescent children. The consequences of these actions become a risk to health and psychological well-being, strongly supporting the initiative of programs aimed at issues related to body image in the school setting.
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One size does not fit all: Trajectories of body image development and their predictors in early adolescence. Dev Psychopathol 2020; 34:285-294. [DOI: 10.1017/s0954579420000917] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background: Negative body image predicts many adverse outcomes. The current study prospectively examined patterns of body esteem development in early adolescence and identified predictors of developmental subtypes. Methods: 328 girls and 429 boys reported annually across a 4-year period (Mage at baseline = 11.14, SD = 0.35) on body esteem, appearance ideal internalization, perceived sociocultural pressures, appearance comparisons, appearance-related teasing, self-esteem, positive and negative affect, and dietary restraint. We performed latent class growth analyses to identify the most common trajectories of body esteem development and examine risk and protective factors for body image development. Results: Three developmental subgroups were identified: (a) high body esteem (39.1%); (b) moderate body esteem (46.1%); and (c) low body esteem (14.8%). Body esteem was stable within the low trajectory and there were minor fluctuations in the high and moderate trajectories. Greater appearance-related teasing, lower self-esteem, less positive affect, and higher dietary restraint predicted the low trajectory, whereas higher self-esteem and lower dietary restraint best predicted the high trajectory. Conclusions: Low body esteem appears to be largely stable from age 11 years. Prevention programming may be enhanced by incorporating components to address transdiagnostic resilience factors such as self-esteem and positive affect.
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Abstract
PURPOSE OF REVIEW Body image is a crucial part of adolescent development for teens all over the world. Studies show that negative body image impacts many aspects of adolescent health and that anticipatory guidance about body image is important at the annual health maintenance exam visit. Weight bias is closely tied to body image and is associated with negative health effects as well; research shows weight bias is a problem throughout healthcare. The purpose of this review is to discuss influencing factors on adolescent body image and to explore interventions to promote positive body image. RECENT FINDINGS Research shows that adolescent body image is shaped by media influence, athletics and personal relationships. Studies have also begun to show that negative and positive body image are separate entities, and that overall health outcomes seem to be better in adolescents with positive body image. In thinking about intervention, there are ways to promote positive body image in the provider--patient interaction, within the school and community, in healthcare education, and at the societal level. SUMMARY Body image is an incredibly important aspect of adolescent health, and clinicians should be aware of ways to help promote positive body image in adolescents.
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Šouláková B, Kasal A, Butzer B, Winkler P. Meta-Review on the Effectiveness of Classroom-Based Psychological Interventions Aimed at Improving Student Mental Health and Well-Being, and Preventing Mental Illness. J Prim Prev 2020; 40:255-278. [PMID: 31140100 DOI: 10.1007/s10935-019-00552-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This meta-review summarizes existing evidence from systematic reviews and meta-analyses on the effectiveness of school-based psychological interventions aimed at improving student mental health and well-being, and preventing mental illness. Systematic reviews and meta-analyses were identified via the electronic databases PsycINFO, Web of Knowledge, Medline, Embase, and HMIC (Health Management Information Consortium). Ten systematic reviews and meta-analysis were eligible for inclusion in the final analyses. These systematic reviews and meta-analyses evaluated the effects of five types of school-based psychological interventions: Mindfulness, Social Emotional Learning, Cognitive Behavioral Therapy, Yoga, and Body-Image. Overall effectiveness reported in the included studies was significant for the most part, and ranging from small to large with respect to the effect size. The authors of all of the studies emphasized the need for additional high-quality trials to further examine the effectiveness of school-based psychological interventions aimed at improving student mental health and well-being, and preventing mental illness.
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Affiliation(s)
- Barbora Šouláková
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
| | - Alexandr Kasal
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Faculty of Social Sciences, Charles University in Prague, Prague, Czech Republic
| | - Bethany Butzer
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,School of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Petr Winkler
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Gordon CS, Rodgers RF, Slater AE, McLean SA, Jarman HK, Paxton SJ. A cluster randomized controlled trial of the SoMe social media literacy body image and wellbeing program for adolescent boys and girls: Study protocol. Body Image 2020; 33:27-37. [PMID: 32086189 DOI: 10.1016/j.bodyim.2020.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 01/28/2020] [Accepted: 02/05/2020] [Indexed: 01/21/2023]
Abstract
Youth spend substantial time on social media, which can foster self-critical processes that increase risk of body dissatisfaction, disordered eating, and depressed mood. To date, there have been few investigations of interventions to decrease the negative impacts of social media engagement in adolescent boys and girls. This paper outlines the protocol for a cluster randomized controlled trial (RCT) of a four-lesson social media literacy program that was developed based on pilot results and aims to decrease body dissatisfaction, dietary restraint, and strategies to increase muscles. The RCT will be conducted with grades 7-8 students from Australian secondary schools. Using block randomization, grade levels within schools will be assigned to either the SoMe program (intervention) or health lessons as usual (control). Primary outcomes will be body satisfaction, dietary restraint, and strategies to increase muscles. Secondary outcomes will be self-esteem and depressed mood. Participants will complete assessments on four occasions - baseline, five-weeks post-baseline, and six- and 12-month post-baseline. Analyses will compare outcomes in the intervention compared to the control group. This study will be the first to implement a RCT design to evaluate the impact of a school-based social media literacy program designed to mitigate negative impacts of social media.
