Translation and validation of the Body Esteem Scale in Adults and Adolescents among Indonesian adolescents.

There is a need for a psychometrically robust body image measure to advance body image scholarship among Indonesian adolescents. This study aimed to validate a Bahasa Indonesia version of the Body Esteem Scale for Adults and Adolescents (BESAA). The measure was forward and back translated from English into Bahasa Indonesia (i.e., primary Indonesian language) and was assessed for comprehension and cultural appropriateness using cognitive interviews and expert reviews. The factor structure, reliability, and validity of the measure was tested with adolescents aged 11-17 years from two districts in Indonesia (N = 650; 51.5 % girls). Exploratory factor analysis identified a suitable 17-item three-factor solution for the BESAA, with Appearance Positive, Appearance Negative, and Weight subscales. This model was confirmed via confirmatory factor analysis and found to be largely invariant across gender and age. Test re-test reliability and internal consistency of the subscales were acceptable. The Bahasa Indonesia version of the BESAA is a psychometrically robust measure suitable for use among Indonesian adolescents. Reasons as to why the factor structure of the BESAA differentiates across cultural contexts are discussed.

Evaluating a school-based body image lesson in Indonesia: A randomised controlled trial.

Negative body image is a common public health concern among adolescents, globally. The aim of the current study was to evaluate the effectiveness, implementation fidelity, and acceptability of a single session, school-based universal body image intervention in Indonesia. A total of 1926 adolescents (59.4 % girls) and 12 school guidance counsellors (lesson facilitators) from nine state junior secondary schools in Surabaya, East Java took part in a two-arm open parallel cluster randomised controlled trial. In response to the changing circumstances due to the COVID-19 pandemic, half of the lessons were conducted in person and half were delivered online. Results showed that the lesson did not significantly improve adolescent body image or secondary outcomes relative to the control, though there was no evidence of harm. There were no substantive findings regarding intervention effectiveness by gender. The mode of intervention delivery (online vs. in-person) did not significantly influence the main findings. Implementation fidelity varied widely, and the lesson content and pedagogy were largely acceptable, though there was a strong preference for in-person lesson delivery. Findings have implications for researchers aiming to improve adolescent body image in low- and middle-income countries. Lessons learned can inform future school-based efforts to support adolescent body image.

Adaptation and validation of the Body Image Life Disengagement Questionnaire (BILD-Q) for use in english among adolescents in urban India.

Body image concerns are a global issue among adolescents, including in India. These concerns can prevent adolescents from engaging in everyday life activities, impeding social and academic development. However, at present, there are no psychometrically valid measures to assess such impact in the Indian context. This study culturally adapted and validated the Body Image Life Disengagement Questionnaire (BILD-Q) for use in English among adolescents in urban India. A total of 1427 adolescents completed an adapted version of the BILD-Q along with additional measures pertaining to body image. Exploratory factor analysis identified one dimension of body image life disengagement, which provided the best fit. The 9-item one-factor model was further supported by confirmatory factor analysis. The scale demonstrated good internal consistency and test re-test reliability. Further analysis demonstrated that the scale can be used to compare scores between boys and girls without measurement bias. This study presents a culturally adapted version of the BILD-Q, which can be used as a valid and reliable measure to assess the impact of body image concerns on life disengagement among English-speaking adolescents in urban India.

Adaptation and Validation of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) for Use in English among Adolescents in Urban India.

Eating pathology is increasingly common among Indian adolescents. However, brief validated measures of disordered eating in Indian contexts are scarce. This study adapted and validated a culturally appropriate English language version of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) among 385 adolescents (mean age = 13.42 years; 47.3% girls) in urban India. Confirmatory factor analysis indicated that a two-factor eight-item solution had an acceptable fit to the data across gender: an 'Eating Concerns and Restraint' subscale and a 'Weight and Shape Concerns' subscale. Further, the questionnaire can be utilised as both a unidimensional and multidimensional tool. This allows for the computation of a total score on the primary factor of 'Child Eating Pathology', as well as the two subscales. Internal consistency of the 'Weight and Shape Concerns' subscale (α = 0.825) and 'Eating Concerns and Restraint' subscale (α = 0.649) was satisfactory. Concurrent validity was established through medium significant correlations with measures of body image and broader mental health. The results support the use of the ChEDE-Q for assessing disordered eating among urban Indian adolescents, thus providing the research community and practitioners with a measure to investigate the nature and scale of disordered eating among adolescents in India.

