Evaluating Dove Confident Me 5-session body image intervention delivered by teachers: A cluster randomised controlled effectiveness trial

Phillippa C. Diedrichs*, Melissa J. Atkinson, Kirsty M. Garbett, George B Leckie

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Purpose: Body dissatisfaction is common during adolescence and predicts poor
psychological and physical health. Interventions have traditionally over-relied 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 randomised controlled trial. Boys and girls aged 11-13 received the 5-session intervention delivered by their teachers (n=848), or lessons-as-usual control (n=647), and were assessed at baseline, post-intervention, 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 (internalisation 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, life engagement).

Results: Compared to the control group, intervention students demonstrated improvements in the primary outcome of body esteem at post- d = 0.15), 2-month (d = 0.26), and 6-month follow-up (d = 0.15). For girls, there was also a significant reduction in experienced appearance-related teasing at 6-month (d = 0.24) and 12-month (d = 0.30) 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 programme 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.
Original languageEnglish
Pages (from-to)331-341
Number of pages11
JournalJournal of Adolescent Health
Issue number2
Early online date24 Nov 2020
Publication statusPublished - 1 Feb 2021


  • body image
  • body dissatisfaction
  • schools
  • intervention
  • adolescence
  • task-shifting
  • teachers


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