Coach-Led Body Image Intervention for Girls in Sport - RCT

NCT05594524 | Completed DMC

• 1 other identifier: HAS.21.03.120c
• Study Type: interventional
• Target: 568
• Locations: 1 country
• Sites: 1

Brief Summary

According to the World Health Organization, only 15% of 11-17-year-old girls meet the recommended daily physical movement guidelines (e.g., 60 minutes per day). Despite extensive research highlighting the protective factors associated with sport on both mental and physical health, body image concerns are a key barrier to girls' participation in, and enjoyment of, sport. Sports-related environments and society more broadly further exacerbate these concerns through harmful gender stereotypes that perpetuate female objectification, discrimination, and harassment. This includes the promotion of unrealistic and sexualized appearances of female athletes, uncomfortable and objectifying uniforms, and appearance and competence-related teasing from male and female peers, as well as coaches. The magnitude of this issue and how best to address it can be understood from a socioecological perspective. Researchers suggest developing multi-faceted and multi-tiered approaches that have scope for targeting the individual, interpersonal, organizational, and societal levels. The current research will test the first coach-led body image program for girls in sport. The Body Confident Athletes program was co-created with girls and coaches through an international multi-disciplinary partnership between academics, health professionals, industry, and community organizations. Multi-disciplinary partnerships can create a supportive landscape by upskilling girls and influential community members (e.g., coaches) in dealing with body image concerns, which will likely lead to sustained sports participation and biopsychosocial benefits. As such, the aim of the present study is to conduct a large-scale randomized controlled trial (RCT) to evaluate the effectiveness of the Body Confident Athletes program. The program consists of three 60-minute sessions delivered by coaches to adolescent girls. Each session tackles a distinct theme related to body image in the sport context. Outcomes will be assessed at pre-intervention, post-intervention (three weeks later), and follow-up (at one and three months). Outcomes will include body image and sport enjoyment (primary outcomes); body appreciation, attuned self-care, resisting objectification, and positive and negative affect (secondary outcomes); and intervention acceptability, fidelity, and adherence (process outcomes). The comparison control arm will be a waitlist control condition. To undertake this project, sports organizations will be cluster-randomized into the intervention group or the control group, with 800 girls anticipated in each arm. Those in the intervention condition will complete baseline assessments (target outcomes and demographic information), take part in the three-week intervention, and then complete the post-intervention and follow-up assessments (target and process outcomes). Those in the waitlist control condition will complete the baseline assessments (target outcomes and demographic information), a second assessment three weeks later (target outcomes only), and follow-up assessments after one and three months, after which they will get access to the intervention. However, their engagement with the intervention will not be monitored or assessed. At completion of the post-intervention survey, all participants will receive a debrief form, outlining the study aims and objectives, and support resources for body image and eating concerns. The investigators hypothesize that girls who take part in the Body Confident Athletes intervention will report higher levels of body esteem, sport enjoyment, body appreciation, attuned self-care, resisting objectification, and positive affect and lower levels of negative affect at post-intervention and follow-up, compared to girls who do not take part in the intervention. Note: This research has been approved by the University of the West of England Research Ethics Committee (ref no. HAS.21.03.120) and the University of Minnesota Institutional Review Board (ref no. STUDY00012457).

Conditions

Intervention; Waitlist Control

Keywords

Body image; Embodiment; Girls; Athletes; Coaches; Task shifting

Outcome Measures

Primary Outcomes (2)

• Change in body esteem (assessed via the Body Esteem Scale for Adults and Adolescents)

  The Body Esteem Scale for Adults and Adolescents (BESAA) assesses body esteem (BE), which refers to self-evaluations of one's body or appearance. The BESAA has 3 subscales: BE-Appearance (general feelings about appearance), BE-Weight (weight satisfaction), and BE-Attribution (evaluations attributed to others about one's body and appearance). For the purposes of this study, only the BE-Appearance and BE-Weight subscales will be utilized. BESAA scores range from 0-4 with higher scores on the BESAA indicating higher levels of body esteem.

  Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention

• Change in sport enjoyment (assessed via the Sources of Enjoyment in Youth Sport Questionnaire)

  The Sources of Enjoyment in Youth Sport Questionnaire (SEYSQ) assesses the source of an athlete's enjoyment in sport according to two spectrums (intrinsic motivation vs. extrinsic motivation and achievement vs. non-achievement factors), resulting in four quadrants indicating the four sources of an athlete's enjoyment. SEYSQ scores range from 1-5.

  Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention

Secondary Outcomes (4)

• Change in body appreciation (assessed via the Body Appreciation Scale-2)

  Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention

• Change in attuned self-care (assessed via the Youth Experience of Embodiment Scale - Attuned Self-Care subscale)

  Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention

• Change in resisting objectification (assessed via the Youth Experience of Embodiment Scale - Resisting Objectification subscale)

  Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention

• Change in positive and negative affect (assessed via the 10-item Positive and Negative Affect Schedule for Children)

  Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention

Other Outcomes (3)

• Total acceptability of the intervention (assessed via a self-report questionnaire)

  Immediately after the intervention (3 weeks later)

• Total intervention fidelity (assessed via self-report and investigator observation of recorded intervention sessions)

  Immediately after the intervention (3 weeks later)

• Total intervention adherence (assessed through session completion)

  Immediately after the intervention (3 weeks later)

Study Arms (2)

Body Confident Athletes

EXPERIMENTAL

Participants in the intervention condition will take part in an in-person program consisting of three sessions over three weeks.

Behavioral: Body Confident Athletes

Waitlist control

NO INTERVENTION

Participants will not be explicitly told their study condition, although they will be made aware of the assessment time points and whether they will receive access to the intervention after the first survey (intervention group) or after follow-up assessments (waitlist control group). Following completion of follow-up assessments, the control condition will get access to the intervention, but they will not be monitored or assessed.

Interventions

Body Confident Athletes BEHAVIORAL

The Body Confident Athletes program is a three-session in-person program designed to be delivered by coaches to their athletes. Groups should be of approximately 10-20 girls. The sports organizations will work with the community partner and researchers on how to schedule the intervention over a three-week period. These sessions can replace a regular sport practice each week or an additional session can be organized by the sports organization. Each session will take approximately 60 minutes and will consist of four phases, including The Game Plan (5 mins), The Knowledge (20 mins), The Skills (20 mins), and The Final Score (15 mins). A variety of activity modalities will be utilized to convey learning outcomes, including group and individual activities and discussion-, writing-, and movement-based activities.

Body Confident Athletes

Eligibility Criteria

• Age: 11 Years - 17 Years
• Gender Eligibility Details: We will include girls in the current study, referring to the girl child defined as younger than 18 years old who was assigned female at birth and all individuals who identify as a girl.
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Girls aged 11-17 years old
• English speaking
• Residing in the United States

You may not qualify if:

• n/a

Sponsors & Collaborators

• University of the West of England: lead
• Unilever R&D: collaborator
• Nike: collaborator
• Tucker Center for Research on Girls & Women in Sport (University of Minnesota): collaborator
• Cairn Guidance: collaborator

Study Sites (1)

Centre for Appearance Research, University of the West of England

Bristol, BS16 1QY, United Kingdom

Location

Related Publications (8)

• Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1.6 million participants. Lancet Child Adolesc Health. 2020 Jan;4(1):23-35. doi: 10.1016/S2352-4642(19)30323-2. Epub 2019 Nov 21.

  PMID: 31761562 BACKGROUND

• Neumark-Sztainer D, MacLehose RF, Watts AW, Pacanowski CR, Eisenberg ME. Yoga and body image: Findings from a large population-based study of young adults. Body Image. 2018 Mar;24:69-75. doi: 10.1016/j.bodyim.2017.12.003. Epub 2017 Dec 27.

  PMID: 29288970 BACKGROUND

• Sabiston, C., Pila, E., Vani, M., & Thogersen-Ntoumani, C. (2019). Body image, physical activity, and sport: A scoping review. Psychology Of Sport And Exercise, 42, 48-57. doi: 10.1016/j.psychsport.2018.12.010

  BACKGROUND

• Sabiston, C. M., Vani, M. F., & Murray, R. M. (2021). Body-related self-conscious emotions in sport and exercise: A self-regulation perspective. In Motivation and Self-regulation in Sport and Exercise (pp. 62-77). Routledge.

  BACKGROUND

• Slater A, Tiggemann M. Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns. J Adolesc. 2011 Jun;34(3):455-63. doi: 10.1016/j.adolescence.2010.06.007. Epub 2010 Jul 31.

  PMID: 20643477 BACKGROUND

• Vani MF, Pila E, Willson E, Sabiston CM. Body-related embarrassment: The overlooked self-conscious emotion. Body Image. 2020 Mar;32:14-23. doi: 10.1016/j.bodyim.2019.10.007. Epub 2019 Nov 13.

  PMID: 31733410 BACKGROUND

• Matheson EL, Schneider J, Tinoco A, White P, Toher D, LaVoi NM, Diedrichs PC. A randomized controlled trial of a body image intervention for girl athletes. Health Psychol. 2025 Dec;44(12):1127-1138. doi: 10.1037/hea0001522. Epub 2025 Jun 2.

  PMID: 40455543 RESULT

• Matheson EL, Schneider J, Tinoco A, Gentili C, Silva-Breen H, LaVoi NM, White P, Diedrichs PC. The co-creation, initial piloting, and protocol for a cluster randomised controlled trial of a coach-led positive body image intervention for girls in sport. BMC Public Health. 2023 Jul 31;23(1):1467. doi: 10.1186/s12889-023-16360-w.

  PMID: 37525161 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 12, 2022
• First Posted: October 26, 2022
• Study Start: January 16, 2023
• Primary Completion: May 7, 2023
• Study Completion: May 7, 2023
• Last Updated: June 10, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)