Clinical trial NCT05594524: Coach-Led Body Image Intervention for Girls in Sport - RCT
Official title: Body Confident Athletes: A Randomized Controlled Trial Testing the Efficacy of a Coach-Led Body Image Intervention for Adolescent Girls in Sport
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Intervention
Waitlist Control
Keywords: Body image
Embodiment
Girls
Athletes
Coaches
Task shifting
Lead sponsor: University of the West of England
Sponsor class: OTHER
Collaborators: name: Unilever R&D
name: Nike
name: Tucker Center for Research on Girls & Women in Sport (University of Minnesota)
name: Cairn Guidance
First posted: 2022-10-26
Enrollment: 568
Sex: FEMALE
Minimum age (years): 11
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: 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-led body image program for girls in sport. 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 large-scale randomized controlled trial (RCT) to evaluate the effectiveness of the Body Confident Athletes program. The program consists of three 60-minute sessions delivered by coaches to adolescent girls. Each session tackles a distinct theme related to body image in the sport context. Outcomes will be assessed at pre-intervention, post-intervention (three weeks later), and follow-up (at one and three months). Outcomes will include body image and sport enjoyment (primary outcomes); body appreciation, attuned self-care, resisting objectification, and positive and negative affect (secondary outcomes); and intervention acceptability, fidelity, and adherence (process outcomes). The comparison control arm will be a waitlist control condition.

To undertake this project, sports organizations will be cluster-randomized into the intervention group or the control group, with 800 girls anticipated in each arm. Those in the intervention condition will complete baseline assessments (target outcomes and demographic information), take part in the three-week intervention, and then complete the post-intervention and follow-up assessments (target and process outcomes). Those in the waitlist control condition will complete the baseline assessments (target outcomes and demographic information), a second assessment three weeks later (target outcomes only), and follow-up assessments after one and three months, 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 support resources for body image and eating concerns.

The investigators hypothesize that girls who take part in the Body Confident Athletes intervention will report higher levels of body esteem, sport enjoyment, body appreciation, attuned self-care, resisting objectification, and positive affect and lower levels of negative affect at post-intervention and follow-up, compared to girls who do not take part in the intervention.

Note: This research has been approved by the University of the West of England Research Ethics Committee (ref no. HAS.21.03.120) and the University of Minnesota Institutional Review Board (ref no. STUDY00012457).


Eligibility criteria: Inclusion Criteria:

* Girls aged 11-17 years old
* English speaking
* Residing in the United States

Exclusion Criteria:

* n/a

Primary outcomes:
measure: Change in body esteem (assessed via the Body Esteem Scale for Adults and Adolescents)
timeFrame: Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention
measure: Change in sport enjoyment (assessed via the Sources of Enjoyment in Youth Sport Questionnaire)
timeFrame: Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention
Secondary outcomes:
measure: Change in body appreciation (assessed via the Body Appreciation Scale-2)
timeFrame: Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention
measure: Change in attuned self-care (assessed via the Youth Experience of Embodiment Scale - Attuned Self-Care subscale)
timeFrame: Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention
measure: Change in resisting objectification (assessed via the Youth Experience of Embodiment Scale - Resisting Objectification subscale)
timeFrame: Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention
measure: Change in positive and negative affect (assessed via the 10-item Positive and Negative Affect Schedule for Children)
timeFrame: Baseline, pre-intervention; immediately after the intervention (3 weeks later); 1 month after completion of the intervention; 3 months after completion of the intervention
Other outcomes:
measure: Total acceptability of the intervention (assessed via a self-report questionnaire)
timeFrame: Immediately after the intervention (3 weeks later)
measure: Total intervention fidelity (assessed via self-report and investigator observation of recorded intervention sessions)
timeFrame: Immediately after the intervention (3 weeks later)
measure: Total intervention adherence (assessed through session completion)
timeFrame: Immediately after the intervention (3 weeks later)
Locations:
city: Bristol
country: United Kingdom
facility: Centre for Appearance Research, University of the West of England
Study officials:
References:
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citation: Sabiston, C. M., Vani, M. F., & Murray, R. M. (2021). Body-related self-conscious emotions in sport and exercise: A self-regulation perspective. In Motivation and Self-regulation in Sport and Exercise (pp. 62-77). Routledge.
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citation: Vani MF, Pila E, Willson E, Sabiston CM. Body-related embarrassment: The overlooked self-conscious emotion. Body Image. 2020 Mar;32:14-23. doi: 10.1016/j.bodyim.2019.10.007. Epub 2019 Nov 13.
citation: Matheson EL, Schneider J, Tinoco A, White P, Toher D, LaVoi NM, Diedrichs PC. A randomized controlled trial of a body image intervention for girl athletes. Health Psychol. 2025 Jun 2. doi: 10.1037/hea0001522. Online ahead of print.