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Affiliation(s)
| | - Rachel F Rodgers
- Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Amy E Slater
- Centre for Appearance Research, University of West of England, Bristol, England, United Kingdom
| | - Siân A McLean
- La Trobe University, Victoria, Australia; Victoria University, Australia
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Evaluation of Teen BodyWise: A pilot study of a body image group adapted for adolescent inpatients with anorexia nervosa. Eat Weight Disord 2020; 25:609-615. [PMID: 30796741 DOI: 10.1007/s40519-019-00658-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/14/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Body image disturbance is a key characteristic of anorexia nervosa (AN); however, research into these difficulties among adolescents with AN is limited and is yet to assess the best treatments for this population. METHODS Fifty-two adolescents receiving inpatient treatment for AN attended Teen BodyWise, an eight-session body image group adapted for adolescents. Measures assessing shape and weight concerns, ability to discuss body image, sociocultural attitudes, body avoidance, body checking, and motivation were given before and after the group, and participant feedback was elicited. RESULTS Significant improvements were found for shape and weight concerns, ability to discuss body image, body checking and sociocultural attitudes. Participants were generally satisfied with the group and found it helpful, yet some aspects were experienced as challenging. CONCLUSIONS Teen BodyWise has potential benefits for adolescents with AN. Controlled research is needed to determine the effectiveness of Teen BodyWise. LEVEL OF EVIDENCE Evidence obtained from multiple time series with or without the intervention, such as case studies, Level IV.
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73
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Chua JYX, Tam W, Shorey S. Research Review: Effectiveness of universal eating disorder prevention interventions in improving body image among children: a systematic review and meta-analysis. J Child Psychol Psychiatry 2020; 61:522-535. [PMID: 31746023 DOI: 10.1111/jcpp.13164] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Increasingly, children are at risk of developing eating disorders. A systematic review and a meta-analysis were conducted to examine the effectiveness of universal eating disorder prevention interventions in improving body image, internalization of appearance ideals, and self-esteem among children aged 5-17 years old. METHODS Nine electronic databases were systematically searched from each database's point of inception to March 2019. The Cochrane Risk of Bias tool assessed each study's risk of bias, while the GRADE approach judged the overall evidence for each review outcome. A meta-analysis was conducted using the random-effect model to obtain standardized mean differences with 95% confidence intervals under the inverse variance method. Heterogeneity was assessed using I2 statistic and Cochran's Q chi-squared test. Publication bias was assessed using funnel plots. RESULTS A total of 24 studies (22 trials) were included in this review. Universal interventions were found to be effective in improving children's body esteem, self-esteem, and internalization of appearance ideals at postintervention and at follow-up timepoints. Subgroup analyses found that girls benefited more from these interventions than boys. Multisessional interventions with an optimal duration of approximately one month were found to be more effective. CONCLUSIONS The findings encourage the incorporation of universal preventive interventions into school curricula to benefit most children. Laypeople such as teachers can deliver these interventions, but content experts should address topics on body dissatisfaction. Due to the low quality of evidence, as accorded by the GRADE approach, current findings should be validated by future research.
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Affiliation(s)
| | - Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Sharif Ishak SIZ, Chin YS, Mohd Taib MN, Chan YM, Mohd Shariff Z. Effectiveness of a school-based intervention on knowledge, attitude and practice on healthy lifestyle and body composition in Malaysian adolescents. BMC Pediatr 2020; 20:122. [PMID: 32171276 PMCID: PMC7071695 DOI: 10.1186/s12887-020-02023-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/09/2020] [Indexed: 12/16/2022] Open
Abstract
Background The ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL) intervention programme was developed to prevent overweight and disordered eating in Malaysian adolescents. This study aimed to evaluate the effectiveness of the EPaL programme on knowledge, attitudes and practices on healthy lifestyle and body composition (body mass index z-score [zBMI], waist circumference [WC] and body fat percentage [BF%]) among adolescents. Methods All measures were taken at three time points: before intervention (Pre), after intervention (Post I) and 3 months after intervention (Post II). The intervention group (IG) participated in the EPaL programme for 16 weeks, whereas the comparison group (CG) received no intervention. Seventy-six adolescents (IG: n = 34; CG: n = 42) aged 13–14 years were included in the final analysis. Repeated measures analysis of covariance (ANCOVA) was used to assess the impact of the EPaL intervention programme on the measures between groups (IG and CG) at Post I and Post II. Results The IG reported significantly higher knowledge scores at both Post I (adjusted mean difference = 3.34; 95% confidence interval [CI] = 0.99, 5.69; p = 0.006) and Post II (adjusted mean difference = 2.82; 95% CI = 0.86, 4.78; p = 0.005) compared with the CG. No significant differences between the IG and CG were found at either Post I or Post II in attitudes, practices, zBMI, WC and BF%. The proportion of participants who were overweight or obese was consistent from Pre to Post II in the IG (35.3%) and increased from 26.2% at Pre to 28.5% at Post II in the CG, but the difference was not statistically significant. The proportion of participants who had abdominal obesity in the IG decreased from 17.6% at Pre to 14.7% at Post II and increased from 16.7% at Pre to 21.4% at Post II in the CG, but the differences were not statistically significant. Conclusion Despite no significant reduction of body composition, this programme shows the positive effect on the adolescents’ knowledge regarding healthy lifestyle. This study contributes to the evidence on the effectiveness of school-based health interventions in Malaysian adolescents. Trial registration UMIN Clinical Trial Registration UMIN000024349. Registered 11 October 2016.
