Effectiveness of a brief school-based body image intervention 'Dove Confident Me: Single Session' when delivered by teachers and researchers: Results from a cluster randomised controlled trial. Body Image in Primary Schools: A pilot evaluation of a primary school intervention program designed by teachers to improve children's body satisfaction. An evaluation of a body image intervention in adolescent girls delivered in single-sex versus co-educational classroom settings. The Efficacy of a Universal School-Based Prevention Program for Eating Disorders among German Adolescents: Results from a Randomized-Controlled Trial Feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders: cluster randomised controlled trial. A qualitative study of perceived social barriers to care for eating disorders: Perspectives from ethnically diverse health care consumers Promoting positive body image in young girls: an evaluation of 'Shapesville'. Prevention Across the Spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity. Impact of interactive school-based media literacy lessons for reducing internalization of media ideals in young adolescent girls and boys. Primary prevention of disordered eating among preadolescent girls: feasibility and short-term effect of a community-based intervention. Disordered eating behaviour and attitudes, associated psychopathology and health-related quality of life: results of the BELLA study A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders Life Smart: a pilot study of a school-based program to reduce the risk of both eating disorders and obesity in young adolescent girls and boys. Happy Being Me in the UK: a controlled evaluation of a school-based body image intervention with pre-adolescent children. Primary prevention of risk factors for eating disorders in adolescent girls: learning from practice. Dietary restraint of 5-year-old girls: Associations with internalization of the thin ideal and maternal, media, and peer influences.
UNLABELLED This study evaluated a 90-min single session school-based body image intervention ( Dove Confident Me : Single Session ) , and investigated if delivery could be task-shifted to teachers . British adolescents ( N = 1707 ; 11 - 13 years ; 50.83 % girls ) participated in a cluster r and omised controlled trial [ lessons as usual control ; intervention teacher-led ( TL ) ; intervention research er-led ( RL ) ] . Body image , risk factors , and psychosocial and disordered eating outcomes were assessed 1-week pre-intervention , immediate post-intervention , and 4 - 9.5 weeks follow-up . Multilevel mixed-models showed post-intervention improvements for intervention students relative to control in body esteem ( TL ; girls only ) , negative affect ( TL ) , dietary restraint ( TL ; girls only ) , eating disorder symptoms ( TL ) , and life engagement ( TL ; RL ) . Awareness of sociocultural pressures increased at post-intervention ( TL ) . Effects were small-medium in size ( ds 0.19 - 0.76 ) and were not maintained at follow-up . There were no significant differences between conditions at post or follow-up on body satisfaction , appearance comparisons , teasing , appearance conversations and self-esteem . The intervention had short-term benefits for girls ' body image and dietary restraint , and for eating disorder symptoms and some psychosocial outcomes among girls and boys . A multi-session version of the intervention is likely to be necessary for sustained improvements . Teachers can deliver this intervention effectively with minimal training , indicating broader scale dissemination is feasible . TRIAL REGISTRATION IS RCT N16782819 Body Image in the Primary School ( Hutchinson & Call and , 2011 ) is a body image curriculum that is widely available but has not yet been evaluated . This study evaluates a set of 6 of the 49 available lessons from this curriculum . Seventy-four girls and 70 boys aged 9 - 10 were recruited from four primary schools in the UK . Schools were r and omly allocated into the intervention condition , where students received 6hours of body image lessons , or to lessons as normal .  Body esteem was significantly higher among girls in the intervention group , compared to the control group , immediately post intervention , and at 3-month follow-up . Moreover , girls with lowest levels of body esteem at baseline reported the largest gains . Internalization was significantly lower among boys in the control group compared to the intervention group at 3-month follow-up . The pattern of results among the control group raises interesting issues for intervention evaluation Body dissatisfaction is now recognized as having considerable negative impact on social , psychological , and physical health , particularly in adolescent girls . Consequently , we have developed a six-session co-educational body image intervention ( Happy Being Me Co-educational ) design ed to reduce body dissatisfaction and its risk factors in Grade 7 girls . In addition to evaluating the program 's efficacy , we aim ed to identify whether girls would benefit equally when it was delivered as a universal intervention to a whole class including both boys and girls ( co-educational delivery ) , or delivered as a selective intervention to girls only ( single-sex delivery ) . Participants were 200 Grade 7 girls from five schools in Melbourne , Australia . Schools were r and omly allocated to receive the intervention in single-sex classes ( n=74 ) , co-educational classes ( n=73 ) , or participate as a no-intervention control ( n=53 ) . Girls completed self-report assessment s of body dissatisfaction , psychological ( internalization of the thin ideal , appearance comparison , and self-esteem ) and peer environment ( weight-related teasing and appearance conversations ) risk factors for body dissatisfaction , and dietary restraint , at baseline , post-intervention , and at 6-month follow-up . Significant improvements in body dissatisfaction and psychological risk factors were observed in the intervention group at post-intervention and these were maintained at follow-up for psychological risk factors . Importantly , no significant differences between universal and selective delivery were observed , suggesting that the intervention is appropriate for dissemination in both modes Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development . Effective prevention programs are needed to prevent unhealthy developmental trajectories . This study evaluated the efficacy of the POPS-program ( POtsdam Prevention at Schools ) , a universal school-based eating disorder prevention program for adolescents . In a cluster-r and omized design , we compared the intervention group receiving the prevention program to a waiting control group . Outcomes included indicators of disordered eating and relevant risk factors for eating disorders ( body dissatisfaction , internalization of the thin ideal , perceived media pressure , perfectionism , emotional element of exercise , social comparison , and perceived teasing ) . Question naires were administered at the start of the intervention , 3 and 12 months post intervention . At baseline , 1112 adolescents aged 10 to 16 years participated ( 49 % girls ; 51 % intervention group ) . Intention-to-treat analyses with the complete data set and per- protocol analyses as a completer analysis were performed . The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing . Effect sizes were small but comparable to other primary prevention programs . At 1-year follow-up , a small but significant effect on disordered eating was observed . Results of the per- protocol analyses were mostly confirmed by the intention-to-treat analyses . Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal . Further studies are warranted examining successful program elements and whether gender-specific programs are needed BACKGROUND Body image dissatisfaction during adolescence is common but not benign . School-based interventions have the potential for wide reach , but scalability of previous programmes is limited by a reliance on external facilitators . AIMS To assess the acceptability , feasibility and efficacy of a teacher-delivered body image intervention . METHOD A pilot clustered r and omised controlled trial in which 16 classes of adolescent girls were allocated to a 6-session body image programme ( n = 261 ) ,  or usual curriculum control ( n = 187 ) ( registration : IS RCT N42594993 ) . RESULTS Students in the intervention group had significantly improved body esteem and self-esteem and reduced thin-ideal internalisation . Effects for body esteem and thin-ideal internalisation were maintained for 3 months . There were no group differences for eating pathology , peer factors or depression . Acceptability , feasibility and efficacy varied between schools . CONCLUSIONS Teacher-delivered body image lessons have promise but further work is needed to increase efficacy and make interventions suitable across a range of schools Objective : The study aim was to identify and describe health consumer perspectives on social barriers to care for eating disorders in an ethnically diverse sample . Method : We conducted an exploratory secondary analysis of qualitative data comprising transcripts from semi-structured interviews with past and prospect i ve consumers of eating disorder treatment ( n = 32 ) . Transcripts were inputted into NVivo 8 for coding , sorting , and quantifying thematic content of interest within strata defined by ethnic minority and non-minority participants . We then examined the influence of key social barriers — including stigma and social stereotypes — on perceived impact on care . Results : The majority of respondents ( 78 % ) endorsed at least one social barrier to care for an eating or weight concern . Perceived stigma ( or shame ) and social stereotyping — identified both within social networks and among clinicians — had adversely impacted care for 59 % and 19 % of respondents , respectively . Discussion : Social barriers to care for eating and weight related concerns may be prevalent in the U.S. and impact both ethnic minority and non-minority health care consumers . © 2009 by Wiley Periodicals , Inc. ( Int J Eat Disord 2010 ; The aim of the current research was to evaluate Shapesville , a children 's picture book design ed to promote positive body image in young children . Participants were a convenience sample comprising 84 girls ( aged 5 - 9 years ) recruited from four private girls ' schools . Girls were r and omly allocated to be read either Shapesville or a control book . Individual measures of body image , stereotyping on the basis of weight and media internalisation , as well as knowledge of non-appearance topics , were obtained at pre- and post-intervention , as well as at 6-week follow-up . Relative to the control book , girls ' appearance satisfaction increased after reading Shapesville . In addition , stereotyping on the basis of weight and internalisation of media ideals was reduced . Finally , reading Shapesville also increased girls ' knowledge base of non-appearance topics , such as recognising their special talents and awareness of healthy eating , at post-intervention . These gains were somewhat reduced at follow-up , yet were largely still significantly greater than at pre-intervention . The present study demonstrates that Shapesville has the potential to be a successful prevention tool for use with young girls . Schools can incorporate Shapesville into their curriculum as early as school entry , in order to help prevent the early development of body dissatisfaction and disordered eating BACKGROUND A r and omized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing  eating disorder and obesity risk factors .  