Governments, schools, and curriculum authorities are increasingly recognizing that body image during adolescence is a public health issue that warrants attention in the school setting.After 30 years of eating disorder prevention research, and given the current interest in this area, it seems timely to review the research on interventions to improve body image in schools. We reviewed universal-selective, classroom-based programs that have been conducted since the year 2000, among adolescents, and found 16 eligible intervention programs. Seven of these programs were effective in improving body image on at least one measure, from pre to post test, though effect sizes were small (d = 0.22-0.48). These effective programs were conducted among younger adolescents 12.33-13.62 years, and included activities focusing on media literacy, self esteem, and the influence of peers.Implications for school personnel and curriculum authorities are discussed, and we provide recommendations for a strategic approach to future research in this area. Keywords: body image, schools, intervention, prevention, adolescents Running Head: WHAT WORKS IN SECONDARY SCHOOLS?3 What works in secondary schools? A systematic review of classroom-based body image programs Body dissatisfaction is common during adolescence. Approximately 70% of adolescent girls and 45% of boys want to change their body weight or shape (Smolak, 2012). Australian adolescents have consistently ranked body image as their number one concern in the Mission Australia Survey over the past six years (Mission Australia, 2006. Similarly, levels of body dissatisfaction among adolescent girls in the USA have remained relatively stable since 1999 (Neumark-Sztainer et al., 2012). Body dissatisfaction during adolescence has been associated with a number of negative health outcomes in prospective studies, most notably the onset of dieting and disordered eating behaviors (Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006). Higher levels of body dissatisfaction have also been linked to depression (Stice, Hayward, Cameron, Killen, & Taylor, 2000), smoking (Neumark-Sztainer, , and unsafe sex practices (Schooler, 2012), with effect sizes ranging from small to moderate. The large number of young people affected, the relative stability of this issue over the past decade, and the wide range of deleterious consequences, indicate an urgent and continuing need to develop and evaluate effective body image interventions for adolescent girls and boys. School-based Body Image InterventionsSchools are widely recognized as appropriate sites for interventions to improve body image among adolescents. They offer the potential for sustained interactions with young people at a developmentally appropriate age, where they are already in a learning environment . School-based interventions also offer opportunities to support program materials with environmental changes (Neumark-Sztainer, Levine, et al., 2006), and a whole-school approach to health promotion (O'Dea & Maloney, 2000;Smolak, Levine, & S...
SUMMARYBody dissatisfaction, dieting, eating disorders and exercise disorders are prevalent among male and female university students worldwide. Male students are also increasingly adopting health-damaging, body-imagerelated behaviors such as excessive weight lifting, body building and steroid abuse. Given the severity and difficulty of treating eating disorders, prevention of these problems is a recognized public health goal. Health promotion and health education programs have been conducted in the university setting since the mid 1980s, but few have achieved significant improvements in target health attitudes and behaviors. In this paper, 27 large, randomized and controlled health promotion and health education programs to improve body dissatisfaction, dieting and disordered eating and exercise behaviors of male and female college students are reviewed. In general, health education programs to improve body image and prevent eating disorders in the university setting have been limited by small sample sizes and the exclusion of male students. The majority of studies were conducted among either female undergraduate psychology students or women that were recruited using on-campus advertising. The latter reduces the ability to generalize results to the whole university population, or the general community. In addition, there has been a paucity of longitudinal studies that are methodologically sound, as only 82% (22/27) of interventions included in the review used random assignment of groups, and only 52% (n ¼ 14) included follow-up testing.Information-based, cognitive behavioral and psychoeducational approaches have been the least effective at improving body image and eating problems among university students. Successful elements for future initiatives are identified as taking a media literacy-and dissonance-based educational approach, incorporating health education activities that build self-esteem, and using computers and the internet as a delivery medium. A newly designed program for Australian university students is described.
This paper examines the important contribution that teachers and other educators (including health educators, school nurses, school counselors, school psychologists, and sports coaches) have to offer in the prevention of eating disorders and child obesity. Our paper notes the important contribution of school educators whilst warning of the current need to specifically examine how teachers and school personnel may be best trained and prepared for such a preventive role, whether they currently feel willing and able to undertake such a role, and whether some groups of teachers may be personally susceptible to body image and eating problems. It is vital to understand the knowledge, behaviors, attitudes, and expectations of educators implementing prevention programs in order to ensure that they are personally and professionally capable of carrying out prevention initiatives in schools. Individuals involved in food and exercise-related careers have been identified as being at environmental and situational risk for body image and eating problems, and it may be possible that they chose their career path due to their own personal experience with eating disorders or weight issues. In such cases, specific training or assistance may be required in order to enable the educators to conduct effective preventive activities. Discussion focuses on what needs to be done in order to enable teachers and other school-based educators to perform most effectively in the implementation of school based eating disorder and child obesity prevention programs.
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