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Affiliation(s)
- Sharifah Intan Zainun Sharif Ishak
- Department of Healthcare Professional, Faculty of Health and Life Sciences, Management and Science University, 40100, Shah Alam, Selangor, Malaysia.,Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia. .,Research Centre of Excellence for Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Mohd Nasir Mohd Taib
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.,Research Centre of Excellence for Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
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Sundgot-Borgen C, Friborg O, Kolle E, Torstveit MK, Sundgot-Borgen J, Engen KME, Rosenvinge JH, Pettersen G, Bratland-Sanda S. Does the Healthy Body Image program improve lifestyle habits among high school students? A randomized controlled trial with 12-month follow-up. J Int Med Res 2020; 48:300060519889453. [PMID: 31802697 PMCID: PMC7607281 DOI: 10.1177/0300060519889453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/28/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Positive embodiment and healthy lifestyle habits seem to be related; therefore, stimulating positive embodiment should promote healthy lifestyle habits. In the current study, we delivered the Healthy Body Image (HBI) intervention among Norwegian high school students and examined the effects on healthy lifestyle habits. METHODS The HBI intervention comprises three interactive workshops, with three overarching themes related to body image, social media literacy, and lifestyle. A total of 2446 boys (43%) and girls in grade 12 (mean age 16.8 years) from 30 high schools participated in this cluster-randomized controlled study. Schools were randomized to the HBI intervention or control study arm. Data on physical activity, eating habits, and sleep were collected at baseline, post intervention, and 3- and 12-month follow-up and analyzed using linear mixed regression models. RESULTS The intervention had a minor negative effect on physical activity levels in boys at 12-month follow-up and short-term small-to-moderate positive effects on consumption of breakfast and fruit and vegetables, and sleep duration on school days. CONCLUSIONS In future, the lack of satisfactorily long-term effects might be better addressed using a combination of cognitive and behavioral approaches to more optimally integrate positive embodiment and lifestyle changes in the daily life of adolescents.Trial registration: ClinicalTrials.gov ID: PRSNCT02901457. Approved by the Regional Committee for Medical and Health Research Ethics.
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Affiliation(s)
| | - Oddgeir Friborg
- UiT – The Arctic University of Norway, Faculty of Health
Sciences Department of Psychology, Tromsø, Norway
| | - Elin Kolle
- The Norwegian School of Sport Sciences, Department of Sports
Medicine, Oslo, Norway
| | - Monica K. Torstveit
- University of Agder, Faculty of Health and Sport Sciences,
Kristiansand, Norway
| | | | - Kethe M. E. Engen
- The Norwegian School of Sport Sciences, Department of Sports
Medicine, Oslo, Norway
| | - Jan H. Rosenvinge
- UiT – The Arctic University of Norway, Faculty of Health
Sciences Department of Psychology, Tromsø, Norway
| | - Gunn Pettersen
- UiT – The Arctic University of Norway, Faculty of Health
Sciences Department of Health and Caring Sciences, Tromsø, Norway
| | - Solfrid Bratland-Sanda
- University College of Southeast Norway, Department of Sports,
Physical Education and Outdoor Studies, Kongsberg, Norway
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Kremer MJ, Kremer KP, Kremer TR. School health class associated with reduced odds of eating disorder symptoms in American adolescents. Int J Eat Disord 2020; 53:383-390. [PMID: 31691342 DOI: 10.1002/eat.23194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Eating disorder symptoms, including eating disorder diagnosis, binge eating, and unhealthy weight loss, are associated with health risks, and adolescence may be an optimal time to provide education on healthy alternatives. This research explored whether in-school health information during adolescence is associated with eating disorder symptoms in young adulthood. METHOD Data were used from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of American youth, including information from Wave I, when participants were in Grades 7-12, and from Wave III, when participants were aged 18-26. Logistic regression analyses predicted eating disorder symptoms from in-school health information, adjusting for demographic and educational covariates. In-school health information and eating disorder symptoms were based on participant self-report. RESULTS In-school health information about both diet (the foods you should and should not eat) and the importance of exercise compared to no health information reduced the odds of youth-reported eating disorder history odds ratio ((OR) = 0.23, 95% CI = 0.11-0.48). Individuals who received information on exercise alone compared to no health information were also less likely to use weight pills to control weight (OR = 0.26, 95% CI = 0.11-0.61). There was no difference in binge-eating symptoms based on school health class. DISCUSSION Findings from this exploratory research study indicate that in-school receipt of information on diet and exercise has modest associations with eating disorder symptoms, including lower odds of a self-reported eating disorder and lower odds of using weight loss pills. Further research is needed to definitely test the role of school health class on eating disorder symptoms.
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Affiliation(s)
| | - Kristen P Kremer
- Department of Sociology, Anthropology, and Social Work, Kansas State University, Manhattan, Kansas
| | - Theodore R Kremer
- School of Medicine, Washington University, St. Louis, Missouri.,Esse Health, St. Louis, Missouri
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Looking to the future: Priorities for translating research to impact in the field of appearance and body image. Body Image 2020; 32:53-61. [PMID: 31790960 DOI: 10.1016/j.bodyim.2019.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/20/2022]
Abstract
The field of body image and appearance research and practice is progressing; however, there is still work to be done to ensure broad societal impact. This article consolidates reflections from a range of established and early career experts in the field of appearance and body image, with a focus on stimulating and guiding future agenda setting and translation from research to impact. We conducted a thematic analysis of transcripts from nine recorded 5-minute presentations, delivered by researchers and clinicians as part of a special invited presentation session at a biennial international conference, 'Appearance Matters,' in the UK. Four themes were identified: Moving Beyond the Individual; Consolidation and Collaboration; Commitment to Implementation; and Positive and Protective Frameworks. These themes are discussed alongside recommendations for researchers and practitioners working in these fields to advance research, advocacy, and impact outside of academia.
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Carrard I, Della Torre SB, Levine M. [Promoting a positive body image in young people.]. SANTE PUBLIQUE 2020; Vol. 31:507-515. [PMID: 31959251 DOI: 10.3917/spub.194.0507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Positive body image is a recent concept that includes several facets, such as the acceptance of one’s body and the ability to take care of it with safe, nurturing methods. The purpose of this article is to explain this concept and its importance, and to review prevention and health promotion interventions that might be effective for its development. METHOD We conducted a narrative review, including the latest publications that summarize the concept’s usefulness and the effectiveness of prevention programs that may contribute to the development of positive body image in youth. RESULTS The development of a positive body image is proposed as a key factor that would allow integrated prevention of the entire spectrum of weight and eating issues in young people, as well as other problems such as depression. Three approaches used for prevention interventions developed primarily to target body dissatisfaction as a risk factor might promote certain aspects of positive body image. It would be advisable to adopt a universal and ecological prevention approach, in order to standardize the messages received throughout the social environment regarding healthy eating, an active lifestyle, and respect for the diversity of weight, shape, and beauty. CONCLUSION This review highlights the importance of positive body image for public health, as well as the various preventive interventions that have proven effective for youth and young adults, so that future developments can build on what has already been performed.
