The healthy body image (HBI) intervention: Effects of a school-based cluster-randomized controlled trial with 12-months follow-up

Christine Sundgot-Borgen,Oddgeir Friborg,Elin Kolle,Kethe M.E Engen,Jorunn Sundgot-Borgen,Jan H Rosenvinge,Gunn Pettersen,Monica Klungland Torstveit,Niva Piran,Solfrid Bratland-Sanda

doi:10.1016/j.bodyim.2019.03.007

Abstract

We examined the effects of the Healthy Body Image (HBI) intervention on positive embodiment and health-related quality of life among Norwegian high school students. The intervention comprised three interactive workshops, with body image, media literacy, and lifestyle as main themes. In total, 2,446 12th grade boys (43%) and girls (mean age 16.8 years) from 30 high schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. Data were collected at baseline, post-intervention, 3- and 12-months follow-up, and analysed using linear mixed regression models. The HBI intervention caused a favourable immediate change in positive embodiment and health-related quality of life among intervention girls, which was maintained at follow-up. Among intervention boys, however, weak post-intervention effects on embodiment and health-related quality of life vanished at the follow-ups. Future studies should address steps to make the HBI intervention more relevant for boys as well as determine whether the number of workshops or themes may be shortened to ease implementation and to enhance intervention effects.

Highlights

Positive embodiment and body appreciation are important aspects of health and quality of life (Avalos, Tylka, & WoodBarcalow, 2005; Piran, 2019; Tiggemann, 2011)
Promoting positive embodiment in adolescence is vital to establish a good basis for health-related quality of life, as such quality of life has proved stable during the life course (Bisegger, Cloetta, von Rueden, Abel, & Ravens-Sieberer, 2005), and can be viewed as a core issue for public health
Girls in the intervention had higher scores on positive embodiment, health-related quality of life, and the general health item compared to girls in the control group

Summary

Introduction

Positive embodiment and body appreciation are important aspects of health and quality of life (Avalos, Tylka, & WoodBarcalow, 2005; Piran, 2019; Tiggemann, 2011). Positive embodiment and body appreciation have been associated with positive self- and body esteem, healthy eating, and performing regular physical activity in boys and girls (Cash & Fleming, 2002; Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006; Santos, Tassitano, do Nascimento, Petribú, & Cabral, 2011; Tylka & Homan, 2015). Adolescent boys report more satisfaction with their bodies and higher levels of embodiment compared to adolescent girls (Franko, Cousineau, Rodgers, & Roehrig, 2013; Holmqvist, Frisén, & Piran, 2018; Neumark-Sztainer et al, 2006; Santos et al, 2011). Promoting positive embodiment in adolescence is vital to establish a good basis for health-related quality of life, as such quality of life has proved stable during the life course (Bisegger, Cloetta, von Rueden, Abel, & Ravens-Sieberer, 2005), and can be viewed as a core issue for public health

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