A Trial of Three School-based Body Image Interventions Delivered by Teachers

NCT03286478 | Unknown

• 1 other identifier: SFS-16-001
• Study Type: interventional
• Target: 2,400
• Locations: 1 country
• Sites: 1

Brief Summary

Body image is one of the leading concerns for young people. Such concerns can have serious health consequences, including unhealthy weight control and exercise behaviours, depression, smoking, low self-esteem and misusing drugs and alcohol. Leading and emerging approaches for improving body image are effective among older adolescent females, and when delivered by expert providers (e.g., psychologists). However, there is a need for body image programmes that include males and so can be delivered in co-educational settings, and can be delivered by non-expert providers (e.g., teachers within schools) to facilitate cost-effective and ongoing use. This project will evaluate three classroom-based programmes for improving young people's body image, delivered by class teachers to girls and boys aged 13-14 years in secondary schools. Two programmes are based on leading (cognitive dissonance) and emerging (mindfulness) approaches for improving body image, but which have not been previously evaluated with both boys and girls and when delivered by teachers. The third programme has previously demonstrated effectiveness in improving body image when delivered by teachers to boys and girls in the classroom setting, and therefore will provide a useful comparison to benchmark these programmes. To assess the impact of each programme, the current study will compare the body image and well-being of students who take part in each programme to students who take part in an alternative programme, and those who do not take part in any programme (classes as usual), over a 6-month period. The investigators will also assess the extent to which gender and pre-existing levels of body image concerns impacts the benefit received from taking part in the lessons. To undertake this project, the investigators will recruit students and teachers from 24 schools in Bristol and surrounding areas in the South West of England. Students will complete questionnaire assessments of body image and well-being before and after the 5-week programme period, and again 6 months later to assess longer-term benefits. The investigators will also gain in-depth feedback from students and teachers via focus groups and interviews, in order to inform future improvement of the programmes for wider implementation. Therefore, this trial will assess whether the two newly adapted programmes result in improved body image compared to those who receive their classes as usual, and compared to an existing teacher-led programme.

Conditions

Body Image

Keywords

body image; school; adolescence; intervention; task-shifting

Outcome Measures

Primary Outcomes (3)

• Change in baseline body esteem over time

  Assessment of global body image using the Body Esteem Scale for Adolescents and Adults, 5-point Likert-type scale, 18 items

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

• Change in baseline body satisfaction over time

  Assessment of body dissatisfaction with specific body parts using the Body Satisfaction (Project Eat III), 5 point Likert-type scale, 14 items

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

• Change in eating pathology over time

  Assessment of eating disorder psychopathology using Eating Disorder Examination-Questionnaire-Short, 4 point Likert-type scale, 12 items

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

Secondary Outcomes (8)

• Sociocultural Attitudes Towards Appearance Questionnaire-3 (Internalisation subscale)

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

• Comprehensive Inventory of Mindfulness Experiences-Adolescents

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

• Media Literacy Scale - Commercially generated and Peer-generated subscales

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

• Positive and Negative Affect Scale for Children

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

• Life Engagement Scale

  Baseline, post-intervention (6-week), 6-month, 12-month (pending further funding)

Study Arms (4)

Mindfulness

EXPERIMENTAL

Mindfulness-based body image intervention

Behavioral: Mindfulness

Dissonance

EXPERIMENTAL

Cognitive dissonance-based body image intervention

Behavioral: Dissonance

Confident Me

EXPERIMENTAL

Dove Confident Me body image intervention

Behavioral: Dove Confident Me

Control

NO INTERVENTION

Classes as usual, assessment-only control group.

Interventions

Mindfulness BEHAVIORAL

Mindfulness-based body image intervention to be delivered 1 lesson per week for 5 weeks (5 x 45 minute lessons), by trained school teachers.

Mindfulness

Dissonance BEHAVIORAL

Dissonance-based body image intervention to be delivered 1 lesson per week for 5 weeks (5 x 45 minute lessons), by trained school teachers.

Dissonance

Dove Confident Me BEHAVIORAL

Dove Confident Me body image intervention to be delivered 1 lesson per week for 5 weeks (5 x 45 minute lessons), by trained school teachers.

Confident Me

Eligibility Criteria

• Age: 12 Years - 15 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Co-educational secondary school
• Available to include Year 9 classes in the study

You may not qualify if:

• Single-sex schools
• Not available to include Year 9 classes in the study

Sponsors & Collaborators

• University of the West of England: lead

Study Sites (1)

University of the West of England

Bristol, Avon, Bs16 1QY, United Kingdom

Location

Related Publications (18)

• Diedrichs PC, Atkinson MJ, Steer RJ, Garbett KM, Rumsey N, Halliwell E. 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. Behav Res Ther. 2015 Nov;74:94-104. doi: 10.1016/j.brat.2015.09.004. Epub 2015 Sep 30.

  PMID: 26469131 BACKGROUND

• Atkinson MJ, Wade TD. Mindfulness-based prevention for eating disorders: A school-based cluster randomized controlled study. Int J Eat Disord. 2015 Nov;48(7):1024-37. doi: 10.1002/eat.22416. Epub 2015 Jun 6.

  PMID: 26052831 BACKGROUND

• Halliwell E, Yager Z, Paraskeva N, Diedrichs PC, Smith H, White P. Body Image in Primary Schools: A pilot evaluation of a primary school intervention program designed by teachers to improve children's body satisfaction. Body Image. 2016 Dec;19:133-141. doi: 10.1016/j.bodyim.2016.09.002. Epub 2016 Sep 28.