Body Image among Girls in Indonesia: Associations with Disordered Eating Behaviors, Life Engagement, Desire for Cosmetic Surgery and Psychosocial Influences.

Body image is an important risk factor for mental and physical health during adolescence. Nonetheless, few studies have empirically investigated body image among girls in Southeast Asia. This cross-sectional study examined the prevalence of body esteem (a holistic measure of body image assessing the degree of satisfaction with one's appearance, weight, and shape), associated behavioral outcomes, and potential psychosocial influences on body image among Indonesian girls to inform future intervention efforts. Girls across Indonesia with internet access (N = 318, Mage = 13.59 years) completed a questionnaire that assessed body image, disordered eating behaviors, appearance-related life engagement, desire for cosmetic surgery, appearance ideal internalization, media literacy, appearance-related teasing, and self-esteem. The younger girls' (10-13 years) responses were analyzed separately from those of the older girls (14-17 years). Over half of the girls did not have high body esteem. Approximately a quarter of the girls across both age groups reported restricting their food intake, emotionally eating, and/or engaging in excessive exercise, and over half desired cosmetic surgery. Disordered eating behaviors and a desire for cosmetic surgery were negatively correlated with body esteem. Hierarchical regression analyses found BMI, internalization, appearance-related teasing, and self-esteem were uniquely associated with body esteem among younger girls. Appearance-related teasing and self-esteem were positively associated with body esteem among older girls. These findings suggest body image interventions may be important for this population, with appearance-related teasing and self-esteem potentially useful targets for intervention efforts. Further prospective research to investigate these findings would be beneficial for a deeper understanding of body image risk factors for girls across Indonesia.

Evaluating the Efficacy of a Social Media-Based Intervention (Warna-Warni Waktu) to Improve Body Image Among Young Indonesian Women: Parallel Randomized Controlled Trial.

BACKGROUND: Body dissatisfaction is a global issue, particularly among adolescent girls and young women. Effective body image interventions exist but face barriers to scaling up, particularly in lower- and middle-income countries, such as Indonesia, where a need exists. OBJECTIVE: We aimed to evaluate the acceptability and efficacy of Warna-Warni Waktu, a social media-based, fictional 6-episode video series with self-guided web-based activities for improving body image among young Indonesian adolescent girls and young women. We hypothesized that Warna-Warni Waktu would increase trait body satisfaction and mood and decrease internalization of appearance ideals and skin shade dissatisfaction relative to the waitlist control condition. We also anticipated improvements in state body satisfaction and mood immediately following each video. METHODS: We conducted a web-based, 2-arm randomized controlled trial among 2000 adolescent girls and young women, aged 15 to 19 years, recruited via telephone by an Indonesian research agency. Block randomization (1:1 allocation) was performed. Participants and researchers were not concealed from the randomized arm. Participants completed self-report assessments of trait body satisfaction (primary outcome) and the internalization of appearance ideals, mood, and skin shade dissatisfaction at baseline (before randomization), time 2 (1 day after the intervention [T2]), and time 3 (1 month after the intervention [T3]). Participants also completed state body satisfaction and mood measures immediately before and after each video. Data were evaluated using linear mixed models with an intent-to-treat analysis. Intervention adherence was tracked. Acceptability data were collected. RESULTS: There were 1847 participants. Relative to the control condition (n=923), the intervention group (n=924) showed reduced internalization of appearance ideals at T2 (F1,1758=40.56, P<.001, partial η2=0.022) and T3 (F1,1782=54.03, P<.001, partial η2=0.03) and reduced skin shade dissatisfaction at T2 (F1,1744=8.05, P=.005, partial η2=0.005). Trait body satisfaction improvements occurred in the intervention group at T3 (F1, 1781=9.02, P=.005, partial η2=0.005), which was completely mediated by the internalization change scores between baseline and T2 (indirect effect: ß=.03, 95% CI 0.017-0.041; direct effect: ß=.03, P=.13), consistent with the Tripartite Influence Model of body dissatisfaction. Trait mood showed no significant effects. Dependent sample t tests (2-tailed) found each video improved state body satisfaction and mood. Cumulative analyses found significant and progressive improvements in pre- and poststate body satisfaction and mood. Intervention adherence was good; participants watched an average of 5.2 (SD 1.66) videos. Acceptability scores were high for understandability, enjoyment, age appropriateness, usefulness, and likelihood to recommend. CONCLUSIONS: Warna-Warni Waktu is an effective eHealth intervention to reduce body dissatisfaction among Indonesian adolescent girls and young women. Although the effects were small, Warna-Warni Waktu is a scalable, cost-effective alternative to more intense interventions. Initially, dissemination through paid social media advertising will reach thousands of young Indonesian women. TRIAL REGISTRATION: ClinicalTrials.gov NCT05383807, https://clinicaltrials.gov/ct2/show/NCT05383807 ; ISRCTN Registry ISRCTN35483207, https://www.isrctn.com/ISRCTN35483207. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/33596.