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Doley JR, McLean SA, Griffiths S, Yager Z. Study protocol for Goodform - a classroom-based intervention to enhance body image and prevent doping and supplement use in adolescent boys. BMC Public Health 2020; 20:59. [PMID: 31937296 PMCID: PMC6961244 DOI: 10.1186/s12889-020-8166-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/07/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Very few programs aimed at improving body image among adolescent boys have been effective, and there is still no clear evidence as to what will work for universal prevention of eating disorders and body dissatisfaction with this group. We combined two previously efficacious programs and used a design thinking framework to optimise program content alongside potential end-users including adolescent boys, teachers, parents, and experts. Goodform is a four-session universal program that aims to reduce body dissatisfaction and prevent the use of muscle-building supplements among 14-to-16 year old adolescent boys. METHODS/DESIGN Goodform will be trialled using a cluster randomised controlled trial (RCT) conducted in Australian schools, with Year 9 boys as participants. The intervention is teacher-delivered. Data will be collected at three time points: baseline, post-intervention, and follow-up (2 months). Three primary outcome constructs will be examined, including body dissatisfaction (Male Body Attitudes Scale-Revised) and attitudes towards appearance and performance enhancing substances (APES; Outcome Expectations for Steroid and Supplement Use, Intentions to use APES) and actual use of APES at each time point. Three secondary outcome constructs will be examined, which are social norms for APES (adapted Peer Norms Scale), negative body talk (Male Body Talk Scale), and internalisation of and pressure to attain appearance ideals (Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised). Internalisation of appearance ideals will also be examined as a mediator of change in primary outcomes. Teachers will provide data on adherence to lessons, student engagement/enjoyment, and understanding of the content. DISCUSSION The GoodForm RCT will trial a novel, generalizable, and extensively developed program intended to improve boys' body image and reduce actual and intended APES use. We anticipate that it will provide a novel contribution to the field of boys' body dissatisfaction prevention. TRIAL REGISTRATION This trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry on May 14th 2019, registration number ACTRN12619000725167.
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Affiliation(s)
- Joanna Rachel Doley
- First Year College, Victoria University, Footscray Park, Footscray, Australia.
| | - Siân Alexandra McLean
- College of Arts and Education, Victoria University, Footscray Park, Footscray, Australia
| | - Scott Griffiths
- School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Zali Yager
- College of Arts and Education, Victoria University, Footscray Park, Footscray, Australia
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80
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Gattario KH, Lindwall M, Frisén A. Life after childhood bullying: Body image development and disordered eating in adulthood. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2019. [DOI: 10.1177/0165025419877971] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Studies have demonstrated that being bullied in childhood may have long-term associations with lower psychological well-being in adulthood. However, although bullying incidents frequently target the victim’s body and appearance, research has overlooked studying victims’ long-term body image development and risk of engaging in disordered eating later in life. This 14-year longitudinal research project examined childhood bullying in relation to body image development and disordered eating in emerging adulthood. Growth curve analyses of participants’ body image at ages 10–21 years ( N = 960) revealed that more victimized children experienced more body dissatisfaction at baseline and maintained their negative body image throughout adolescence and into adulthood. Mediation analyses showed that childhood bullying (age 10 years) predicted more negative body image in adolescence (age 18 years), which in turn predicted more disordered eating in adulthood (age 24 years). The indirect effect was stronger for girls than for boys. The findings suggest that bullied children are likely to face both more body image problems and disordered eating as they evolve through adolescence and into adulthood, indicating the need for early and effective interventions. Incorporating components known to promote a more positive body image could be a valuable feature of future interventions. Thus, as children and adolescents are taught to cope with bullying situations, they could also be helped to deal with the appearance culture that permeates many of these situations.
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81
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Wærholm AC, Meland E, Kjome RLS. Can subjective well-being and body concern in adolescence predict prescribed medication in adulthood? Findings from the Nord-Trøndelag Health Study and the Norwegian Prescription Database. Scand J Public Health 2019; 48:559-566. [PMID: 31405328 DOI: 10.1177/1403494819863516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Aim: To examine whether subjective well-being (SW) and body concern among adolescents aged 15-19 years has an impact on adult health, measured by medications dispensed on average 18 years later. Methods: Data collected in the Nord-Trøndelag Health Study (HUNT) was paired with data from the Norwegian Prescription database (NorPD). We investigated the effects of adolescent SW and body concern on total number of medications, on use of anti-infectives (ATC-group J), medication for the musculo-skeletal system (ATC-group M), anxiolytics, hypnotics and sedatives (ATC-groups N05B and N05C), and finally antipsychotics, antidepressants and psychostimulants, agents used for attention-deficit/hyperactivity disorder and nootropics (ATC-groups N05A, N06A and N06B). We used multi-variable models where we entered body dissatisfaction and SW simultaneously in the models in order to adjust for the associations between the predictors, and also adjusted for possible confounders in the models. Results: Both body concern (dieting and dieting desire) and impaired SW predicted drug use 17-18 years after the participants were surveyed in adolescence. The impact was disease specific as body concern was the most influential predictor for drugs used for somatic diseases and complaints, whereas impaired SW was more strongly associated with drug use for mental health diseases and complaints. Conclusions: SW and body concern are important health determinants in the transition between adolescence and adulthood.
