Eating Disorders
Conditions
Keywords
Prevention, Peer Leader, Feeding and Eating Disorders
Brief summary
This present study will compare the efficacy of in-person versus virtually-delivered Body Project groups. It will also evaluate whether this body acceptance class produces greater reductions in eating disorder risk factor symptoms (pursuit of the thin ideal, body dissatisfaction, dieting, dietary restraint, negative affect, eating disorder symptoms, and the future onset of eating disorders over a 3-month follow-up in this population. It will also evaluate the effectiveness of this body acceptance class's ability to impact social appearance anxiety, body compassion, and self-stigma surrounding attaining help.
Detailed description
Dozens of eating disorder prevention programs have been evaluated, but only the 4-hr Body Project has reduced eating disorder symptoms and future eating disorder onset over 3-4 year follow-up, produced larger reductions in outcomes than credible alternative interventions, been shown to engage the intervention target (valuation of the thin beauty ideal), and produced effects in trials from several independent teams. The proposed study will evaluate the effectiveness of a peer-implemented, virtually delivered, body acceptance class compared to a peer-implemented, in-person delivery of the same class. Participation in the intervention will last four weeks. Participants will be randomly assigned to the in-person or virtual body acceptance class. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.
Interventions
BEHAVIORALPeer Led Group Intervention
A four-week dissonance-based program where individuals with body image concerns complete verbal, written, and behavioral activities. The program consists of four 60-minute sessions
Sponsors
Stanford University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
The outcomes assessor at the 3-month follow-up is blind to participant randomization.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Participants had to express body image concerns and all gender identities besides cisgender and transgender men were eligible.
Exclusion criteria
* Cisgender and transgender men were excluded due to the fact that The Body Project is typically administered with groups of all cisgender women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change Over Time in Body Dissatisfaction | Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week) | Ten items from the Satisfaction and Dissatisfaction with Body Parts Scale assessed satisfaction with body parts with a response scale ranging from 1 = extremely dissatisfied to 6 = extremely satisfied. The mean score across the items is reported. Overall scores can range from 1 to 6 and a higher score indicate a greater level of body satisfaction. |
| Change Over Time in Thin Ideal Internalization | Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week) | The eight-item Ideal-Body Stereotype Scale-Revised will assess endorsement of the thin beauty ideal using a response scale ranging from 1 = strongly disagree to 5 = strongly agree. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates a greater level of thin ideal internalization. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change Over Time in Self-Stigma of Seeking Help Scale | Pre intervention obtained on intake, and immediately post intervention. | The 10-item Self-Stigma of Seeking Help Scale will assess participants' views towards seeking help using a scale ranging from 1 = strongly disagree to 5 = strongly agree. |
| Body Comparison Orientation | Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week) | The six selected items from the Body, Eating, and Exercise Comparison Orientation Scale will assess the frequency of body comparisons using a response scale ranging from 1 = strongly disagree to 5 = strongly agree. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates greater frequency of body comparison. |
| Change Over Time in Social Appearance Anxiety | Pre intervention obtained on intake, and immediately post intervention. | The 16-item Social Appearance Anxiety Scale will assess levels of social appearance anxiety using a response scale ranging from 1 = not at all to 5 = extremely. |
| Change Over Time in Negative Affect | Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week) | Twenty items from the sadness, guilt, and fear/anxiety subscales from the Positive Affect and Negative Affect Scale-Revised will assess negative affect. Participants reported the extent to which they had felt negative emotions on scales ranging from 1 = very slightly or not at all to 5 = extremely. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates a greater level of negative affect. |
| Number of Eating Disorder Behaviors (Events) as a Measure of Change Over Time in Eating Disorder Symptoms | Pre intervention and 3 months after the end of the intervention. | Interviewer assesses frequency of eating disorder behaviors using Eating Disorder Diagnostic Interview. |
| Body Project Specific Attitude Measures | Pre intervention obtained on intake, and immediately post intervention. | 7 items assessing attitudes that are targeted as part of The Body Project training using a response scale ranging from 1 = strongly disagree to 5 = strongly agree. |
| Body Project Specific Outcome Measures | Pre intervention obtained on intake, and immediately post intervention. | 7 items assessing attitudes that are targeted as part of The Body Project training using a response scale ranging from 1 = strongly disagree to 5 = strongly agree. |
| Change Over Time in Body Compassion | Pre intervention obtained on intake, and immediately post intervention. | The 10-item Body Appreciation Scale-2 will assess levels of body compassion using a response scale ranging from 1 = never to 5 = always. |
| Change Over Time in Dieting | Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week) | The 10-item Dutch Restrained Eating Scale will assess the frequency of dieting behaviors using a response scale ranging from 1 = never to 5 = always. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates greater frequency of dieting behaviors. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Body Project: In Person Delivery In the in-person peer-led group intervention, participants voluntarily engage in verbal, written, and behavioral exercises in which they critique and discuss the costs of pursuing the thin-ideal ideal. The intervention is 4 sessions long (1-hr each) and is administered by trained peer facilitators who use an intervention script. Participants will be asked to complete weekly home exercises throughout the course of the intervention.
Peer Led Group Intervention: A four-week dissonance-based program where individuals with body image concerns complete verbal, written, and behavioral activities. The program consists of four 60-minute sessions | 33 |
| Body Project: Virtual Delivery In the virtual peer-led group intervention held over Zoom, participants voluntarily engage in verbal, written, and behavioral exercises in which they critique and discuss the costs of pursuing the thin-ideal ideal. The intervention is 4 sessions long (1-hr each) and is administered by trained peer facilitators who use an intervention script. Participants will be asked to complete weekly home exercises throughout the course of the intervention.
