Exploring the Relationship Between Body Image Perception and Nutritional Knowledge, Attitudes, and Practices: A Cross-Sectional and Intervention Study Among University Students in Brunei Darussalam (Preprint)
Authors: Baladandapla Shivappa Pushpa , Abdul Latif 2nd Siti Norhedayah , Sharbini 3rd Sharimawati , Murang 4th Zaidah Rizidah , Ahmad 5th Siti Rohaiza Ahmad 
Published: November 2024

BACKGROUND

Body image, defined as internal cognitions, feelings, evaluations, and behaviours related to one's appearance, significantly influences adolescents and young adults (AYAs) between the ages of 15 and 30. Negative body image is associated with various psychological issues, including eating disorders and obesity, which are prevalent in AYAs. This paper describes a research protocol which aims to study the association between body image perception and dietary knowledge, attitude, and practices and also aims to evaluate the effectiveness of a newly developed video-based intervention in improving these outcomes among Brunei Darussalam University students.

OBJECTIVE

The primary objective is to assess the association between body image perception and dietary knowledge, attitude, and practices among university students in Brunei Darussalam. The secondary aim is to develop and evaluate the effectiveness of video education intervention in improving nutritional knowledge, attitude, and practices, and body image perception among Brunei Darussalam University students.

METHODS

The research will assess body image satisfaction using Figure rating scales, including the Body Image Coping Strategies Inventory, and gather data on the Knowledge, Attitude and Practice on Healthy Lifestyle Questionnaire (KAP-HLQ) and socio-demographic factors through questionnaires. Phase I consisted of a systematic review which has already been published and Phase II is a pilot study of the intervention and outcome measurements which is currently underway. In the current paper, baseline data collection (Phase III) will form the cross-sectional study to measure body image perception and dietary knowledge, attitudes, and practice outcomes. Students aged 18-25 will be recruited across three universities in Brunei Darussalam to complete validated online questionnaires. The online video intervention will be delivered to the students in Phase IV of the research, consisting of one theme per week over three weeks: Nutritional Knowledge; Physical Activity and Nutrition; and Mindfulness and Mindful Eating. The intervention is underpinned by the Health Belief Model and the contents will be validated by qualified nutritionists and psychologists. Follow-up data will be collected in Phase V immediately after the intervention ends. Associations between body image perception and nutrition and physical activity knowledge, attitudes, and practice scores will be examined through Pearson’s correlation coefficients. The association of body shape and body image perception will also be examined through chi-square tests. The effect of the intervention on dietary outcomes at follow-up will be assessed using chi-squared analyses for individual items and multilevel linear regression models for the combined scores. Intervention effectiveness on body image perception at follow-up will be assessed using multilevel random effects linear regression models for the separate items, the combined scores of the three components (appearance fixing, avoidance, and positive rational acceptance), and the overall score.

RESULTS

Expected Outcomes: The findings will provide insights into the complex relationships between body image, nutritional knowledge, mindfulness, eating habits, and socio-demographic variables in the Bruneian context. The study aims to develop an appropriate educational intervention that is focused on nutritional knowledge, physical activity, nutrition, mindfulness, and mindful eating. The aim of the study is to achieve positive outcomes such as increase in nutritional knowledge or a reduction in body image dissatisfaction. The nutritional education is tailored for AYAs to promote healthy body image and improve dietary practices.

CONCLUSIONS

Conclusion: This research will fill a critical gap in understanding body image issues and nutritional knowledge among AYAs in Brunei, fostering evidence-based interventions to promote healthier lifestyle choices and improve overall well-being.

CLINICALTRIAL

Ethical approval for this study was obtained by the Institute of Health Sciences Research Ethics Committee (IHSREC), ref: UBD/PAPRSBIHSREC/2024/16; the Office of the Assistant Vice-Chancellor (Research, Innovation & Sustainability) and the University Research Ethics Committee (UREC), ref: UBD/IHS/B3/8; and the Department of Planning, Development, and Research, ref: KP/DP/19. A doctoral thesis of the research will be submitted, and a presentation will be made for evaluation at the Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences (PAPRSB IHS), Universiti Brunei Darussalam. The research study findings will be submitted as peer-reviewed journal articles and presented at relevant conferences as posters and/or oral presentations.