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Affiliation(s)
- Adelheid-Charlotte Wærholm
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Centre for Pharmacy, University of Bergen, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Reidun L S Kjome
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Centre for Pharmacy, University of Bergen, Norway
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82
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Physical Activity Trends in Separate Contexts Among South Australian Older Children (10-12 Y) and Early Adolescents (13-15 Y) From 1985 to 2013. Pediatr Exerc Sci 2019; 31:341-347. [PMID: 30602321 DOI: 10.1123/pes.2018-0082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/08/2018] [Accepted: 09/19/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess trends in South Australian children's physical activity between 1985 and 2003 and 2013 in the contexts of school active transport, organized sport, physical education, and school break times. METHOD The 1985 Australian Health and Fitness Survey was administered in South Australian schools in 2004 (8 schools) and 2013 (9 schools) and was demographically matched to the 10 South Australian schools in the Australian Health and Fitness Survey. Ordinal logistic modeling was used to identify trends, stratified by older children (10-12 y) and early adolescent (13-15 y) subgroups. RESULTS School active transport generally declined for males and older female children (19 and 20 percentage points per decade, respectively), whereas early adolescent females increased in walking to school (11 percentage points per decade). School sport participation declined for early adolescents, and club sport participation declined in early adolescent females (23 percentage points per decade). Moderate to vigorous physical activity participation during school break times (particularly lunchtime) generally declined (16-26 percentage points per decade). Observed changes in most contexts occurred between 2004 and 2013. CONCLUSION There was evidence of context-specific declines in children's physical activity participation over this time span. Early adolescent females were the subgroup of most concern, experiencing declines in most contexts.
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83
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The healthy body image (HBI) intervention: Effects of a school-based cluster-randomized controlled trial with 12-months follow-up. Body Image 2019; 29:122-131. [PMID: 30928681 DOI: 10.1016/j.bodyim.2019.03.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 11/22/2022]
Abstract
We examined the effects of the Healthy Body Image (HBI) intervention on positive embodiment and health-related quality of life among Norwegian high school students. The intervention comprised three interactive workshops, with body image, media literacy, and lifestyle as main themes. In total, 2,446 12th grade boys (43%) and girls (mean age 16.8 years) from 30 high schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. Data were collected at baseline, post-intervention, 3- and 12-months follow-up, and analysed using linear mixed regression models. The HBI intervention caused a favourable immediate change in positive embodiment and health-related quality of life among intervention girls, which was maintained at follow-up. Among intervention boys, however, weak post-intervention effects on embodiment and health-related quality of life vanished at the follow-ups. Future studies should address steps to make the HBI intervention more relevant for boys as well as determine whether the number of workshops or themes may be shortened to ease implementation and to enhance intervention effects.
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84
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Schwartz C, Drexl K, Fischer A, Fumi M, Löwe B, Naab S, Voderholzer U. Universal prevention in eating disorders: A systematic narrative review of recent studies. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.mph.2019.200162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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85
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Whitaker C, Gough B, Fawkner H, Deighton-Smith N. Young men's body dissatisfaction: A qualitative analysis of anonymous online accounts. J Health Psychol 2019; 26:636-649. [PMID: 30819027 DOI: 10.1177/1359105319832352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Associated with numerous adverse health outcomes, body dissatisfaction in young men requires close examination. This study explores online accounts relating to male body image, including young men's personal disclosures within one online newspaper article, and posts responding to this topic. Discursively informed thematic analysis indicated that non-disclosure was considered a problematic social expectation by the young men featured in the article. Also, reader posts variously constructed body dissatisfaction as a symptom of adolescence, a lack of self-care and an incapacity to capitalise on compensatory qualities. Our analysis suggests young men may welcome safe opportunities to critically discuss prevailing body image ideals.
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86
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Abstract
Body dissatisfaction is a risk factor for development of eating disorders and represents a core psychopathologic feature of eating disorders. Prevention and treatment interventions address established risk and maintaining factors for body dissatisfaction: appearance pressures, internalization of appearance ideals, upward appearance comparison, avoidance and checking, and body disparagement. It is essential to address body dissatisfaction within eating disorders treatment to improve outcomes and reduce risk of relapse. Future directions in research and treatment aim to reach populations increasingly recognized as in need, including children, men, and individuals at higher weights, with the ultimate goal of reducing the significant distress associated with body dissatisfaction.
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87
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Halliwell E, Dawson K, Burkey S. A randomized experimental evaluation of a yoga-based body image intervention. Body Image 2019; 28:119-127. [PMID: 30660059 DOI: 10.1016/j.bodyim.2018.12.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 01/24/2023]
Abstract
Recent literature argues that body image interventions need to become more embodied. This paper evaluates a brief yoga-based body image intervention which incorporates themes specifically tailored to focus on positive body image. Young women (Mage = 20.21, SDage = 2.15) were randomly allocated to a four-session yoga intervention (n = 22) or a control condition (n = 22). Compared to controls, participants in the yoga condition reported significant increases in body appreciation, body connectedness, body satisfaction, and positive mood at posttest and at 4-week follow-up. There were no significant changes in negative mood or body surveillance. These findings add to existing evidence that yoga can improve women's body image and positive mood. In addition, they suggest that a strong thematic focus on positive body image can achieve benefits at relatively low yoga doses. These findings are important as intervention length impacts the potential for dissemination.
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Affiliation(s)
- Emma Halliwell
- Centre for Appearance Research, University of the West of England, UK.
| | - Kayleigh Dawson
- Centre for Appearance Research, University of the West of England, UK
| | - Samantha Burkey
- Centre for Appearance Research, University of the West of England, UK
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88
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Golan M, Ahmad WA. School-based versus after-school delivery of a universal wellness programme - A randomized controlled multi-arm trial. Eat Behav 2018; 31:41-47. [PMID: 30103205 DOI: 10.1016/j.eatbeh.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 07/25/2018] [Accepted: 08/09/2018] [Indexed: 11/28/2022]
Abstract
UNLABELLED Positive self-image and body image as well as high self-esteem and media literacy are considered protective factors against health-compromising behaviours. Investigation of the optimal setting for body image prevention programmes is important to maximize outcomes from such programmes. Most universal wellness programmes are school based and thus delivered to a "captive" population. Only a few reports have been published about wellness programmes delivered in after-school settings, and none of them compared delivery after school to delivery in a school-based setting. AIMS To assess the acceptability, feasibility and efficacy of an interactive wellness preventive programme (In Favour of Myself) when delivered in a school-based setting versus an after-school setting. METHODS A randomized controlled multi-arm trial with 224 adolescent girls aged 13-15 years old was conducted. There were 102 girls participating in the after-school setting and 102 girls in the school-based setting. The programme contained nine 90-minute lessons, delivered weekly over 2 months. An intention-to-treat assessment was performed three times: at baseline, at the programme's conclusion (two months) and at follow-up (3 months). RESULTS At programme termination and follow-up, the impact of In Favour of Myself was higher among participants in the after-school setting than in the school-based setting with respect to advertisement strategies, media pressure, gap between current and ideal body image, drive for thinness and self-esteem. CONCLUSIONS This study provides support for a community-led approach to promote health behaviours, an approach that currently is a significant feature of health improvement policy and practice.
