Coach-Led Body Image Intervention for Girls in Sport - Pilot

Study Overview
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Brief Summary
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According to the World Health Organization, only 15% of 11-17-year-old girls meet the recommended daily physical movement guidelines (e.g., 60-minutes per day). Despite extensive research highlighting the protective factors associated with sport on both mental and physical health, body image concerns are a key barrier to girls' participation in and enjoyment of sport. Sports-related environments and society more broadly further exacerbate these concerns through harmful gender stereotypes that perpetuate female objectification, discrimination, and harassment. This includes the promotion of unrealistic and sexualized appearances of female athletes, uncomfortable and objectifying uniforms, and appearance and competence-related teasing from male and female peers, as well as coaches. The magnitude of this issue and how best to address it, can be understood from a socioecological perspective. Researchers suggest developing multi-faceted and multi-tiered approaches that have scope for targeting the individual, interpersonal, organizational, and societal levels. The current research will test the first coach delivered embodying sports program for girls that will be implemented through sporting organizations. The Body Confident Athletes program was co-created with girls and coaches through an international multi-disciplinary partnership between academics, health professionals, industry, and community organizations. Multi-disciplinary partnerships can create a supportive landscape by upskilling girls and influential community members (e.g., coaches) in dealing with body image concerns, which will likely lead to sustained sports participation and biopsychosocial benefits. As such, the aim of the present study is to conduct a randomized controlled trial (RCT) to evaluate the effectiveness, feasibility, and acceptability of the Body Confident Athletes program. The program consists of five 60-minute sessions delivered by coaches to adolescent girls. Each session tackles a distinct theme related to body image in the sporting context. Outcomes will be assessed at pre- and post-intervention (5 weeks later) and include body image (primary outcome), sport enjoyment and embodied experiences (secondary outcomes), and feasibility, acceptability, and adherence (process outcomes). The comparison control arm will be a waitlist control condition. To undertake this project, sporting organizations will be cluster-randomized into the intervention group or the control group, with 80 girls anticipated in each arm. Those in the intervention condition will complete baseline assessments (target outcomes and demographic information), take part in the five-week intervention, and then complete the post-intervention assessments (target outcomes and feasibility and acceptability measures). Those in the waitlist control condition will complete the baseline assessments (target outcomes and demographic information) and a second assessment five weeks later (target outcomes only), after which they will get access to the intervention. However, their engagement with the intervention will not be monitored or assessed. At completion of the post-intervention survey, all participants will receive a debrief form, outlining the study aims and objectives, and additional resources for body image and eating concerns. Lastly, to compensate participants for their time, girls and coaches will receive an electronic voucher to the value of $60 dollars. The investigators hypothesize that girls who take part in the Body Confident Athletes intervention will report better body image, greater sport enjoyment, and higher levels of embodiment at post-intervention than girls who do not take part in the intervention.

Official Title
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Body Confident Athletes: Acceptability Testing of a Coach-Led Body Image Intervention for Adolescent Girls in Sport

Conditions
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Intervention, Waitlist Control

Intervention / Treatment
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* Behavioral: Body Confident Athletes


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Girls aged 11-17 years old English speaking US resident Exclusion Criteria: n/a

Ages Eligible for Study
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Minimum Age: 11 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Body Confident Athletes<br>Participants in the intervention condition will take part in an in-person program consisting of five sessions over five weeks. | Behavioral: Body Confident Athletes<br>* The Body Confident Athletes program is a five-session in-person program designed to be delivered by coaches to their athletes. Groups should be of approximately 10 girls. The organizations will work with the community partner and researchers on how to schedule the intervention over a five-week period. These sessions can replace a regular sport practice each week or an additional session can be organized by the sport organizations. Each session will take approximately 60 minutes and will consist of four phases, including The Game Plan (5 mins), The Skills (20 mins), Game Time (20 mins), and The Final Score (15 mins). A variety of activity modalities are utilized to convey learning outcomes, including group and individual activities, and discussion-, writing- and movement-based activities.<br>|
| No Intervention: Waitlist control<br>Participants will not be explicitly told their study condition, although they will be made aware of the assessment time points and whether they receive the intervention between T1 and T2 (intervention) or after T2 (waitlist control). Following completion of post-intervention assessments (T2), the control condition will participate in the intervention; but, they will not be monitored or assessed. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in body esteem (assessed via the Body Esteem Scale for Adults and Adolescents) | The Body Esteem Scale for Adults and Adolescents (BESAA) assesses body esteem (BE), which refers to self-evaluations of one's body or appearance. The BESAA has 3 subscales: BE-Appearance (general feelings about appearance), BE-Weight (weight satisfaction), and BE-Attribution (evaluations attributed to others about one's body and appearance). BESAA scores range from 0-4 with higher scores on the BESAA indicating higher levels of body esteem. | Baseline, pre-intervention; immediately after the intervention (5 weeks later) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in embodiment (assessed via the Youth Experience of Embodiment Scale) | The Youth Experience of Embodiment Scale (YEES) assesses how girls inhabit their body (e.g., body connection and comfort, attuned self-care) and how they navigate the world (e.g., with agency, resisting self-objectification). YEES scores range from 1-5 with higher scores on the YEES indicating higher levels of embodiment. | Baseline, pre-intervention; immediately after the intervention (5 weeks later) | 
| Change in sport enjoyment (assessed via the Sources of Enjoyment in Youth Sport Questionnaire) | The Sources of Enjoyment in Youth Sport Questionnaire (SEYSQ) assesses the source of an athlete's enjoyment in sport according to two spectrums (intrinsic motivation vs. extrinsic motivation and achievement vs. non-achievement factors), resulting in four quadrants indicating the four sources of an athlete's enjoyment. SEYSQ scores range from 1-5. | Baseline, pre-intervention; immediately after the intervention (5 weeks later) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Body image, Embodiment, Girls, Athletes, Coaches, Task shifting