Promoting positive body image among university students: A collaborative pilot study

Public perceptions of the brand image of nursing: Cross-cultural differences between the United States and China

BACKGROUND

Measures of public opinion regarding nursing's brand image are needed to identify and correct perceptions that are incongruent with the breadth and scope of contemporary nursing practice. Misperceptions of nursing's influence may serve to minimize or disregard nursing's unique contributions to addressing the Social Determinants of Health which are foundational for improving the health of global populations.

PURPOSE

To compare public perceptions of the brand image of nursing between China and the United States (US) and determine whether sociodemographic variables influenced factors between the two countries.

METHODS

A cross-sectional online survey was distributed among members of the Chinese and U.S. public. Perceptions of nursing's brand image were assessed through the original Nursing Brand Image Scale-Public Version in the US (NBIS-P) and when translated to Chinese (NBIS-P-C). Descriptive statistics and multigroup confirmatory factor analyses were used to compare perceptions of the brand image of nursing and to examine the influence of demographics.

DISCUSSION

The reliability of the Chinese version of the NBIS-P-C was confirmed by this study. Age and gender did not influence public perceptions of nursing's brand image in either China or the US. Instead, educational attainment was the significant demographic variable and positively correlated with the public's perceptions of nursing in both countries (p < .05). Public respondents with lower educational attainment scored both the traditional nursing factor "Caregiver Virtues/Attributes" (e.g., Trusted, Caring, Nurturing/Mothering) and the factor "Lack Authority/Identity" (e.g., White Cap/Uniform, Subservient, Female) higher, while scoring the factor for "Leadership" (e.g., Decision Makers, Influential, Leaders) significantly lower than those with higher educational levels.

CONCLUSION

A disparity exists between nursing's contemporary contributions to healthcare and the public's limited understanding of the diverse leadership roles all nurses provide, across a variety of settings, and in global public health initiatives. The virtuous traits of the nurse are perceived most directly and immediately by the public while their roles as autonomous decision-makers and leaders are less (or not at all) visible. Enhancing the accuracy and visibility of a strong brand image could advance public perceptions of nurses as experts and leaders in nursing science, thus paving the way for nurses to more effectively direct and influence the health of the public, particularly those with lower educational attainment who represent some of the most vulnerable populations. Targeted interventions that incorporate the educational level of the public offer a foundational opportunity for the nursing profession to correct inaccurate and outdated stereotypes that prevent nurses from achieving their desired brand image as influential leaders. Such campaigns could also be used to inform policy, guide strategic planning, and transform the future direction of the nursing profession.

A qualitative exploration of positive body image experiences among nonbinary individuals

One group whose positive body image experiences remain under-explored is individuals who identify as nonbinary, gender fluid, and/or genderqueer (including other nonbinary identities). Thus, we sought to answer the questions: What does it look like to have a positive body image for a nonbinary person? and How do nonbinary persons form and maintain a positive body image? To answer these questions, we conducted in-depth, semi-structured interviews with 15 nonbinary individuals who were assessed as having positive body image using the Body Appreciation Scale-2 (Tylka & Wood-Barcalow, 2015a). Data were analyzed using reflexive thematic analysis. Four themes were identified as characterizing the core features of positive body image among nonbinary persons: body appreciation, body- and self-acceptance, bodily appearance embodied their authentic self, and holding flexible ideals for ways of being. Six themes were identified as related to on-going processes that explain how body image is formed and maintained among nonbinary persons: reframing negative body image information, staging resistance, experiencing representation, receiving and giving social support, practicing self-compassion and self-care, and using dress to create a satisfying presentation of self. In keeping with the tenets of queer theory, findings reflected how gender identity set a context for participants' positive body image experiences.

What about being a feminist is protective? An examination of constructs related to feminist beliefs as moderators of the relationship between media awareness and thin-ideal internalization

Feminist beliefs have been identified as a potential protective factor in the relationship between media awareness and thin-ideal internalization; however, the precise reason why feminist beliefs serve this role is unclear. A series of three studies examined the reasons why feminist beliefs may be protective in non-student samples, considering as possible explanations open-minded thinking, critical thinking, and media attitudes and literacy. Study 1 showed that the moderating role of feminist beliefs on the relationship between media awareness and thin-ideal internalization held in a non-undergraduate sample. Study 2 found that feminist beliefs and self-identifying as a feminist were related to open-minded thinking, critical thinking, and media attitudes and literacy. Study 3 found that most of these constructs did not serve the same moderating role as feminist beliefs. However, a complex relationship emerged when both feminist self-identification and media attitudes and literacy were considered simultaneously as moderators, adding to the literature emphasizing that self-identifying as a feminist has a protective role over and above that of merely holding feminist beliefs. These results suggest that feminist beliefs may be a unique combination of these constructs or that there may be yet a different reason why feminist beliefs are protective against thin-ideal internalization.

Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers

Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman's Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students' body image through physical activity programmes, education and sex-specific individualised attention.

Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students

PURPOSE

The aim of this study was to test the effectiveness of an 8-week classroom education and mindfulness-based physical activity intervention for the promotion of positive body image in female students.

METHODS

A quasi-experimental study was carried out with 110 Lithuanian female students (mean age 21.5 ± 3.5, range 19-35 years). Thirty students voluntarily participated in the intervention programme and 80 students volunteered in the assessment-only control group. The intervention comprised five cognitive behavioural therapy classroom education sessions and mindfulness-based exercise (one exercise workout per week). The intervention group was evaluated with a pre-test and post-test and the control group completed measures at parallel times.

RESULTS

Compared with the control group participants, the intervention group participants reported greater improvements in positive body image and a reduction in body dissatisfaction and drive for thinness and internalisation of stereotyped beauty ideals, with medium to large effects. There were significant time × group interactions for pre-test to post-test changes in internalisation of beauty ideals, body area satisfaction, body dissatisfaction and body appreciation. In all cases, the interaction reflected greater pre-test to post-test changes in the intervention group compared with the control group, whose scores remained stable. A decrease in appearance orientation, overweight preoccupation, disordered eating and physical activity was observed in the control group, but the effect sizes were low.

CONCLUSION

The preliminary findings of this study support the efficacy of cognitive behavioural therapy methods and mindfulness-based exercise intervention aimed to promote positive body image in student-aged women. Future studies should test the efficacy of the introduced programme in larger randomised samples of young women.

LEVEL IV

Evidence obtained from multiple time series with or without an intervention.

Body image is more negative in patients with chronic low back pain than in patients with subacute low back pain and healthy controls

Background and aims Body image as an increasing research field has been integrated into pain research within the last years. However, research on cognitive-affective dimensions of body image dependent on different pain groups like acute/subacute and chronic pain patients, and healthy controls is still lacking. Therefore, this study aims to explore three dimensions of body image, namely self-acceptance, physical efficacy, and health in patients with low back pain and healthy controls. The present study is the first to distinguish between patients with low back pain in different stages of pain with regard to the concept of body image. In a second step we investigated the differences in exercise frequency between the three groups. Methods Seventy seven patients (53.2% female) suffering from low back pain and 57 healthy controls (42.1% female) filled in a battery of questionnaires in terms of body image, pain parameters and exercise frequency. Results Main results indicate first that patients suffering from chronic low back pain revealed a more negative body image in all three body image-dimensions than healthy controls. Second, patients suffering from subacute pain revealed a more negative body image of physical efficacy compared to the healthy controls. Conclusions Our results suggest that body image is relevant for the treatment of low back pain, because patients suffering from low back pain revealed a more negative body image than healthy controls. Implications To investigate the cognitive-affective dimensions of body image in different patient groups suffering from low back pain seems to be an important aspect for future research to improve therapy options and prevention of low back pain. Future research should also focus on improvements or on positive aspects of body image in patients with low back pain.

A controlled study of an integrated prevention program for improving disordered eating and body image among Mexican university students: A 3-month follow-up

Obesity and eating disorders are currently two significant health problems in Mexico. The aim of this study was to examine the effects of an integrated prevention program on university students through an exploratory controlled study that targeted specific predisposing factors of disordered eating and obesity related to healthy eating, physical activity, body image satisfaction and perceived pressure to be thin. A total of 388 university students participated (264 females and 124 males) and were assigned either to an intervention condition or one of the two control conditions (study skills vs. nonintervention); each comprised of a total of eight workshops lasting 90 min. The program did not have any effect on the male students. In contrast, there was an interaction effect for time and group in thin-ideal internalization (η²  = 0.04) and in disordered eating attitudes/behaviours (η²  = 0.03); both showed improvements over time only among the female sample. Though, the effect size was insignificant, which means that the effectiveness of this integrated prevention program was limited. Integrated prevention approaches to eating and weight-related problems are still nascent in Mexico, and further research in this field is warranted so as to fine tune future prevention programs.