Evaluating a body image school-based intervention in India: A randomized controlled trial.

Body dissatisfaction is highly prevalent among adolescents in low- and middle- income countries, including in India. However, evidence-based interventions are lacking. This study evaluated the efficacy of a school-based mixed-gender body image intervention among adolescents in India. A randomized controlled trial was conducted among 568 (43 % girls) Year 7 students (aged 11-14; 94 % aged 12-13) in six schools in Delhi. Each school was randomly allocated to receive five 45-minute intervention sessions delivered by trained psychologists or a wait-list control condition. The primary outcome of body image and related secondary outcomes were assessed at pre-intervention, post-intervention, and 3-month follow-up. Intention-to-treat linear mixed models analyses showed improvements in body image relative to the control group at post-intervention and 3-month follow-up. Significant improvements were identified at post-intervention for internalization, life disengagement, disordered eating, self-esteem, and negative affect, with effects maintained in nearly all outcomes (girls only - internalization, boys only - life disengagement) at 3-month follow-up. This study presents the first mixed-gender school-based body image intervention in India, which was efficacious in improving urban adolescents' body image, disordered eating, and related outcomes.

The Body Esteem Scale for Adults and Adolescents: Translation, adaptation and psychometric validation among Brazilian adolescents.

A lack of rigorously validated body image measures for use among adolescents is hampering research in Brazil. This study aimed to validate a Brazilian Portuguese version of the Body Esteem Scale for Adults and Adolescents (BESAA; Mendelson et al., 2001). The BESAA was forward and back translated from English into Brazilian Portuguese before examining its factor structure, reliability, and validity among 475 adolescents (50.3% girls) aged 13 - 18 years (Mage = 15.35) from various regions across Brazil. Exploratory factor analysis identified an 18-item three-factor solution, with Appearance-Positive, Appearance-Negative, and Weight subscales. The removal of five problematic items led to a psychometrically robust model, invariant across gender and age, and was verified using confirmatory factor analysis. Test re-test reliability and internal consistency were good-to-excellent across all three factors (Cronbach's a =0.85,.88, and.89). Concurrent validity was established through significant correlations with body dissatisfaction. Convergent validity was demonstrated via significant correlations with positive and negative affect. This Brazilian Portuguese version of the BESAA is a valid, reliable, and psychometrically robust measure of body image suitable for administration among adolescents in Brazil.

A Novel, Scalable Social Media-Based Intervention ("Warna-Warni Waktu") to Reduce Body Dissatisfaction Among Young Indonesian Women: Protocol for a Parallel Randomized Controlled Trial.

BACKGROUND: Despite the prevalence of body dissatisfaction among young Indonesian women and its consequential negative impacts, there are currently no evidence-based, culturally appropriate interventions to tackle this issue. Therefore, there is a need to develop scalable, cost-effective, and accessible interventions to improve body image among this population. OBJECTIVE: This paper describes the study protocol of a parallel randomized controlled trial to evaluate the effectiveness of Warna-Warni Waktu, a social media-based intervention that aims to reduce state and trait body dissatisfaction and improve mood among young Indonesian women aged 15-19 years. METHODS: The trial will take place online. Approximately 1800 young women from 10 cities in Indonesia, evenly split across the ages of 15-19 years, will be recruited via a local research agency's established research panel. Participants will be randomly allocated to the intervention condition or a waitlist control condition. The intervention consists of six 5-minute videos, with each video supplemented with up to five brief interactive activities. The videos (and associated activities) will be delivered at a rate of one per day across 6 days. All participants will complete three self-report assessments: at baseline (Day 1), 1 day following the intervention (Day 9), and 1 month following the intervention (Day 36). The primary outcome will be change in trait body dissatisfaction. Secondary outcomes include change in internalization of appearance ideals, trait mood, and skin shade satisfaction. Intervention effectiveness on these outcomes will be analyzed using linear mixed models by a statistician blinded to the randomized condition. Intervention participants will also complete state measures of body satisfaction and mood before and after watching each video to assess the immediate impact of each video. This secondary analysis of state measures will be conducted at the within-group level. RESULTS: Recruitment began in October 2021, with baseline assessments underway shortly thereafter. The results of the study will be submitted for publication in 2022. CONCLUSIONS: This is the first study to evaluate an eHealth intervention aimed at reducing body dissatisfaction among young Indonesian women. If effective, the intervention will be disseminated to over half a million young women in Indonesia via Facebook, Instagram, and YouTube. TRIAL REGISTRATION: ClinicalTrials.gov NCT05023213; https://clinicaltrials.gov/ct2/show/NCT05023213. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/33596.

