Preventing obesity and promoting healthy body image in Australian secondary schools

We will develop and test a universal online education program about healthy nutrition and physical activity (SHINE) for adolescents that is designed to be part of the Year 7 health curriculum in 15 secondary schools across metropolitan Melbourne. The program will dynamically tailor content to provide additional advice for the targeted/selected young people with weight and shape concerns who are at risk of developing disordered eating behaviours and attitudes. It will also provide specific guidance for those who are overweight or obese, where intervention is required. Using machine learning predictive models to deliver individually customised advice, SHINE provides core health messages and, where indicated, additional information to optimise intervention engagement and efficacy. The program is tailored to increase the potential to improve body image and weight-related problems; improve nutrition and physical activity; help prevent the development or progression of obesity and thereby decrease the associated morbidities in later life. Fifteen schools will be randomly selected to receive the intervention, and all students will complete the program as part of the usual Health and Physical Education (HPE) class. Trained Research Assistants will take participants' body measures (height, weight and body composition) and facilitate the delivery of an online questionnaire to participants at baseline, post-program, 12, 24 and 36 months post-program commencement. The 8 week, online SHINE program will be delivered during usual HPE classes by the class teacher who has received training on the SHINE program. Booster sessions will be delivered during one HPE class period when participants are in Year 8, 9 and 10. These sessions will consist of participants completing online food and activity logs as well as reviewing the key messages of the SHINE program and collecting body measures by trained Research Assistants. Two-weeks post-booster session, participants will again complete the online food and activity logs during usual HPE class with their HPE class teacher. Upon receipt of participant data (completion of weekly food and activity logs), the program will deliver individually tailored automated messages that cover progress, motivation and problem solving immediately to participants by email or text to encourage ongoing adherence to behavioural goals and to address barriers. To monitor adherence to the intervention, students will navigate through core/compulsory topics at their own choosing however, progression to additional/targeted topics will be blocked until all core topics have been completed. The software for the program has been written to ensure only the core topics are initially visible, with further topics revealed after completion of all core topics. Additional adherence monitoring will be carried out by research staff who will conduct weekly spot checks of the participant database.