The Norwegian healthy body image intervention promotes positive embodiment through improved self-esteem

Christine Sundgot-Borgen,Andreas Stenling,Jan H Rosenvinge,Gunn Pettersen,Oddgeir Friborg,Jorunn Sundgot-Borgen,Elin Kolle,Monica Klungland Torstveit,Kethe M.E Svantorp-Tveiten,Solfrid Bratland-Sanda

doi:10.1016/j.bodyim.2020.08.014

Abstract

We examined both direct and indirect effects of the Healthy Body Image (HBI) intervention on positive embodiment among Norwegian high school students. In total, 2446 12th grade boys (43 %) and girls (mean age 16.8 years) from 30 schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. We tested mediation models using path analysis and found that among several hypothesized mediators, only self-esteem mediated a positive intervention effect on positive embodiment for both boys and girls. A direct effect of the intervention on positive embodiment was only found in girls. The study provides novel findings indicating that health promotion interventions to address a positive embodiment should focus on enhancing adolescent’s self-esteem. Serial mediation modeling might reveal more complex explanations of change mechanisms and could further evolve current knowledge.

Highlights

Positive embodiment is defined as positive body connection and comfort, embodied agency and passion, and attuned self-care (Piran, 2016)
We reported that the Healthy Body Image (HBI) intervention promoted positive embodiment, with a 12-months follow up-effect in girls (Sundgot-Borgen et al, 2019)
The variable time spent on body appearance related content in social media had approximately 88 % missing data at T3 and was excluded from the analysis due to the uncertainty in the full information maximum likelihood (FIML) estimation (Muthén & Muthén, 2017)

Summary

Introduction

Positive embodiment is defined as positive body connection and comfort, embodied agency and passion, and attuned self-care (Piran, 2016). This construct does overlap with positive body image (Tylka, 2019), as both constructs emphasize positive connection to, and appreciation of, the body, as well as attuned care of the body (Tylka & Piran, 2019). Existing evidence of body image interventions including media literacy content has been reported, few studies have tested the mediational effect of media literacy. The only example is the study of Agam-Bitton et al (2018) who found that media literacy mediated the intervention effect on “current body image” among a female adolescent sample

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