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Affiliation(s)
- Moria Golan
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel; Shahaf, Community Services for the Management of Weight-Related Problems, Tel Aviv, Israel.
| | - Wiessam Abu Ahmad
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel; Brown School of Public Health and Community Medicine, the Hebrew University - Hadassah, Jerusalem, Israel
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89
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Tiggemann M, Barbato I. "You look great!": The effect of viewing appearance-related Instagram comments on women's body image. Body Image 2018; 27:61-66. [PMID: 30138768 DOI: 10.1016/j.bodyim.2018.08.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/13/2018] [Accepted: 08/13/2018] [Indexed: 12/22/2022]
Abstract
Instagram is an increasingly popular social networking site where users post and share photos. The aim of the present study was to experimentally investigate the effect of viewing appearance-related comments accompanying Instagram images on women's body image. Participants were 128 female undergraduate students who viewed a set of attractive images paired with a brief positive comment. For half the participants, comments were related to appearance; the other half viewed the same images with place-related comments. As predicted, exposure to appearance comments led to greater body dissatisfaction than exposure to place comments. There was no significant effect on state self-objectification, but trait self-objectification predicted increase in body dissatisfaction regardless of experimental condition. It was concluded that comments form an important and integral part of Instagram imagery, one that has implications for body image in its own right.
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90
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MacCallum F, Widdows H. Altered Images: Understanding the Influence of Unrealistic Images and Beauty Aspirations. HEALTH CARE ANALYSIS 2018; 26:235-245. [PMID: 27432005 PMCID: PMC6061013 DOI: 10.1007/s10728-016-0327-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this paper we consider the impact of digitally altered images on individuals’ body satisfaction and beauty aspirations. Drawing on current psychological literature we consider interventions designed to increase knowledge about the ubiquity and unreality of digital images and, in the form of labelling, provide information to the consumer. Such interventions are intended to address the negative consequences of unrealistic beauty ideals. However, contrary to expectations, such initiatives may not be effective, especially in the long-term, and may even be counter-productive. We seek to understand this phenomenon of our continued aspiration for beauty ideals we know to be unreal and even impossible. We draw on our respective disciplines to offer psychological and philosophical accounts for why this might be. We conclude that beauty ideals are deeply embedded in our aspirations, practices, and in our constructions of ourselves. Given this, it is not surprising that simply increasing knowledge, or providing information, will be insufficient to challenge them.
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Affiliation(s)
- Fiona MacCallum
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, UK.
| | - Heather Widdows
- Department of Philosophy, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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91
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Relations between sociocultural pressures and weight control behavior among early adolescent boys. PSYCHOLOGY IN THE SCHOOLS 2018. [DOI: 10.1002/pits.22212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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92
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Damiano SR, Yager Z, McLean SA, Paxton SJ. Achieving body confidence for young children: Development and pilot study of a universal teacher-led body image and weight stigma program for early primary school children. Eat Disord 2018; 26:487-504. [PMID: 29578841 DOI: 10.1080/10640266.2018.1453630] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Negative body image attitudes develop in early childhood and there is a need for school-based resources during the early school years, but no teacher-delivered curriculum-based resources exist to mitigate these attitudes in young children. Achieving Body Confidence for Young Children (ABC-4-YC), a universal body dissatisfaction and weight stigma prevention program, was developed and then delivered in a pilot study. Fifty-one 5- to 8-year-old children completed pre- and post-intervention interviews assessing body image attitudes, and seven teachers provided feedback. Significant improvement in body esteem and positive teacher feedback were found. The results provide preliminary support for ABC-4-YC to improve children's body image attitudes, but extensive evaluation is needed.
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Affiliation(s)
- Stephanie R Damiano
- a School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Zali Yager
- b Institute for Health and Sport, Victoria University , Melbourne , Australia
| | - Siân A McLean
- a School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Susan J Paxton
- a School of Psychology and Public Health , La Trobe University , Melbourne , Australia
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93
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Lee GY, Park EJ, Kim YR, Kwag KH, Park JH, An SH, Lee JH, Sim JH, Treasure J. Feasibility and acceptability of a prevention program for eating disorders (Me, You and Us) adapted for young adolescents in Korea. Eat Weight Disord 2018; 23:673-683. [PMID: 28871526 DOI: 10.1007/s40519-017-0436-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/23/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to assess the adaptability and acceptability of a prevention program. METHODS A total of 169 Korean students (83 boys and 86 girls) with a mean age of 12.3 years from a 6th grade class at an elementary school participated in the study. Mental health social workers delivered Me, You and Us, a school-based body image intervention program originally developed in the UK, through a set of six sessions. The participants were assessed in terms of their body satisfaction and self-esteem before the program, after the program, and at 1-month follow-up. They were also surveyed about their satisfaction and acceptability levels after the program. RESULTS At baseline, girls had lower body satisfaction and self-esteem than boys, and their body satisfaction and self-esteem improved after the program. The improved body satisfaction was maintained at the 1-month follow-up. The efficacy of the program on body satisfaction was positively correlated with the frequency of their baseline level of "fat talk." The program was more effective in girls with possible symptoms of an eating disorder at baseline. 93.7% of boys and 77.4% of girls responded that they enjoyed the program. CONCLUSIONS The program Me, You and Us was well-accepted by early adolescents in Korea and it can play a role in increasing body satisfaction and self-esteem by reducing "fat talk" in 6th grade students. LEVEL OF EVIDENCE Level III, cohort study with intervention.
