Reviewer’ s report
Title: #Ihaveembraced: A pilot cross-sectional naturalistic evaluation of the documentary
film Embrace and its potential associations with body image in adult women
Version: 1Date: 12 Feb 2019
Reviewer: Viren Swami
Reviewer's report:
At its heart, this study examined differences in body image scores between women who had and
had not seen the documentary film Embrace. Overall, I felt this was a poor study, with theconclusions drawn on the basis of cross-sectional data to be grossly exaggerated. It is possible thedata collected and reported here might be useful for a pilot study that informs future experimentalwork, but the in the absence of the latter, none of the conclusions drawn by the present authors canbe supported. I am sorry to be so critical, but there is clearly a potential confound that the authorsare not able to control for: that those with more positive body image and/or lower negative bodyimage were more likely to have seen the documentary. Given the nature of the current data, theauthors simply cannot rule out this possibility and so to make claims about the use of the film as aneffective intervention method is, in my view, highly misleading at best and grossly disingenuous atworst. Until the authors can provide experimental evidence that the film has a causal effect inimproving body image indices, I cannot recommend publication of this work. I have some otherconcerns about this manuscript, which I list by order of appearance in the manuscript:1.IN-TRODUCTION, I: Overall, I found the Introduction to lack any kind of coherent structure. Theauthors discuss a number of distinct issues (body image, body image interventions, the effects offilms on psychological well-being in general) and it is not always clear how these disparate topics
fit together. In my view, the authors should remove all claims about interventionism - they simply
do not have the data to support such claims - and so it may be worth omitting or at least shorteningthe sections on the effectiveness of other body image interventions. Conversely, when discussingbody image, I think the authors need to be much clearly about theoretical considerations relating tothe distinction between positive and negative body image. The title and focus elsewhere in thismanuscript appear to be on a facet of positive body image (i.e., body appreciation), yet theopening paragraph only considers negative body image and it also becomes apparent later on thatthe authors have included far more indices of negative body image. This sort of confusion recursthroughout the manuscript and I suspect it stems from a misunderstanding and conflation ofpositive and negative body image. To be clear, the two constructs are not polar opposites andshould not be treated as such.2.INTRODUCTION, II: I would have liked to have seen a muchbetter introduction as to whether films have been used to promote positive body imagespecifically, as opposed to psychological well-being. There is a recent study by Swami et al.(2018) in Body Image that showed experimentally that exposure to a brief film of a first-personwalk in nature had a significant positive effect on body appreciation. I was surprised not to see thatstudy cited, but more problematically the findings of that study suggest that documentary-lengthfilms are not necessary to attain positive effects in terms of body image improvement. Somediscussion of film length and/or content would have been useful.3.INTRODUCTION, III: The
study is framed as exploratory in several places, but this does not excuse the fact that the authors
neglected to introduce the variables that were used to assess claimed effectiveness of the film (e.g.,
why include measures of both positive and negative body image? why include these specificmeasures and not others?) or to provide clear hypotheses. I am generally supportive of exploratorywork that substantively advanced knowledge, but there is still a requirement for authors to clearlyintroduce their work and at least conduct hypothesis-driven research. The present authors fail onboth these counts.4.RECRUITMENT: There was likely a clear response bias (supported by theirdata) as a result of the recruitment method. I'm guessing the authors were after a large dataset, butmy feeling is that this was unnecessary. The authors have prioritised big data over a carefullycontrolled design in which response biases were minimised. 5.RECRUITMENT, II: It would have
been useful to mention why only women were surveyed. 6.PROCEDURES: The authors should
answer the following questions: Who hosted the survey link? What information were participantsgiven about the study prior to participation? Why were the specific inclusion criteria used? Wereparticipants remunerated? Were participants debriefed? Was the order of presentation of measuresrandomised for participants? 7.MEASURES, I: Given that the sample was international, how wasthe demographic items standardised so as to be appropriate for use internationally? Also, in theResults, the authors refer to country of birth, but this was not included in the items listed in theMethod. Why was it necessary to ask about number of children? 8.MEASURES, II: I stronglyrecommend reporting omega and its CI instead of Cronbach's alpha.9.MEASURES, III: I did notunderstand the rationale for including the open-ended questions. This was not introduced and itsinclusion was puzzling, especially as two of the items are not relevant to body image issues.10.ANALYSES: I missed a rationale for controlling for age, BMI, and educational level. It wouldhave been useful to have conducted some multi-level analyses to examine whether age and BMIinteracted with outcomes. 11.DISCUSSION: I haven't read the Discussion in much detail. As Ihave indicated above, I just don't think any of the claims made in the Discussion can be supportedwithout additional data.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
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