METHOD A total of 1316 grade 7 and 8 girls and boys ( mean age = 13.21 years ) across three Australian states were r and omly allocated to : Media Smart ; Life Smart ; the Helping , Encouraging , Listening and Protecting Peers ( HELPP ) initiative ; or control ( usual school class ) . Risk factors were measured at baseline , post-program ( 5 weeks later ) , and at the 6- and 12-month follow-ups . RESULTS Media Smart girls had half the rate of onset of clinical ly significant concerns about shape and weight than control girls at the 12-month follow-up . Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up . Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up . Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys . A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up , while a main effect for group found Media Smart participants reported less screen time than controls . CONCLUSIONS Media Smart was the only program to show benefit on both disordered eating and obesity risk factors . Whilst further investigations are indicated , this study suggests that this program is a promising approach to reducing risk factors for both problems OBJECTIVE The primary objective of the current study was to examine the efficacy of single media literacy lessons in reducing media internalization in young adolescents . METHOD Eleven classes of 237 students ( 100 girls and 137 boys ; mean age = 13.79 years , SD = .42 ) r and omly received 1 of 6 lessons . Eating disorder risk factors were assessed at baseline , and the Sociocultural Attitudes Towards Appearance Question naire-3 ( SATAQ-3 ) was used to assess media internalization postintervention . RESULTS At postintervention , boys had significantly lower SATAQ-3 scores on 4 of the 5 subscales ( effect sizes = .42-.71 ) , whereas girls had significantly lower scores on 1 subscale ( effect size = .54 ) . Higher baseline levels of dietary restraint , magazines bought/read , and perceived sociocultural pressure predicted smaller reductions in boys ' scores , whereas depression predicted smaller reductions in girls ' scores . CONCLUSION The current study provides support that boys be included in eating disorder prevention programs and that media literacy may represent a promising prevention approach OBJECTIVE To evaluate a community-based intervention aim ed at the primary prevention of disordered eating among preadolescent girls . DESIGN Girl Scout troop members were r and omized into control and intervention groups . Program feasibility and effect at postintervention and 3-month follow-up were evaluated . SUBJECTS/ SETTING 226 girls ( mean age = 10.6 years , st and ard deviation = 0.7 ) from 24 Girl Scout troops . INTERVENTION Six 90-minute sessions focusing on media literacy and advocacy skills . MAIN OUTCOME MEASURES Evaluation focused on program satisfaction and short-term effect on dieting behaviors , body image attitudes , and media knowledge , attitudes , and habits . STATISTICAL ANALYSES Performed t tests , chi 2 tests , and analyses of covariance including troop as a r and om source of variation . RESULTS At baseline , 29 % of the girls were trying to lose weight . The program had a notable positive influence on media-related attitudes and behaviors including internalization of sociocultural ideals , self-efficacy to impact weight-related social norms , and print media habits . A modest program effect on body-related knowledge and attitudes was apparent at post-intervention ( i.e. , on body size acceptance , puberty knowledge , and perceived weight status ) but not at follow-up . Significant changes were not noted for dieting behaviors , but they were in the hypothesized direction . Satisfaction with the program was high among girls , parents , and leaders . APPLICATIONS/ CONCLUSIONS It is feasible to use community youth setting s , such as the Girl Scouts , to implement interventions to prevent disordered eating behaviors . The program led to positive trends in outcome variables ; however , longer and more intensive interventions are needed for lasting changes in body image and dieting behaviors Objective To identify disordered eating behaviour and attitudes in a large representative population in order to determine the relationship with body weight status , and to assess associated psychopathology and health-related quality of life . Methods A total of 11–17 year-old adolescents ( n = 1,895 ) were r and omly selected from the national representative sample of 17,641 families participating in the German Health Interview and Examination Survey for Children and Adolescents ( KiGGS ) . Weight and height were assessed by trained staff . Mental health problems and health-related quality of life were examined by means of a telephone interview and different question naires . Eating disordered behaviour and attitudes were identified by the SCOFF , an instrument consisting of five questions originally developed to screen for eating disorders in clinical setting s. Results About one third of the girls and 15 % of the boys reported disordered eating behaviour and attitudes , which were most prevalent in overweight youth . There was a significant association between the presence of disordered eating behaviour and psychopathology , which was comprised of internalising and externalising behavioural problems . In addition , adolescents with disordered eating behaviour reported reduced quality of life . Conclusion The high prevalence of disordered eating in the general population of Germany is of great concern . Health professionals should not only be aware of disordered eating in underweight adolescents , but in all youth , especially overweight individuals . Disordered eating behaviour is associated with a wide range of psychopathological and psychosocial concerns . Thus , youngsters engaging in disordered eating behaviour should also be explored for other serious mental or social problems OBJECTIVE This pilot study investigated the effectiveness