One size does not fit all: Trajectories of body image development and their predictors in early adolescence.

Background: Negative body image predicts many adverse outcomes. The current study prospectively examined patterns of body esteem development in early adolescence and identified predictors of developmental subtypes. Methods: 328 girls and 429 boys reported annually across a 4-year period (Mage at baseline = 11.14, SD = 0.35) on body esteem, appearance ideal internalization, perceived sociocultural pressures, appearance comparisons, appearance-related teasing, self-esteem, positive and negative affect, and dietary restraint. We performed latent class growth analyses to identify the most common trajectories of body esteem development and examine risk and protective factors for body image development. Results: Three developmental subgroups were identified: (a) high body esteem (39.1%); (b) moderate body esteem (46.1%); and (c) low body esteem (14.8%). Body esteem was stable within the low trajectory and there were minor fluctuations in the high and moderate trajectories. Greater appearance-related teasing, lower self-esteem, less positive affect, and higher dietary restraint predicted the low trajectory, whereas higher self-esteem and lower dietary restraint best predicted the high trajectory. Conclusions: Low body esteem appears to be largely stable from age 11 years. Prevention programming may be enhanced by incorporating components to address transdiagnostic resilience factors such as self-esteem and positive affect.

'Dove Confident Me Indonesia: Single Session': study protocol for a randomised controlled trial to evaluate a school-based body image intervention among Indonesian adolescents.

BACKGROUND: Due to the prevalence and associated adverse health consequences of negative body image among adolescents globally, there is a need to develop acceptable, effective, and scalable interventions. School-based body image interventions delivered by trained teachers show promise in reducing negative body image in adolescents. However, there is currently a lack of evidenced-based body image interventions for use in low- and middle-income countries (LMICs). This paper outlines a protocol for the development and evaluation of Dove Confident Me Indonesia: Single Session, a single-session, teacher-led body image intervention for Indonesian adolescents. METHOD: The effectiveness of the intervention will be evaluated using a cluster randomised controlled trial design. Due to the COVID-19 pandemic, the trial will be conducted online. Trained teachers or school guidance counsellors will deliver the intervention. Self-report questionnaires will be collected at three time points: baseline, post-intervention, and two-month follow-up. The primary outcome is body esteem. Secondary outcomes are internalisation of appearance ideals, mood, engagement in life activities, tendency to engage in appearance comparisons, and skin shade satisfaction. A minimum of 1000 participants will provide 95% power to detect small-to-medium intervention effects. To account for attrition and potential internet issues, the sample will comprise of 2000 Indonesian adolescents in grades 7-9, attending state junior high schools in Surabaya, East Java. Quantitative and qualitative data on acceptability of the intervention will also be collected from teachers and students. Additionally, fidelity of lesson implementation will be assessed. This project received ethical approval from the Universitas Indonesia and the University of the West of England. The intervention will be disseminated in junior high schools throughout Indonesia via UNICEF's Life Skills Education (LSE) programme, which will be freely available for teachers to download. DISCUSSION: This paper presents Dove Confident Me Indonesia: Single Session, a culturally adapted school-based intervention designed to improve Indonesian adolescents' body image. It details the plan for evaluation, highlighting the strengths and limitations of the proposed study design. It will be informative for others aiming to adapt evidence-based school curricula to promote well-being among adolescents in LMICs. TRIAL REGISTRATION: NCT04665557 . Registered 11th December 2020.

