Efficacy of a prevention program for eating disorders in schools: a cluster-randomized controlled trial (original) (raw)
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BMC Psychiatry, 2015
Background: There are a high number of adolescents who are at risk of developing an eating disorder. There is, therefore, a strong need to implement prevention programs aimed at reducing the incidence of eating disorders at this critical age. Among other factors, successful prevention programs have been shown to be interactive, carried out by professionals, focused on educational as well as psychosocial elements and have taken risk factors as well as resources into account. The objective of this study protocol is to present the design of a new prevention program for eating disorders in schools. Methods/Design: The gender-adapted prevention program extends over six school hours. It contains interactive and educational elements about eating disorders and their treatment. Participants pass through different exercises and reflect on the influences of the media, self-esteem, body perception and individual resources. A cluster-randomized controlled trial is chosen to evaluate the program. Based on an estimated effect size of d = 0.3 a total of 1848 participants are enrolled in the study. Eating disorder risk, internalization of Western beauty ideals, body dissatisfaction, self-concept as well as anxiety and symptoms of depression are measured before and immediately after the intervention as well as at a six-month follow-up. In addition, the intervention group evaluates the different components of the program.
School-Based Prevention Programs for Eating Disorders Achievements and Opportunities
Scarce resources are dedicated to research on school-based prevention programs for eating disorders. Despite this, however, recent years have witnessed an abundance of publications on controlled prevention trials. We now have a cumulative body of knowledge available to guide future developments in the prevention of eating disorders. Medline and PsychInfo were searched for the years 1985–2002 to find relevant publications for this review. Nineteen universal and ten targeted school-based prevention programs were identified and then evaluated. The results obtained by the controlled trials evaluated reassure parents, teachers, and stakeholders in the healthcare sector that school-based eating disorder prevention programs do not have harmful effects on student attitudes and behaviors. Targeted prevention programs have obtained promising results in high-risk individuals. Other positive effects have been obtained using an interactive format. Universal prevention programs have unfortunately been disappointing in their ability to change unhealthy behaviors. Results can be improved by gaining a greater understanding of those risk factors which are most strongly linked to eating disorders and most susceptible to change. A broad range of interventions is needed for further consideration. Promising results from the field of eating disorder prevention and from modern risk factor research could build a new generation of universal prevention trials for eating disorders without the methodological limitations seen in the current literature and with real effectiveness in achieving the goal of reducing the prevalence of eating disorders in the general population.
Combining Universal and Targeted Prevention for School-Based Eating Disorder Programs
… Journal of eating …, 2004
Objective: This study examined a step toward providing a universal prevention program to all students while targeting those at risk. Method: Seventy-eight 10th-grade female students were provided an on-line eating disorder prevention program and randomized to participate in (1) a higher risk and higher motivated group, (2) a lower risk or lower motivated group, or (3) a combined group. Results: The students in the first group made significantly fewer negative and more positive comments in the on-line group discussion than the higher risk and higher motivated participants in the combined group. However, there were no differences among groups on outcome measures. Discussion: The results suggest that, because it is relatively easy to provide interventions with separate groups, it seems appropriate to do so, if for no other reason than to minimize the few very negative comments that were posted by students that might have created an adverse environment for the higher risk-participants that the intervention specifically targets. # 2003 by Wiley Periodicals, Inc. Int J Eat Disord 35: 1-9, 2004.
Eating Disorders: A Trial of Prevention in a High Risk School Setting
The Journal of Primary Prevention, 1999
The study describes the long-term outcome of a program aimed at the prevention of eating disorders in a world-class, residential ballet school for female and male students, ages 10–18. The prevention program followed the paradigm of health promoting schools outlined by the World Health Organization and involved systemic changes as well as direct interventions with students. Three all-school surveys have been conducted, the baseline survey was conducted in 1987, within the first year of implementation of the program, and the second and third ones in 1991 and 1996, respectively. Measures included the Diagnostic Survey for Eating Disorders, the Eating Attitude Test, and the Eating Disorder Inventory. Comparisons between the baseline cohort and the two latter cohorts, revealed significant reductions in disordered eating patterns and disturbed attitudes about eating and body shape, as well as significant increases in healthy eating patterns. The study suggests the benefits of implementing multifaceted prevention programs for eating disorders in high risk settings.
