TY - JOUR
T1 - Evaluating the "Dove Confident Me" Five-Session Body Image Intervention Delivered by Teachers in Schools
T2 - A Cluster Randomized Controlled Effectiveness Trial
AU - Diedrichs, Phillippa C
AU - Atkinson, Melissa J
AU - Garbett, Kirsty M
AU - Leckie, George
N1 - Publisher Copyright:
© 2020 Society for Adolescent Health and Medicine
PY - 2021/2/1
Y1 - 2021/2/1
N2 - 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.
AB - 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.
U2 - 10.1016/j.jadohealth.2020.10.001
DO - 10.1016/j.jadohealth.2020.10.001
M3 - Article (Academic Journal)
C2 - 33243723
SN - 1054-139X
VL - 68
SP - 331
EP - 341
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 2
ER -