Acceptability and preliminary efficacy of a school-based body image intervention in urban India: A pilot randomised controlled trial.

This pilot study evaluated the acceptability and preliminary efficacy of a culturally adapted school-based body image intervention, Dove Confident Me, for use in urban India. Two private schools in New Delhi were randomly assigned at the school level to receive either the five-session intervention facilitated by trained psychologists or lessons-as-usual (control). Participants were Year 7 students (N = 166; Mage = 11.9 years). Students, facilitators, and observing teachers, provided acceptability feedback. Fidelity was assessed. Body image and related measures were completed by students in a classroom setting at pre-intervention, post-intervention, and two-month follow-up. Most students enjoyed (73.7 %) and understood (84.2 %) the intervention. Facilitators (90 %) and observing teachers (70 %) reported that the learning objectives were achieved. Adherence and facilitator competence were rated as very good. Body esteem improved significantly among intervention students at post-intervention and follow-up (Cohen's ds = .45-.46), relative to control students. Positive affect also improved at post-intervention (d = .58). No significant effects on internalisation, life engagement, eating pathology, self-esteem, or negative affect emerged. This study provides evidence for the acceptability and preliminary efficacy of Dove Confident Me in urban India. Intervention refinements to increase acceptability and efficacy are recommended.

Cultural adaptation and validation of the Body Esteem Scale for Adults and Adolescents for use in English among adolescents in urban India.

Body image research is growing in India; however, there are no psychometrically valid measures to assess body image concerns among an Indian population. In this study, the Body Esteem Scale for Adults and Adolescents (BESAA) underwent adaptation and validation among urban Indian adolescents in English. Cultural adaptations were made in consultation with body image experts and acceptability interviews with adolescents in India. 1462 adolescents living in Northern India completed the adapted BESAA and measures to assess construct validity. For girls, a 15-item three-factor model provided the best fit to our data, using exploratory factor analysis, with 'Appearance-Negative', 'Appearance-Positive', and 'Weight' subscales. For boys, a 7-item two-factor model provided best fit, with 'Appearance-Negative' and 'Appearance-Positive' subscales. Models were confirmed via confirmatory factor analysis. The scales demonstrated good internal consistency and satisfactory test-retest reliability. Construct, convergent validity was supported for girls and boys through significant correlations with figure rating scales and disordered eating. Further analyses using common items across the female and male scales, produced a psychometrically sound scale that can be used comparatively across genders. This study presents a culturally adapted, shortened BESAA as a valid and reliable measure to assess body image concerns in English among urban Indian adolescents.

Adaptation and validation of the Internalisation-General subscale of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3) in English among urban Indian adolescents.

Few studies have validated body image related measures in Asian countries, including in India, thus stunting research progress. To provide a robust method of assessing internalisation of cultural appearance ideals, the purpose of this study was to validate a culturally appropriate English version of the Internalisation-General subscale from the Sociocultural Attitudes Towards Attitudes Questionnaire-3 among a school sample of 1,432 urban Indian adolescents (Mage = 12.9 years; 44 % girls). Exploratory factor analyses revealed a one-factor solution for both girls and boys. Analyses indicated a six-item scale for girls and a four-item scale for boys; both of which were verified by confirmatory factor analysis. Cronbach's alpha was high for both female (.88) and male scales (.87), and convergent validity was confirmed via significant correlations with measures of body esteem and disordered eating. Using the items which were common in both the male and female versions of the scale, confirmatory factor analysis supported a psychometrically sound model that was gender invariant, and thus can be used to assess and compare both genders. Overall, results support the reliability and validity of the Internalisation-General subscale among English-speaking urban Indian adolescents.

Adaptation and validation of the Eating Disorder Examination-Questionnaire in English among urban Indian adolescents.

