Abstract
BackgroundVery few programs aimed at improving body image among adolescent boys have been effective, and there is still no clear evidence as to what will work for universal prevention of eating disorders and body dissatisfaction with this group. We combined two previously efficacious programs and used a design thinking framework to optimise program content alongside potential end-users including adolescent boys, teachers, parents, and experts. Goodform is a four-session universal program that aims to reduce body dissatisfaction and prevent the use of muscle-building supplements among 14-to-16 year old adolescent boys.Methods/designGoodform will be trialled using a cluster randomised controlled trial (RCT) conducted in Australian schools, with Year 9 boys as participants. The intervention is teacher-delivered. Data will be collected at three time points: baseline, post-intervention, and follow-up (2 months). Three primary outcome constructs will be examined, including body dissatisfaction (Male Body Attitudes Scale-Revised) and attitudes towards appearance and performance enhancing substances (APES; Outcome Expectations for Steroid and Supplement Use, Intentions to use APES) and actual use of APES at each time point. Three secondary outcome constructs will be examined, which are social norms for APES (adapted Peer Norms Scale), negative body talk (Male Body Talk Scale), and internalisation of and pressure to attain appearance ideals (Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised). Internalisation of appearance ideals will also be examined as a mediator of change in primary outcomes. Teachers will provide data on adherence to lessons, student engagement/enjoyment, and understanding of the content.DiscussionThe GoodForm RCT will trial a novel, generalizable, and extensively developed program intended to improve boys’ body image and reduce actual and intended APES use. We anticipate that it will provide a novel contribution to the field of boys’ body dissatisfaction prevention.Trial registrationThis trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry on May 14th 2019, registration number ACTRN12619000725167.
Highlights
2) Video: Pressure to conform to the cultural ideal 3) Digital Tool and worksheet: Define and critique the cultural ideal for men 4) Worksheet: How do we challenge this ideal? Homework: Write your advice to a younger boy Session 2: Supplements and Steroids
The present study aims to examine the efficacy of Goodform relative to a waitlist control condition for achieving the primary outcomes of reducing body dissatisfaction, favourable attitudes towards appearance and performance enhancing substances, and actual use of APES in mid-adolescent boys
1) Quiz: Recap previous content 2) Jigsaw Activity: Role Plays to counter the use of supplements and steroids 3) Jigsaw Assignment: Develop a media campaign against steroid use Session 4: Advocacy and Activism
Summary
As boys’ body image is becoming increasingly recognised as an issue, it is essential that programs are developed with boys in mind, and trialled to examine their efficacy. Emerging literature on the role of APES, supplements and steroids in body image [34, 51] highlights the importance of prevention and early intervention, and to our knowledge, GoodForm is the first program to address both for an adolescent male audience. There is capacity to discuss Appearance and Performance Enhancing supplements within the Australian Curriculum, very few resources exist to facilitate education about these substances or to facilitate changes in attitudes and behaviours towards APES in the school setting. Traditional resources to support education about performance-enhancing drug use in sport are generally developed along a moralistic, and value-based framework, rather than one that addresses the psychological and behavioural drivers of supplement use.
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