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Affiliation(s)
- Gi Young Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Eun Jin Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea.,Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea. .,Department of Neuropsychiatry, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea.
| | - Kyung Hwa Kwag
- Institute of Human, Environment and Future, Inje University, Kimhae, Republic of Korea
| | - Jin Hong Park
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea.,Department of Neuroscience, Scripps Graduate Program, The Scripps Research Institute, Jupiter, FL, USA
| | - So Hyun An
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea
| | - Jeong Hun Sim
- Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, UK
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94
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Vassilopoulos SP, Koutsoura A, Brouzos A, Tamami D. Promoting forgiveness in Greek preadolescents: a universal, school-based group intervention. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2018. [DOI: 10.1080/03069885.2018.1527285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Alexandra Koutsoura
- Department of Primary Education, University of Patras, Patras, 26 110, Greece
| | - Andreas Brouzos
- Department of Primary Education, University of Ioannina, Ioannina, 451 10, Greece
| | - Despoina Tamami
- Department of Primary Education, University of Patras, Patras, 26 110, Greece
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95
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Tiggemann M, Hayden S, Brown Z, Veldhuis J. The effect of Instagram "likes" on women's social comparison and body dissatisfaction. Body Image 2018; 26:90-97. [PMID: 30036748 DOI: 10.1016/j.bodyim.2018.07.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 11/15/2022]
Abstract
Photo-based activity on social networking sites has recently been identified as contributing to body image concerns. The present study aimed to investigate experimentally the effect of number of likes accompanying Instagram images on women's own body dissatisfaction. Participants were 220 female undergraduate students who were randomly assigned to view a set of thin-ideal or average images paired with a low or high number of likes presented in an Instagram frame. Results showed that exposure to thin-ideal images led to greater body and facial dissatisfaction than average images. While the number of likes had no effect on body dissatisfaction or appearance comparison, it had a positive effect on facial dissatisfaction. These effects were not moderated by Instagram involvement, but greater investment in Instagram likes was associated with more appearance comparison and facial dissatisfaction. The results illustrate how the uniquely social interactional aspects of social media (e.g., likes) can affect body image.
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Affiliation(s)
| | | | - Zoe Brown
- School of Psychology, Flinders University, Australia
| | - Jolanda Veldhuis
- Department of Communication Science, VU University Amsterdam, Netherlands
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96
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Agam-Bitton R, Abu Ahmad W, Golan M. Girls-only vs. mixed-gender groups in the delivery of a universal wellness programme among adolescents: A cluster-randomized controlled trial. PLoS One 2018; 13:e0198872. [PMID: 29912918 PMCID: PMC6005464 DOI: 10.1371/journal.pone.0198872] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Investigation of the optimal setting for body image prevention programmes is important to maximize the outcomes of such programmes. OBJECTIVES We examined the preferred setting for a school-based wellness programme called "In Favour of Myself". METHODS A total of 259 girls (mean 13.82±0.64 years) were divided into a girls-only intervention group, a mixed-gender intervention and a waiting list control group. The participants completed self-report questionnaires at baseline, post-intervention (2 months) and at follow-up (3 months) examining changes in self-esteem, media literacy, body image and risk factors for eating disorders. The intervention group participants also completed a satisfaction questionnaire. RESULTS Both intervention groups demonstrated statistically significant improvements in identifying advertising strategies (p<0.01) compared with the controls, with the girls-only arm (p<0.001) showing better results. Compared with the girls-only arm and the control group, the mixed-gender group demonstrated statistically significantly greater improvements in the internalization of pressure for thinness (p<0.004), the body-esteem appearance subscale (p<0.025) and body-esteem body-weight subscale (p<0.012) as well as reductions in their perceived current body silhouettes and in the gap between their current and ideal body image (p<0.003). Body dissatisfaction was increased following the programme, although not in a statistically significant manner, with the worst negative effect observed in the girls-only arm. All other differences among the study arms did not show statistically significant differences. Mediation models revealed that body-esteem was directly mediated by group, with statistically significant mediation only in the mixed group. Current body image was mediated indirectly by group through media literacy (i.e., recognizing advertisement strategies and internalization of pressure for thinness), with statistical significance only in the mixed-gender arm compared with the girls-only arm. Higher programme satisfaction was reported in the mixed-gender group (91%) vs. the girls-only groups (79%). CONCLUSIONS These outcomes provide preliminary evidence indicating the superiority of a mixed-gender setting compared with a girls-only setting for delivering prevention programmes to 13- to 14-year-old adolescents to enhance their media literacy, positive self-esteem and body image. TRIAL REGISTRATION NCT02653586.
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Affiliation(s)
- Reut Agam-Bitton
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel
| | - Wiessam Abu Ahmad
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Moria Golan
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel
- Shahaf, Community Services for the Management of Weight-Related Problems, Tel Aviv, Israel
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Sundgot-Borgen C, Bratland-Sanda S, Engen KME, Pettersen G, Friborg O, Torstveit MK, Kolle E, Piran N, Sundgot-Borgen J, Rosenvinge JH. The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students. BMC Psychol 2018; 6:8. [PMID: 29510762 PMCID: PMC5840729 DOI: 10.1186/s40359-018-0221-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/02/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating. METHODS AND DESIGN Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme. DISCUSSION The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services. TRIAL REGISTRATION The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.
