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Evaluating the ‘Dove Confident Me’ 5-session body image intervention delivered by teachers in schools: A cluster randomised controlled effectiveness trial

Diedrichs, Phillippa C; Atkinson, Melissa J; Garbett, Kirsty M; Leckie, George


Melissa J Atkinson

George Leckie


Purpose: Body dissatisfaction is common during adolescence and predicts poor psychological and physical health. Interventions have traditionally over-relied on delivery by external providers (e.g., researchers and psychologists), preventing scalability. This study evaluated the acceptability and effectiveness of a school-based body image intervention delivered by schoolteachers. Methods: Six British schools participated in a pragmatic cluster randomised controlled trial. Boys and girls aged 11-13 received the 5-session intervention delivered by their teachers (n=848), or lessons-as-usual control (n=647), and were assessed at baseline, post-intervention, 2-, 6-, 12-, 24- and 36-month follow-up. The primary outcome was body image (body esteem), secondary outcomes included risk factors for body image (internalisation of appearance ideals, sociocultural pressures, social comparisons, appearance-related teasing and conversations), and tertiary outcomes included psychosocial well-being (negative affect, self-esteem, dietary restraint, life engagement). Results: Compared to the control group, intervention students demonstrated improvements in the primary outcome of body esteem at post-intervention (Cohen’s d = 0.15), 2-month (d = 0.26), and 6-month follow-up (d = 0.15). For girls, there was also a significant reduction in experienced appearance-related teasing at 6-month (d = 0.24) and 12-month (d = 0.30) follow-up. No other significant intervention effects were observed. The intervention was acceptable to students. Conclusions: These findings present the longest sustained improvements in a cognitive affective body image outcome observed among girls and boys during a teacher-led universal body image programme to date. Intervention refinement and improved teacher training may further improve outcomes. Task-shifting intervention delivery to community providers to scale-up interventions is a promising strategy.

Journal Article Type Article
Print ISSN 1054-139X
Publisher Elsevier
Peer Reviewed Peer Reviewed
APA6 Citation Diedrichs, P. C., Atkinson, M. J., Garbett, K. M., & Leckie, G. (in press). Evaluating the ‘Dove Confident Me’ 5-session body image intervention delivered by teachers in schools: A cluster randomised controlled effectiveness trial. Journal of Adolescent Health,
Additional Information This study was funded by a research grant from the Dove Self-Esteem Project, Unilever. The funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation. They were permitted to review the manuscript and suggest changes, but the authors exclusively retained the final decision on content. Disclosure Statement: PD is an independent research consultant to the Dove Self-Esteem Project global education initiative and was on their Global Advisory Board from 2013-2016. The authors declare no other potential conflicts of interest in relation to this work. Clinical Trials Registration: ISRCTN16782819