of a social media literacy intervention for adolescent girls on risk factors for eating disorders . METHOD A quasi-experimental pre- to post-test design comparing intervention and control conditions was used . Participants were 101 adolescent girls ( Mage = 13.13 , SD = 0.33 ) who were allocated to receive three social media literacy intervention lessons  ( n = 64 ) or to  receive classes as usual  ( n = 37 ) . Self-report assessment s of eating disorder risk factors were completed one week prior to , and one week following the intervention . RESULTS Significant group by time interaction effects revealed improvements in the intervention condition relative to the control condition for body image ( body esteem-weight ; d = .19 ) , disordered eating ( dietary restraint ; d = .26 ) and media literacy ( realism scepticism ; d = .32 ) . DISCUSSION The outcomes of this pilot study suggest that social media literacy is a potentially useful approach for prevention of risk for  eating disorders in adolescent girls in the current social media environment of heightened vulnerability . Replication of this research with larger , r and omized controlled trials , and longer follow-up is needed OBJECTIVE To develop and pilot Life Smart , an eight-lesson program aim ed at reducing risk factors for both eating disorders and obesity . METHODS Grade 7 girls and boys ( N = 115 ) from one independent school were r and omly allocated to the Life Smart ( two classes ; N = 51 ) or control ( three usual classes ; N = 64 ) conditions . Risk factors were measured at baseline and post-program ( 5 weeks later ) . RESULTS Life Smart was rated as moderately enjoyable and valuable by participants . ANCOVAs with baseline as a covariate revealed a significant main effect for group favoring Life Smart for shape and weight concern ( Effect Size [ ES ] = .54 ) , with post-hoc testing finding girls particularly benefited on this variable ( ES = .78 ) . CONCLUSIONS Feedback was generally favorable , with some suggestions for even more interactive content . The program showed more promise with girls . Informed by these findings , the program underwent revisions and is now being evaluated in a r and omized controlled trial This study evaluated an adapted version of ' Happy Being Me ' , a school-based body image intervention , with girls and boys aged 10 - 11 years . Forty-three children participated in a three-week intervention , and 45 children formed a control group .  Both groups completed measures of body satisfaction , risk factors for negative body image , eating behaviors , self-esteem , and intervention topic knowledge , at baseline , post-intervention , and 3-month follow-up . For girls , participation in the intervention result ed in significant improvements in body satisfaction , appearance-related conversations , appearance comparisons , eating behaviors and intervention topic knowledge at post-intervention , although only the change in body satisfaction was maintained . There was also a significant decrease in internalization of cultural appearance ideals from baseline to follow-up . For boys , participation in the intervention result ed in significant improvements in internalization and appearance comparisons at post-intervention ; however , neither of these changes were sustained at follow-up . There were no improvements in the control group over time OBJECTIVE This study evaluates the effectiveness and feasibility of a primary prevention program for risk factors for eating disorders in adolescent girls . METHOD Nearly 500 seventh- grade girls participated in " Full of Ourselves : Advancing Girl Power , Health , and Leadership , " and were assessed at baseline , immediately after program completion , and 6 months later on several self-report measures of knowledge , body image , and eating and weight-related behaviors . RESULTS Significant differences were found between participants and controls on measures of knowledge and weight-related body esteem , which were maintained at 6-month follow-up . Eating related behaviors , including skipping meals and dieting , appeared unaffected by program participation . DISCUSSION The program was feasible , safe , and result ed in positive and maintained changes in knowledge and weight satisfaction for adolescent girls OBJECTIVE Underst and ing socio-cultural factors associated with the development of dieting tendencies is important for preventing future disordered eating . We explored individual and socio-cultural factors associated with weight-focussed dietary restraint tendencies ( described as dietary restraint ) in 5-year-old girls . METHOD Participants were 111 5-year-old girls and 109 of their mothers . Girls were interviewed about their dietary restraint , body image , appearance ideals , positive weight bias ( attributing positive characteristics to thinner figures ) , and peer conversations . Mothers completed self-report question naires assessing  dietary restraint  and appearance ideals , as well as measures reporting on their daughter 's media exposure  and  peer appearance interest  . RESULTS Thirty-four percent of girls reported at least a moderate level of dietary restraint .  While most girls were satisfied with their body size , half showed some internalization of the thin ideal . Girls ' dietary restraint was correlated with weight bias favoring thinner bodies , and greater internalization of the thin ideal , media exposure , and appearance conversations with peers . Media exposure and appearance conversations were the strongest predictors of  dietary restraint .  DISCUSSION These cross-sectional findings suggest that the socio-cultural environment of young girls may be important in the very early development of unhealthy dieting tendencies . Longitudinal research is necessary to identify whether these are prospect i ve risk factors
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 .