Instilling hope for a brighter future: A mixed-method mentoring support programme for individuals with and recovered from anorexia nervosa

AIMS AND OBJECTIVES

To investigate the feasibility of a 13-week mentoring programme in providing social support to promote hope for recovery in anorexia nervosa.

BACKGROUND

With no clear first-line psychological treatment for people with anorexia nervosa, mentoring support programmes, as an adjunct to treatment, may provide the social support necessary to promote hope for recovery.

DESIGN

A mixed-method study; participatory action research.

METHODS

Women (n = 11), recovering and who had recovered from anorexia nervosa, participated in the programme and completed self-report questionnaires related to quality of life, distress and the mentoring relationship at different time points. Qualitative feedback from logbooks, workshop evaluation questionnaires, interviews and focus groups was also collected to assess the programme's acceptability.

RESULTS

General compliance for completing most study outcome questionnaires was 90%; however, the mentoring relationship questionnaires were not completed to the same degree. Five key themes emerged from the focus group/interview data: (i) she understands me and could relate to me; (ii) reconnecting with the world-asking questions and being challenged; (iii) mentors' altruistic motivations and the transformation and discovery of self; (iv) instilling hope-recovery is possible; and (v) effective communication-the key to successful mentoring.

CONCLUSIONS

Further research is needed; however, the results provide preliminary support for the mentoring programme's feasibility as an adjunct to treatment. We found that having someone who understands, to talk and share with, met a clear need for people with anorexia nervosa.

RELEVANCE TO CLINICAL PRACTICE

While further research is warranted mentoring support or recovered mentors, may play a potentially valuable role in supporting those in community settings.

Benefits of a mentoring support program for individuals with an eating disorder: a proof of concept pilot program

OBJECTIVE

The aim of this proof-of-concept pilot study was to assess the usefulness of a mentoring support program with a goal to improve hope for recovery in people with an eating disorder.

RESULTS

Significant improvements (p ≤ 0.05) in hope for recovery were found for the mentees in the following domains: social relationships (p = 0.027), romantic relationships (p = 0.032), family life (p = 0.047), work (0.003) and overall scores (p = 0.003). There were no significant findings for any of the areas for the mentors. Despite this, mentoring programs that focus on improving hope may provide a valuable adjunct support for those in treatment for an eating disorder.

I Should but I Can't: Controlled Motivation and Self-Efficacy Are Related to Disordered Eating Behaviors in Adolescents With Type 1 Diabetes

PURPOSE

Among adolescents with type 1 diabetes, disordered eating behaviors (DEBs) are more prevalent and have more serious health implications than in adolescents without diabetes, necessitating identification of modifiable correlates of DEB in this population. This study hypothesized that (1) autonomous motivation and (2) controlled motivation for healthy eating (i.e., eating healthfully because it is important to oneself vs. important to others, respectively) are associated with DEB among adolescents with type 1 diabetes. The third hypothesis was that baseline healthy eating self-efficacy moderates these associations.

METHODS

Adolescents with type 1 diabetes (n = 90; 13-16 years) participating in a behavioral nutrition intervention efficacy trial reported DEB, controlled and autonomous motivation, and self-efficacy at baseline, 6, 12, and 18 months. Linear-mixed models estimated associations of controlled and autonomous motivation with DEB, adjusting for treatment group, body mass index, socioeconomic status, age, and gender. Separate models investigated the interaction of self-efficacy with each motivation type.

RESULTS

Controlled motivation was positively associated with DEB (B = 2.18 ± .33, p < .001); the association was stronger for those with lower self-efficacy (B = 3.33 ± .55, p < .001) than those with higher self-efficacy (B = 1.36 ± .36, p < .001). Autonomous motivation was not associated with DEB (B = -.70 ± .43, p = .11).

CONCLUSIONS

Findings identify controlled motivation for healthy eating as a novel correlate of DEB among adolescents with type 1 diabetes and show that self-efficacy can modify this association. Motivation and self-efficacy for healthy eating represent potential intervention targets to reduce DEB in adolescents with type 1 diabetes.