Clinical Psychologist, 2010
The objective of this study was to explore two aspects not investigated in a 2.5-year controlled evaluation of an 8-lesson media literacy program. First, the impact of the program on over-evaluation of shape and weight. Second, an examination of the program effects by participant baseline risk of developing an eating disorder. Grade 8 students (N ¼ 540, mean age ¼ 13.62 years) were assessed at baseline, post-program, 6-month, and 2.5-year follow-up. Controlling for baseline observations, linear mixed model analyses revealed a main effect for group, favouring media literacy, and a group 6 risk interaction, where high-risk media literacy participants had significantly lower over-evaluation scores than high-risk control participants. Both high-risk media literacy girls and boys, and low-risk media literacy girls scored significantly lower at 2.5year follow-up than controls. Media literacy can have a lasting, beneficial impact in reducing the core cognitive component of eating disorders in both high-and low-risk young adolescents.
European Eating Disorders Review, 2010
There is currently controversy surrounding the effectiveness of universal versus selective prevention in eating disorders (ED). The present study aims at evaluating the effectiveness of universal school-based ED prevention administered to female secondary school students (n = 349). Students received either the full prevention programme (learning basic concepts of nutrition, criticism of aesthetic models of beauty emphasising extreme thinness, media literacy (ML)), a partial version of the programme (without nutritional education), or no prevention programme. Students were also classified on the presence or absence of distinct risk factors for ED: Early menarche, overweight, dieting, negative attitudes to food and perceived pressure to be thin. Pre-test data were collected 1 week prior to implementation of the prevention programme, and post-test data were collected on the last day of the programme. Results suggested that both the full and partial prevention programmes reduced perceived pressure to be thin and improved eating attitudes and knowledge of nutrition in all the participants (regardless of risk); however, greater effect sizes were found among particular high-risk groups (early menarche, overweight and highly influenced by aesthetic models of beauty emphasising extreme thinness). School-based programmes of universal intervention may have an important role to play in the prevention of ED. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association.
Psychological Medicine, 2014
BackgroundA randomized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors.MethodA total of 1316 grade 7 and 8 girls and boys (mean age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; the Helping, Encouraging, Listening and Protecting Peers (HELPP) initiative; or control (usual school class). Risk factors were measured at baseline, post-program (5 weeks later), and at the 6- and 12-month follow-ups.ResultsMedia Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at the 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month ...
Eating Disorders, 2005
A prevention program for disordered eating was evaluated. Grade 9 girls (N = 173) were assigned to a prevention intervention (n = 114) or a no-treatment control group (n = 59). High-risk, but not low-risk, girls reported significant improvements in body dissatisfaction, drive for thinness, and interoceptive awareness at post-intervention. These changes were not maintained at three-month follow-up, although nonsignificant trends were still apparent for high-risk girls. Individual session analyses indicated that the program was rated positively overall. The importance of assessing effects of programs on different recipient types is discussed.
A Quantitative Analysis of an Eating Disorder Prevention Program
2011
A Quantitative Analysis of an Eating Disorder Prevention Program Jennalee Murray Department of Counseling Psychology and Special Education, BYU Education Specialist Eating disorders affect millions of people in the United States alone. This study aimed to test the effectiveness of a preventative curriculum for eating disorders called Eating Disorders: Physical, Social, and Emotional Consequences, A High School Curriculum about Anorexia, Bulimia, and Compulsive Eating (EDPSEC). Participants included an experimental group of 27 students in their ninth grade health class and a control group of 21 students. The research examined the integrity of the curriculum administration and changes in participating students’ attitudes and behaviors. The outcome measures used were students’ scores on the Eating Attitudes Test (EAT-26) and the Eating Survey (ES). Results indicate high treatment integrity (85%) and significant change on students’ EAT-26 scores, but not students’ ES scores. Students’ E...