  PMID: 27693763 BACKGROUND

• Yager Z, Diedrichs PC, Ricciardelli LA, Halliwell E. What works in secondary schools? A systematic review of classroom-based body image programs. Body Image. 2013 Jun;10(3):271-81. doi: 10.1016/j.bodyim.2013.04.001. Epub 2013 May 14.

  PMID: 23683611 BACKGROUND

• Halliwell E, Diedrichs PC. Testing a dissonance body image intervention among young girls. Health Psychol. 2014 Feb;33(2):201-4. doi: 10.1037/a0032585. Epub 2013 May 13.

  PMID: 23668845 BACKGROUND

• Bird EL, Halliwell E, Diedrichs PC, Harcourt D. Happy Being Me in the UK: a controlled evaluation of a school-based body image intervention with pre-adolescent children. Body Image. 2013 Jun;10(3):326-34. doi: 10.1016/j.bodyim.2013.02.008. Epub 2013 Apr 3.

  PMID: 23562583 BACKGROUND

• Stice E, Shaw H, Becker CB, Rohde P. Dissonance-based Interventions for the prevention of eating disorders: using persuasion principles to promote health. Prev Sci. 2008 Jun;9(2):114-28. doi: 10.1007/s11121-008-0093-x. Epub 2008 May 28.

  PMID: 18506621 BACKGROUND

• Al Sabbah H, Vereecken CA, Elgar FJ, Nansel T, Aasvee K, Abdeen Z, Ojala K, Ahluwalia N, Maes L. Body weight dissatisfaction and communication with parents among adolescents in 24 countries: international cross-sectional survey. BMC Public Health. 2009 Feb 6;9:52. doi: 10.1186/1471-2458-9-52.

  PMID: 19200369 BACKGROUND

• Xie B, Unger JB, Gallaher P, Johnson CA, Wu Q, Chou CP. Overweight, body image, and depression in Asian and Hispanic adolescents. Am J Health Behav. 2010 Jul-Aug;34(4):476-88. doi: 10.5993/ajhb.34.4.9.

  PMID: 20218759 BACKGROUND

• Neumark-Sztainer D, Paxton SJ, Hannan PJ, Haines J, Story M. Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. J Adolesc Health. 2006 Aug;39(2):244-51. doi: 10.1016/j.jadohealth.2005.12.001.

  PMID: 16857537 BACKGROUND

• Halliwell E, Jarman H, McNamara A, Risdon H, Jankowski G. Dissemination of evidence-based body image interventions: A pilot study into the effectiveness of using undergraduate students as interventionists in secondary schools. Body Image. 2015 Jun;14:1-4. doi: 10.1016/j.bodyim.2015.02.002. Epub 2015 Mar 21.

  PMID: 25805217 BACKGROUND

• Atkinson MJ, Wade TD. Enhancing dissemination in selective eating disorders prevention: an investigation of voluntary participation among female university students. Behav Res Ther. 2013 Dec;51(12):806-16. doi: 10.1016/j.brat.2013.09.012. Epub 2013 Oct 9.

  PMID: 24140874 BACKGROUND

• Wilksch SM, Paxton SJ, Byrne SM, Austin SB, McLean SA, Thompson KM, Dorairaj K, Wade TD. Prevention Across the Spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity. Psychol Med. 2015 Jul;45(9):1811-23. doi: 10.1017/S003329171400289X. Epub 2014 Dec 19.

  PMID: 25524249 BACKGROUND

• Fairburn CG, Patel V. The global dissemination of psychological treatments: a road map for research and practice. Am J Psychiatry. 2014 May;171(5):495-8. doi: 10.1176/appi.ajp.2013.13111546. No abstract available.

  PMID: 24788281 BACKGROUND

• Sharpe H, Schober I, Treasure J, Schmidt U. Feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders: cluster randomised controlled trial. Br J Psychiatry. 2013 Dec;203(6):428-35. doi: 10.1192/bjp.bp.113.128199. Epub 2013 Oct 10.

  PMID: 24115345 BACKGROUND

• Ivers NM, Halperin IJ, Barnsley J, Grimshaw JM, Shah BR, Tu K, Upshur R, Zwarenstein M. Allocation techniques for balance at baseline in cluster randomized trials: a methodological review. Trials. 2012 Aug 1;13:120. doi: 10.1186/1745-6215-13-120.

  PMID: 22853820 BACKGROUND

• Richardson SM, Paxton SJ. An evaluation of a body image intervention based on risk factors for body dissatisfaction: a controlled study with adolescent girls. Int J Eat Disord. 2010 Mar;43(2):112-22. doi: 10.1002/eat.20682.

  PMID: 19350648 BACKGROUND

• Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002 Oct;59(10):877-83. doi: 10.1001/archpsyc.59.10.877.

  PMID: 12365874 BACKGROUND

MeSH Terms

Interventions

Mindfulness

Intervention Hierarchy (Ancestors)

Cognitive Behavioral Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Melissa J Atkinson, PhD

  University of the West of England

  PRINCIPAL INVESTIGATOR

• Phillippa C Diedrichs, PhD

  University of the West of England

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Masking not possible within design.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Parallel 4-arm cluster randomised controlled trial.

Study Record Dates

• First Submitted: September 8, 2017
• First Posted: September 18, 2017
• Study Start: September 18, 2017
• Primary Completion: July 1, 2018
• Study Completion: December 1, 2018
• Last Updated: September 20, 2017

Record last verified: 2017-09

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)