REbeL Peer Education: A model of a voluntary, after-school program for eating disorder prevention

The Impact of Delivering School-Based Wellness Programs for Emerging Adult Facilitators-A Quasi-Controlled Clinical Trial

A quasi-controlled clinical trial included a university-based supervision course for facilitators of an interactive wellness school-based program. The study aimed to investigate how students that facilitate prevention programs are personally affected by delivering content related to self-esteem, body-image, and media literacy. In total, 66 university students who were either facilitators of preventive programs (intervention group) or non-facilitators (comparison group) completed questionnaires before, after, and three months following the program’s termination. All methods were performed following the Declaration of Helsinki regulations and Consort 2010 guidelines. Participants in the facilitator group demonstrated statistically significant superiority, with large effect size, regarding improvement in identifying advertisement strategies. Weight-related body-esteem, and the reduced impact of media messages’ pressure also had statistically significant superiority, with small effect size. The number of participants with pathological EAT-26 scores (>20) decreased from 5 to 2 in the facilitator group compared to an increase from 5 to 6 (no statistical significance) in the comparison group. Both groups demonstrated statistically significant decreases in eating disorder perceptions and behaviors from baseline to 3-month follow-up. Delivering a prevention program proved beneficial to facilitators, in addition to the target school pupils, and thus may be considered as part of the prevention programs’ effectiveness assessment.

The Role of Trait Impulsivity in the Associations between Rumination and Alcohol-Related Outcomes

Background/Purpose: Emerging adults engage in high rates of alcohol consumption, which contribute to negative alcohol-related consequences and alcohol-related aggression. Rumination, or repetitive thinking about negative experiences, predicts greater negative alcohol-related consequences and alcohol-related aggression. Mechanisms of these associations are not well understood. We examined whether impulsivity mediates the effect of rumination on alcohol-related outcomes. We also tested an alternative model in which impulsivity moderates the effect of rumination on these outcomes. Methods: In a cross-sectional study with 202 undergraduates, we assessed trait rumination, four facets of impulsivity (urgency, premeditation, perseverance, and sensation seeking), recent alcohol use, negative alcohol-related consequences, and alcohol-related aggression. Results: Mediational analyses revealed that rumination indirectly predicted greater negative alcohol-related consequences and alcohol-related aggression via more urgency. Moderational analyses yielded nonsignificant interactions. Conclusion: Although cross-sectional data cannot suggest causality, the pattern of correlations suggests that rumination may lead to more clinically relevant alcohol-related outcomes because it triggers rash responding to negative affect.

Prevention of eating disorders: 2018 in review

This article reviews the 10 prevention-related publications in Eating Disorders: The Journal of Treatment & Prevention during 2018. Two models frame this analysis. This first is the Mental Health Intervention Spectrum from health promotion → types of prevention → case identification and referral → treatment (recovery). The second parses the phases of prevention into rationale, theory, and methodology → clarification of risk factors, including very high risk, shading into warning signs → implications for specific preventive interventions → design innovation and feasibility (pilot) research → efficacy and effectiveness research → program dissemination. Collectively, the articles illustrate how complex and demanding the field of prevention is, with respect to, for example, phases of program development, the multidimensional ecology of interventions, and methodological requirements for demonstrating that a program deserves to be designated "evidence-based." A subset of the articles also illustrates how far the increasingly broad and dynamic field of prevention has advanced. Examples include models of eating disorder development in high-risk populations such as people with type 1 diabetes; prevention programming for young children; and after-school preventive interventions that combine dissonance-based lessons with empowering participation in community advocacy and activism.

School-based versus after-school delivery of a universal wellness programme - A randomized controlled multi-arm trial

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.

Sex as a Moderator of Adolescents' Weight Loss Treatment Outcomes

PURPOSE

Weight loss treatments targeting adolescents often occur in mixed-sex contexts and produce variable outcomes. Sex considerations may be of particular importance, especially given differences in social relating. This study aggregated data from two randomized controlled trials of a peer-enhanced intervention compared with a standard cognitive-behavioral weight loss intervention to test the hypothesis that adolescent girls may demonstrate greater benefit than boys from a peer-enhanced weight loss intervention.

METHODS

Participants were 193 adolescents with overweight/obesity (age M = 14.4 years, standard deviation = .99) from two randomized clinical trials comparing a peer-enhanced intervention with an active cognitive-behavioral weight loss intervention. Adolescents' percent over body mass index (percent greater than the 50th percentile for age and sex) was measured at baseline, end of treatment, and approximately 6 months post treatment. Multilevel modeling was used to test hypotheses.

RESULTS

Findings suggested different weight change trajectories from baseline to end of treatment, and from end of treatment to follow-up. On average, all participants demonstrated weight loss from baseline to end of treatmentm and there was evidence that adolescent boys in the peer-enhanced condition may have benefited the most. On average, weight was maintained from end of treatment to follow-up.

CONCLUSION

Adolescent males may particularly benefit from weight loss interventions that incorporate a team component to supervised physical activity.