A systematic review and meta-synthesis of the effects and experience of mentoring in eating disorders and disordered eating

In this review, we aimed to explore the benefits, effects and experiences of mentoring on those with an eating disorder or disordered eating. After a systematic search of the literature, four papers were included in the review. A qualitative analysis of the papers identified three key themes. The themes were (1) diverse benefits (mentees), (2) finding comfort in belonging (mentees), and (3) affirmation of the transformation they have made (mentors). The experience of mentoring was shown to have value for both mentors and mentees. Mentorship should be further utilized in the areas of eating disorders and disordered eating, as it shows promising reciprocal benefits for both mentor and mentee.

Body image and appearance perceptions from immigrant adolescents in Canada: An interpretive description

Body dissatisfaction has been linked to a number of poor health outcomes, including eating disorders. However, very few studies have investigated body dissatisfaction among immigrant adolescents. Using inductive qualitative inquiry, this study recruited a purposeful sample of immigrant adolescents (N=18, 78% female) with an eating disorder (n=8) and without an eating disorder (n=10). All adolescents were between 16 and 19 years of age (M=16.80, SD=0.89) and were recruited from three municipalities in Ontario. Each adolescent participated in a face-to-face, qualitative interview. Content analysis revealed descriptions of body image that were similar across the sample. The main themes emerging from this work include (a) the "moderately slim" and "moderately muscular" ideal, (b) the "slim and curvy paradox," (c) "ideal" privilege, (d) having an "expected" appearance, and (e) wishful comparisons. Findings have implications for reducing appearance-related dissatisfaction among immigrant adolescents in Canada.

Effectiveness of alcohol media literacy programmes: a systematic literature review

Alcohol media literacy is an emerging field that aims to address the link between exposure to alcohol advertising and subsequent expectancies and behaviours for children and adolescents. The design, rigour and results of alcohol media literacy programmes vary considerably, resulting in a number of unanswered questions about effectiveness. To provide insight into some of these questions, a systematic literature review of alcohol media literacy studies was conducted. The review was guided by the following research question: What considerations are needed to develop an effective school-based alcohol media literacy programme? On the basis of a critical synthesis of 10 interventions (published in the period 1997 to May 2014), our findings provide a comprehensive understanding of the descriptive, methodological and outcome characteristics of this small body of significant research. The review provides considerations for future alcohol media literacy programmes, including the need for an interactive pedagogical approach within the naturalistic school setting, implementation fidelity and a holistic approach to programme evaluation, a means for maintaining relevance, consideration of gender differences, relevance for an international audience and use of follow-up and longitudinal data.

Do you "like" my photo? Facebook use maintains eating disorder risk

OBJECTIVE

Social media sites, such as Facebook, merge two factors that influence risk for eating disorders:media and peers. Previous work has identified cross-sectional and temporal associations between Facebook use and disordered eating. This study sought to replicate and extend these findings using an experimental design.

METHOD

In Study 1, 960 women completed self-report surveys regarding Facebook use and disordered eating. In Study 2, 84 women were randomly assigned to use Facebook or to use an alternate internet site for 20 min.

RESULTS

More frequent Facebook use was associated with greater disordered eating in a cross-sectional survey. Facebook use was associated with the maintenance of weight/shape concerns and state anxiety compared to an alternate internet activity.

DISCUSSION

Facebook use may contribute to disordered eating by maintaining risk for eating pathology. As such, targeting Facebook use may be helpful in intervention and prevention programs.

"I'm thankful for being Native and my body is part of that": the body pride experiences of young Aboriginal women in Canada

Body pride may be a predictor of health and well-being among Aboriginal youth. Body pride could potentially be addressed in health interventions, but it is critical to understand how body pride is conceptualized among Aboriginal youth. The purpose of this qualitative description study was to better understand the experiences of body pride among young Aboriginal women living in urban centers in Alberta, Canada. Eight young Aboriginal women (15-18 years old) participated in one-on-one interviews. A qualitative content analysis highlighted five themes that represent the participants' meanings of body pride. Participants described how body pride is: (a) accepting everything about your body, (b) who you are and how you show it, (c) connected to culture, (d) being healthy, and (e) being thankful to be Native. This research makes a contribution to the growing body pride literature by providing an initial glimpse into the complexities of young Aboriginal women's body pride experiences.

"Drunkorexia": exploring the who and why of a disturbing trend in college students' eating and drinking behaviors

OBJECTIVE

"Drunkorexia," limiting food intake before alcohol consumption, increases college students' risk for negative alcohol-related health consequences. The current study tested whether (1) women engage in drunkorexia more frequently than men; (2) weight control motivations explain sex differences in drunkorexia; and (3) among women, weight control motivations are a particularly strong predictor of drunkorexia for heavier drinkers.

