Preventing eating disorders with an interactive gender-adapted intervention program in schools: Study protocol of a randomized controlled trial (original) (raw)
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BMC psychiatry, 2017
Previous prevention programs in the school context have not addressed both genders, have been time-consuming, or have had deficits in the evaluation method. The aim of the present study was to evaluate the impact of a universal prevention program for female and male adolescents on eating disorder pathology and related risk factors. Between February 2012 and July 2014, 2515 students in 23 schools from 8th or 11th grade were assessed for eligibility in this longitudinal cluster-randomized controlled trial with a six months follow-up. Of those students, 2342 were cluster-randomized to the intervention condition which received a six school hours universal prevention program or to the no treatment control condition. The complete case population comprised 724 students in the intervention (54.3% female, M = 14.3 years, SD = 1.61) and 728 in the control condition (57.0% female, M = 14.7 years, SD = 1.63). Random-effects analysis of covariance on the primary outcome showed no significant dif...
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.
Iranian Evolutionary Educational Psychology Journal, 2022
Social media can cause body dissatisfaction by presenting social ideals about appearance. This dissatisfaction can lead to eating problems and low self-esteem, which is frequently seen in adolescents. Therefore, intervention in this situation can be valuable for research and treatment purposes. The present study aimed to investigate the effectiveness of the school-based intervention “Dove Confident Me” on eating problems and self-esteem in female adolescents with eating disorders. This quasi-experimental research was performed using a pre-test-post-test design with a control group. The statistical population of the research included all female high school students in Bandar Abbas (Iran) in 2021. A total of 47 female students were selected by purposive sampling and randomly assigned to experimental (23 people) and control (24 people) groups. Eating Disorder Diagnostic Scale (EDDS) and Rosenberg Self-Esteem Scale (RSES) were used to collect data. Research hypotheses were tested using multivariate covariance analysis (MANCOVA). The results indicated that the school-based intervention “Dove Confident Me” had a significant effect on the improvement of symptoms of eating disorders (F = 6.41, p < 0.05) and self-esteem (F = 5.35, p < 0.05) in female adolescents with eating disorders. According to the findings, the “Dove Confident Me” intervention can improve eating problems and self-esteem of female adolescents with eating disorders by correcting social ideals about appearance and improving media literacy. Furthermore, it can be applied as an effective treatment and training method.
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.
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.
The British Journal of Psychiatry, 2013
Body dissatisfaction during adolescence is common but not benign. Between 17 and 33% of adolescents report body dissatisfaction, with the figure higher for girls than boys. 1,2 Body dissatisfaction is a major public health concern because of its association with an array of negative outcomes, ranging from depression and eating disorders, to cosmetic surgery use, over-and under-exercising, obesity and unhealthy weight loss behaviours such as smoking. 1,3 As such, body dissatisfaction has been the focus of government policy in a number of countries. Schools offer an opportunity for prevention of body dissatisfaction, as programmes can be delivered across the population prior to the increase in body image dissatisfaction seen in late adolescence. 6 Previous work has shown that school-based interventions can reduce body dissatisfaction and its precursors. 7,8 However, delivery has usually been by clinical psychologists, 7,8 who are an expensive and limited resource in schools.
The MABIC project: An effectiveness trial for reducing risk factors for eating disorders
Behaviour Research and Therapy, 2015
Challenges in the prevention of disordered eating field include moving from efficacy to effectiveness and developing an integrated approach to the prevention of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. This effectiveness trial tested whether this program has effects when previously trained community providers in an integrated approach to prevention implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post-test and 1-year follow-up measures. The sample included girls in the 8th grade from six schools (n = 152 girls) in a city near Barcelona (intervention group), and from eleven schools (n = 413 girls) in four neighboring towns (control group). The MABIC risk factors of disordered eating were assessed as main outcomes. Girls in the intervention group showed elsevier_BRT_2937 Worldwide lifetime prevalence for eating disorders in young women is estimated at about 5% (Treasure, Claudino, & Zucker, 2010), according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). Eating disorders are associated with some of the highest mortality rates for any mental disorder (Arcelus, Mitchell, Wales, & Nielsen, 2011). In addition, disordered eating attitudes and behaviors, such as unhealthy weight-control practices or the desire to be thinner, are highly prevalent among adolescents worldwide (
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.