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Affiliation(s)
- Christine Sundgot-Borgen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, P.O. Box 4014, Sognsveien 220, N-0806 Oslo, Norway
| | - Solfrid Bratland-Sanda
- Department of Sports, Physical Education and Outdoor Studies, University College of Southeast Norway, P.O. Box 235, N- 3603 Kongsberg, Norway
| | - Kethe M. E. Engen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, P.O. Box 4014, Sognsveien 220, N-0806 Oslo, Norway
| | - Gunn Pettersen
- Faculty of Health Sciences Department of Health and Caring Sciences, UiT -The Arctic University of Norway, N- 9037 Tromsø, Norway
| | - Oddgeir Friborg
- Faculty of Health Sciences Department of Psychology, UiT –The Arctic University of Norway, 9037 Tromsø, Norway
| | | | - Elin Kolle
- Department of Sports Medicine, The Norwegian School of Sport Sciences, P.O. Box 4014, Sognsveien 220, N-0806 Oslo, Norway
| | - Niva Piran
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street West, Toronto, ON M5S 1V6 Canada
| | - Jorunn Sundgot-Borgen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, P.O. Box 4014, Sognsveien 220, N-0806 Oslo, Norway
| | - Jan H. Rosenvinge
- Faculty of Health Sciences Department of Psychology, UiT –The Arctic University of Norway, 9037 Tromsø, Norway
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Carey FR, Wilkinson AV, Ranjit N, Mandell D, Hoelscher DM. Perceived Weight and Bullying Victimization in Boys and Girls. THE JOURNAL OF SCHOOL HEALTH 2018; 88:217-226. [PMID: 29399837 DOI: 10.1111/josh.12600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/30/2017] [Accepted: 11/08/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Research suggests that perceived weight poses separate risks from objective weight on adolescents' risks of being bullied. We examined if the prevalence of bullying victimization differed by perceived and objective weight status, and how these associations varied by sex. METHODS Data were analyzed for 6716 8th and 11th graders from the School Physical Activity and Nutrition project, a Texas statewide survey of public school students. Participants reported demographics, bullying victimization, and weight perceptions. Height and weight were measured. RESULTS In the last 6 months, 10.8% of students reported being bullied. Nearly 70% of normal weight and overweight and 50% of obese adolescents perceived themselves as weighing the right amount. Perceiving oneself as weighing too little or too much was significantly associated with increased bullying victimization (p < .05 for both), whereas objective weight was not. Statistical interactions between perceived weight and sex were significantly associated with victimization (p < .05) among boys only; boys who perceived themselves as weighing too little had higher predicted probabilities of victimization. CONCLUSIONS Perceived weight may play a greater role in bullying victimization than objective weight, especially among boys. Interventions to prevent bullying should consider adolescents' self-perceptions of weight to effectively identify those at greater risk for victimization.
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Affiliation(s)
- Felicia R Carey
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701
| | - Nalini Ranjit
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701
| | - Dorothy Mandell
- Office of Program Decision Support, Texas Department of State Health Services, UT System Administration, 210 West 6th Street, Suite B.140E, Austin, TX 78701
| | - Deanna M Hoelscher
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701
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Stock NM, Feragen KB, Rumsey N. Adults’ Narratives of Growing up with a Cleft Lip and/or Palate: Factors Associated with Psychological Adjustment. Cleft Palate Craniofac J 2018; 53:222-39. [DOI: 10.1597/14-269] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Growing up with a cleft lip and/or palate presents a number of challenges for those affected and their families. Understanding why some individuals cope well while others struggle is key to psychological research in this field. A better appreciation of the factors and processes that contribute to psychological adjustment to cleft lip and/or palate (CL/P) from the patient perspective would be of value to both researchers and clinicians. Design Qualitative data elicited from individual interviews with 52 adults born with CL/P. Result Inductive thematic analysis identified three main themes: “background” factors (age, gender, sexual orientation, culture, additional conditions, socioeconomic status, and adoption), “external” factors (treatment autonomy, familial coping and support, salience, public understanding, psychological input, and peer support), and “internal” psychological factors (perceptions of difference, noticeability and teasing, social confidence, internalization of beauty ideals, valence, expectations of treatment, responding to challenges, social comparisons, acceptance, faith, dispositional style, and recognition of strengths and positive growth). Conclusions The number and breadth of factors identified in this study are testament to the importance of psychology in the field of CL/P and may offer guidance in relation to developing and assessing the value of psychological interventions. There is a clear role for psychologists in tackling appearance-related concerns, designing materials, supporting patient decision making, and improving social interaction, as well as providing specialist psychological support. The findings illustrate the potential degree of individual variation in perspectives and offer insight into the conflicting results found within current literature.
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Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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Efficacy of a prevention program for eating disorders in schools: a cluster-randomized controlled trial. BMC Psychiatry 2017; 17:293. [PMID: 28800753 PMCID: PMC5553667 DOI: 10.1186/s12888-017-1454-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/03/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous prevention programs in the school context have not addressed both genders, have been time-consuming, or have had deficits in the evaluation method. The aim of the present study was to evaluate the impact of a universal prevention program for female and male adolescents on eating disorder pathology and related risk factors. METHODS Between February 2012 and July 2014, 2515 students in 23 schools from 8th or 11th grade were assessed for eligibility in this longitudinal cluster-randomized controlled trial with a six months follow-up. Of those students, 2342 were cluster-randomized to the intervention condition which received a six school hours universal prevention program or to the no treatment control condition. RESULTS The complete case population comprised 724 students in the intervention (54.3% female, M = 14.3 years, SD = 1.61) and 728 in the control condition (57.0% female, M = 14.7 years, SD = 1.63). Random-effects analysis of covariance on the primary outcome showed no significant differences between the intervention and control groups in their eating disorder pathology change scores six months after the intervention. Regarding secondary outcomes, participants in the intervention group showed a greater increase in knowledge about eating disorders both after the intervention (p < .001, ES = 1.06) and six months later (p = .01, ES = 0.40). Greater reductions in anxiety severity were observed in the intervention group post-intervention (p = .02, ES = 0.22) which was not maintained at the six months follow-up. Results differed between participants from grade 8 and 11. CONCLUSION The present universal prevention program can be particularly recommended for adolescents from grade 11. TRIAL REGISTRATION ISRCTN 97989348.
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