OBJECTIVE: Eating pathology is a salient issue in India, with clinical features reported among adults and adolescents. However, there are currently no validated measures of disordered eating in the Indian context. The present study therefore aimed to validate a culturally appropriate English language version of the Eating Disorder Examination Questionnaire (EDE-Q), a widely used measure, among adolescents in India. METHOD: We adapted and examined the factor structure, reliability, and construct validity of the EDE-Q among an urban sample of 1,413 Indian adolescents (mean age = 13 years; 45% girls). RESULTS: In contrast to the original four-factor model, exploratory factor analysis identified a two-factor solution for girls and boys, which was verified by confirmatory factor analysis; a "Preoccupation and Control" subscale and a "Weight and Shape Concerns" subscale. The total scale comprised 15 items for girls and 18 items for boys. Test-retest reliability and internal consistency were satisfactory for the girls' and boys' scales (Cronbach's α = .91 for both) and their comprising subscales (αs ≥ .80). Concurrent validity was established through medium-high significant correlations with measures of body image and internalization of appearance ideals. Combining items common to both versions of the scale led to a psychometrically acceptable model which was largely invariant across both genders, thus facilitating gendered comparison. DISCUSSION: Findings indicate the reliability and validity of the EDE-Q among English-speaking urban Indian adolescents. This will facilitate further research examining the prevalence and nature of eating pathology among adolescents in India.

Evaluating the "Dove Confident Me" Five-Session Body Image Intervention Delivered by Teachers in Schools: A Cluster Randomized Controlled Effectiveness Trial.

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.

Using online blogs to explore positive outcomes after burn injuries.

This study uses blog analysis, a new and novel technique, to explore the positive outcomes experienced by burn survivors. This study examined 10 burn survivor blogs to offer a unique, longitudinal insight into burn survivor recovery. Using thematic analysis, three themes emerged: shift in self-perception, enhanced relationships and a change in life outlook. Many of these themes contained stories and experiences unique to a traumatic burn injury, suggesting that standardised trauma scales are not effectively measuring the impact of a burn in this population. Reflections on blog analysis are discussed, along with a recommendation that health researchers utilise the vast amount of data available from online blogs.

Improving uptake and engagement with child body image interventions delivered to mothers: Understanding mother and daughter preferences for intervention content.

Mothers are a key influence on adolescent girls' body image. This study aimed to improve understanding of mothers' and daughters' preferences for content in body image interventions designed to assist mothers to promote positive body image among their daughters. British mother-daughter dyads (N=190) viewed descriptions of five evidence-based influences on body image (family, friends, and relationships; appearance-based teasing; media and celebrities; appearance conversations; body acceptance and care). Mothers and daughters each selected the two most important influences to learn about in these interventions. Overall, both mothers and daughters most frequently opted for family, friends, and relationships and body acceptance and care, whereas media and celebrities was their least preferred topic. While the overall sample of mothers and daughters agreed on preferences, Fisher's exact tests showed that within-dyad agreement was low. Recommendations for improving parent and child engagement with, and effectiveness of, child body image interventions delivered to parents are discussed.

Randomized controlled trial of an online mother-daughter body image and well-being intervention.

OBJECTIVE: Poor body image is a public health issue. Mothers are a key influence on adolescent girls' body image. This study evaluated an accessible, scalable, low-intensity internet-based intervention delivered to mothers (Dove Self Esteem Project Website for Parents) on mothers' and their adolescent daughters' body image and psychosocial well-being. METHOD: British mother-daughter dyads (N = 235) participated in a cluster randomized controlled trial (assessment-only control; mothers viewed the website without structured guidance [website-unstructured]; mothers viewed the website via a tailored pathway [website-tailored]). Dyads completed standardized self-report measures of body image, related risk factors, and psychosocial outcomes at baseline, 2 weeks post-exposure, 6-week, and 12-month follow-up. RESULTS: Dyadic models showed that relative to the control, mothers who viewed the website reported significantly higher self-esteem at post-exposure (website-tailored), higher weight esteem at 6-week follow-up (website-tailored), lower negative affect at 12-month follow-up (website-tailored), engaged in more self-reported conversations with their daughters about body image at post-exposure and 6-week follow-up, and were 3-4.66 times more likely to report seeking additional support for body image issues at post-exposure (website-tailored), 6-week, and 12-month (website-tailored) follow-up. Daughters whose mothers viewed the website had higher self-esteem and reduced negative affect at 6-week follow-up. There were no differences on daughters' body image, and risk factors among mothers or daughters, at post-exposure or follow-up. Tailoring website content appeared beneficial. CONCLUSIONS: This intervention offers a promising 'first-step' toward improving psychosocial well-being among mothers and daughters. In order to further optimize the intervention, future research to improve body image-related outcomes and to understand mechanisms for change would be beneficial. (PsycINFO Database Record

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.

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 randomised controlled trial [lessons as usual control; intervention teacher-led (TL); intervention researcher-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: ISRCTN16782819.