Peer Led Group Intervention: A four-week dissonance-based program where individuals with body image concerns complete verbal, written, and behavioral activities. The program consists of four 60-minute sessions | 36 |
| Total | 69 |
Baseline characteristics
| Characteristic | Body Project: In Person Delivery | Body Project: Virtual Delivery | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 7 Participants | 6 Participants | 13 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 26 Participants | 30 Participants | 56 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 5 Participants | 3 Participants | 8 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 2 Participants | 4 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 5 Participants | 7 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 2 Participants | 4 Participants | 6 Participants |
| Race (NIH/OMB) White | 22 Participants | 22 Participants | 44 Participants |
| Region of Enrollment United States | 33 participants | 36 participants | 69 participants |
| Sex: Female, Male Female | 33 Participants | 36 Participants | 69 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 33 | 0 / 36 |
| other Total, other adverse events | 0 / 33 | 0 / 36 |
| serious Total, serious adverse events | 0 / 33 | 0 / 36 |
Outcome results
Primary
Change Over Time in Body Dissatisfaction
Ten items from the Satisfaction and Dissatisfaction with Body Parts Scale assessed satisfaction with body parts with a response scale ranging from 1 = extremely dissatisfied to 6 = extremely satisfied. The mean score across the items is reported. Overall scores can range from 1 to 6 and a higher score indicate a greater level of body satisfaction.
Time frame: Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Body Project: In Person Delivery | Change Over Time in Body Dissatisfaction | .42 score on a scale |
| Body Project: Virtual Delivery | Change Over Time in Body Dissatisfaction | 0.51 score on a scale |
Primary
Change Over Time in Thin Ideal Internalization
The eight-item Ideal-Body Stereotype Scale-Revised will assess endorsement of the thin beauty ideal using a response scale ranging from 1 = strongly disagree to 5 = strongly agree. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates a greater level of thin ideal internalization.
Time frame: Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Body Project: In Person Delivery | Change Over Time in Thin Ideal Internalization | -0.64 scale |
| Body Project: Virtual Delivery | Change Over Time in Thin Ideal Internalization | -0.59 scale |
Secondary
Body Comparison Orientation
The six selected items from the Body, Eating, and Exercise Comparison Orientation Scale will assess the frequency of body comparisons using a response scale ranging from 1 = strongly disagree to 5 = strongly agree. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates greater frequency of body comparison.
Time frame: Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Body Project: In Person Delivery | Body Comparison Orientation | -0.38 scale score |
| Body Project: Virtual Delivery | Body Comparison Orientation | -0.60 scale score |
Secondary
Body Project Specific Attitude Measures
7 items assessing attitudes that are targeted as part of The Body Project training using a response scale ranging from 1 = strongly disagree to 5 = strongly agree.
Time frame: Pre intervention obtained on intake, and immediately post intervention.
Secondary
Body Project Specific Outcome Measures
7 items assessing attitudes that are targeted as part of The Body Project training using a response scale ranging from 1 = strongly disagree to 5 = strongly agree.
Time frame: Pre intervention obtained on intake, and immediately post intervention.
Secondary
Change Over Time in Body Compassion
The 10-item Body Appreciation Scale-2 will assess levels of body compassion using a response scale ranging from 1 = never to 5 = always.
Time frame: Pre intervention obtained on intake, and immediately post intervention.
Secondary
Change Over Time in Dieting
The 10-item Dutch Restrained Eating Scale will assess the frequency of dieting behaviors using a response scale ranging from 1 = never to 5 = always. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates greater frequency of dieting behaviors.
Time frame: Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Body Project: In Person Delivery | Change Over Time in Dieting | -0.48 scale score |
| Body Project: Virtual Delivery | Change Over Time in Dieting | -0.77 scale score |
Secondary
Change Over Time in Negative Affect
Twenty items from the sadness, guilt, and fear/anxiety subscales from the Positive Affect and Negative Affect Scale-Revised will assess negative affect. Participants reported the extent to which they had felt negative emotions on scales ranging from 1 = very slightly or not at all to 5 = extremely. The mean score across the items is reported. Overall scores can range from 1 to 5 and a higher score indicates a greater level of negative affect.
Time frame: Pre intervention obtained on intake, and immediately post intervention (after completion of 4 weeks of group session once a week)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Body Project: In Person Delivery | Change Over Time in Negative Affect | -0.17 scale score |
| Body Project: Virtual Delivery | Change Over Time in Negative Affect | -0.41 scale score |
Secondary
Change Over Time in Self-Stigma of Seeking Help Scale
The 10-item Self-Stigma of Seeking Help Scale will assess participants' views towards seeking help using a scale ranging from 1 = strongly disagree to 5 = strongly agree.
Time frame: Pre intervention obtained on intake, and immediately post intervention.
Secondary
Change Over Time in Social Appearance Anxiety
The 16-item Social Appearance Anxiety Scale will assess levels of social appearance anxiety using a response scale ranging from 1 = not at all to 5 = extremely.
Time frame: Pre intervention obtained on intake, and immediately post intervention.
Secondary
Number of Eating Disorder Behaviors (Events) as a Measure of Change Over Time in Eating Disorder Symptoms
Interviewer assesses frequency of eating disorder behaviors using Eating Disorder Diagnostic Interview.
Time frame: Pre intervention and 3 months after the end of the intervention.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Body Project: In Person Delivery | Number of Eating Disorder Behaviors (Events) as a Measure of Change Over Time in Eating Disorder Symptoms | -5.22 events |
| Body Project: Virtual Delivery | Number of Eating Disorder Behaviors (Events) as a Measure of Change Over Time in Eating Disorder Symptoms | -3.68 events |