PARTICIPANTS

Undergraduate males and females (N = 63) recruited during fall of 2011.

METHODS

PARTICIPANTS self-reported their alcohol consumption, drunkorexia, and weight control motivations online.

RESULTS

Findings supported hypotheses: weight control motivations explained why women engage in drunkorexia more than men; and the weight control motivation → drunkorexia relation was strongest for heavier- (vs lighter-) drinking women.

CONCLUSION

Women have more weight concerns than men, which makes them more likely to engage in drunkorexia. Heavy-drinking women with strong weight control motivations are at greatest risk for drunkorexia. Interventions should help students more safely reconcile pressures to be thin and drink alcohol.

Body image satisfaction and self-esteem in Thai female adolescents: the moderating role of self-compassion

AIM

Body image satisfaction significantly influences self-esteem in female adolescents. Increased reports of lowered satisfaction in this population have raised concerns regarding their compromised self-esteem. This research study, therefore, sought to identify a culturally significant moderator of the association between body image satisfaction and self-esteem in Thai female adolescents. Orientation toward self-compassion, found to be particularly high in Thailand, was examined.

MATERIALS AND METHODS

A total of 302 Thai female undergraduates from three large public and private universities in the Bangkok metropolitan area responded to a set of questionnaires, which measured demographic information, body image satisfaction, self-compassion, and self-esteem. Data were analyzed using correlation and multiple regression analyses. Self-compassion was tested as a moderator of the relationship between body image satisfaction and self-esteem.

RESULTS

Although its effect was relatively small, self-compassion significantly moderated the positive relationship between body image satisfaction and self-esteem. The relationship became less stringent for those with high self-compassion.

DISCUSSION

The cultivation of self-compassion was recommended in female adolescents. In addition to moderating the association between body image satisfaction and self-esteem, the benefits to health and well-being of generalizing this cultivation are discussed.

The paradoxical moderating effect of body image investment on the impact of weight-based derogatory media

Weight-based derogatory media consist of derogation of celebrities for failing to meet the thin ideal. This study examined the impact of weight-based derogatory media on women's body satisfaction, appearance self-esteem, fear of negative appearance evaluation, and negative affect. Female undergraduates (N=240) were exposed to either tabloid-style pictures and articles derogating average size celebrities for gaining weight, or to the same images accompanied by neutral information. Women in the derogation condition reported greater fear of negative appearance evaluation than did women in the neutral media condition. Contrary to predictions, women low in maladaptive body image investment reported lower body satisfaction and appearance self-esteem in the derogatory media condition than they did in the neutral condition, while women high in maladaptive investment did not differ across conditions. Highly invested women's unexpected reaction may be understood as a defence against a threat to a valued domain of the self.

The relationships between fat talk, body dissatisfaction, and drive for thinness: perceived stress as a moderator

Although body dissatisfaction and drive for thinness are commonplace in college-aged women, their relationships with fat talk and stress are understudied. This study examined (a) whether fat talk predicts body dissatisfaction and drive for thinness and (b) whether stress moderates these relationships. Results from self-report questionnaires completed by 121 female college students revealed that fat talk and perceived stress were significantly positively correlated with body dissatisfaction and drive for thinness. Although fat talk was a significant independent predictor of body dissatisfaction and drive for thinness, stress moderated these relationships such that they were stronger at lower stress levels. Although contrary to predictions, these results are logical when means are considered. Results suggest that fat talk positively predicts body dissatisfaction and drive for thinness in students with relatively lower stress levels, but does not for students under high stress because mean levels of these constructs are all already high.

"I bet they aren't that perfect in reality:" Appearance ideals viewed from the perspective of adolescents with a positive body image

In this qualitative study, we examined the topic of appearance ideals from the perspective of 14-year-old adolescents (N=29) with a positive body image. A thematic analysis revealed that the adolescents with a positive body image were very critical against current ideals, describing them as unnatural and unrealistic, and criticizing media for only showing those consistent with the ideals and having underlying intentions with doing so. Instead, the adolescents defined beauty widely and flexibly, stressed the importance of looking like 'oneself', and conveyed the idea of personality as outplaying looks. The perception of beauty as subjective was also prominent. These results may be helpful when forming preventions targeting those at risk for developing negative body image, adding support for preventions based on media literacy and feminist theories. Additionally, we stress the significance of providing adolescents with alternative ways of thinking about ideals, beauty, and attractiveness.