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'Digital Bodies': A Controlled Evaluation of a Brief Classroom-Based Intervention for Reducing Negative Body Image among Adolescents in the Digital Age

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Title: 'Digital Bodies': A Controlled Evaluation of a Brief Classroom-Based Intervention for Reducing Negative Body Image among Adolescents in the Digital Age
Language: English
Authors: Bell, Beth T. (ORCID 0000-0002-6587-0336), Taylor, Caitlin, Paddock, Danielle, Bates, Adam
Source: British Journal of Educational Psychology. Mar 2022 92(1):280-298.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 19
Publication Date: 2022
Document Type: Journal Articles
Reports - Research
Descriptors: Intervention, Self Concept, Human Body, Adolescents, Social Media, Foreign Countries, Satisfaction
Geographic Terms: United Kingdom
DOI: 10.1111/bjep.12449
ISSN: 0007-0998
Abstract: Background: A growing body of research has linked social media use to negative body image. Aims: The present research aimed to evaluate the efficacy of "Digital Bodies," a brief classroom-based intervention that aims to improve adolescents' body image. Methods: British adolescents (N = 290; Age M = 12.81; SD = 0.40; Range = 12-13; Female = 151) were cluster randomized to intervention or waiting list control groups. Measures of body satisfaction, appearance ideal internalization (thin and athletic ideal internalization) and self-objectification were completed at baseline (T1), 1-week post-intervention (T2) and 8-week follow-up (T3). Results: Multi-level modelling showed adolescents in the intervention group reported improved body satisfaction at T2, in comparison to the control, and crucially this effect was sustained at T3. Additionally, girls reported less thin ideal internalization at T2 relative to the control, but this effect was not sustained at T3. No other intervention effects were found. Conclusions: Overall, the findings provide initial support for the efficacy of "Digital Bodies" as an intervention for improving adolescents' body satisfaction.
Abstractor: As Provided
Notes: https://osf.io/detr9/?view_only=8495dc9574304b69856d2704558f809a
Entry Date: 2022
Accession Number: EJ1326272
Database: ERIC
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  Value: <anid>AN0155146848;6kx01mar.22;2022Feb11.02:48;v2.2.500</anid> <title id="AN0155146848-1">Digital Bodies: A controlled evaluation of a brief classroom‐based intervention for reducing negative body image among adolescents in the digital age </title> <p>Background: A growing body of research has linked social media use to negative body image. Aims: The present research aimed to evaluate the efficacy of Digital Bodies, a brief classroom‐based intervention that aims to improve adolescents' body image. Methods: British adolescents (N = 290; Age M = 12.81; SD = 0.40; Range = 12–13; Female = 151) were cluster randomized to intervention or waiting list control groups. Measures of body satisfaction, appearance ideal internalization (thin and athletic ideal internalization) and self‐objectification were completed at baseline (T1), 1‐week post‐intervention (T2) and 8‐week follow‐up (T3). Results: Multi‐level modelling showed adolescents in the intervention group reported improved body satisfaction at T2, in comparison to the control, and crucially this effect was sustained at T3. Additionally, girls reported less thin ideal internalization at T2 relative to the control, but this effect was not sustained at T3. No other intervention effects were found. Conclusions: Overall, the findings provide initial support for the efficacy of Digital Bodies as an intervention for improving adolescents' body satisfaction.</p> <p>Keywords: adolescents; athletic ideal internalization; body image; intervention; social media; thin ideal internalization</p> <hd id="AN0155146848-2">Background</hd> <p>Social media plays an increasingly prominent role in the lives of adolescents, facilitating social and identity development, and providing a continuous source of entertainment (Boyd, 2014). Many popular social media platforms (e.g., Instagram) are structured around the exchange of visual media, with users creating, sharing, and responding to content as means of social interaction (Bayer, Ellison, Schoenebeck, & Falk, 2016; Bell, 2019). However, concerns have been raised about the appearance potency of social media platforms, and a growing body of research has documented the myriad ways social media use (e.g., selfie viewing and posting, viewing appearance commentary) contributes to the development of negative body image among adolescents (Holland & Tiggemann, 2016; Rodgers & Melioli, 2016; Wang, Xie, Fardouly, Vartanian, & Lei, 2021). Mitigating these negative impacts through effective intervention is important.</p> <p>Classroom‐based interventions have demonstrated some efficacy in reducing adolescents' risk of negative body image by encouraging resistance to problematic sociocultural messages surrounding appearance (Chua, Tam, & Shorey, 2020; Yager, Diedrichs, Ricciardelli, & Halliwell, 2013). But to date, few have focused on the unique challenges to adolescent body image posed by the social media environment (for exception, see Gordon et al., 2020; McLean, Wertheim, Masters, & Paxton, 2017). This focus is particularly important given that the new compulsory health education curriculum for UK secondary schools now mandates education surrounding the role of online environments, such as social media, in setting unrealistic body image standards (Department for Education, 2020). Therefore, classroom‐based interventions have potential to serve dual intervention and education functions. The present research aims to evaluate the efficacy of a single‐session classroom‐based intervention aimed at promoting critical engagement with social media – <emph>Digital Bodies –</emph> in terms of its impact on adolescents' body satisfaction, appearance ideal internalization, and self‐objectification.</p> <hd id="AN0155146848-3">Negative body image, social media, and adolescence</hd> <p>Negative body image refers to the experience of negative thoughts and feelings towards one's own body (Grogan, 2016). It is highly prevalent among adolescents living in Western cultures, particularly among girls (Al Sabbah et al., 2009; Karazsia, Murnen, & Tylka, 2017) for whom negative body image is regarded as a form of 'normative discontent' (Rodin, Silberstein, & Streigel‐Moore, 1985). It is a potent, yet modifiable, risk factor for clinical eating disorders (Rohde, Stice, & Marti, 2015; Smolak & Levine, 2015), and been linked concurrently and prospectively to a wide range of negative mental and physical health outcomes (Cruz‐Sáez, Pascual, Wlodarczyk, & Echeburúa, 2018; Neumark‐Sztainer et al., 2006; Zimmer‐Gembeck, Webb, Kerin, Waters, & Farrell, 2020). Thus, improving adolescents' body image is regarded a pressing public health concern (Paxton, 2015).</p> <p>The tripartite model (Thompson, Heinberg, Altabe, & Tantleff‐Dunn, 1999) and objectification theory (Fredrickson & Roberts, 1997) emphasize the role of social and cultural factors, including social media, in the development of negative body image. According to these theories, adolescents are repeatedly exposed to messages emphasizing the importance of physical attractiveness (Fredrickson & Roberts, 1997), which is defined in terms of culturally prescribed, unrealistic and artificial body, and beauty ideals (Thompson et al., 1999). Adolescents, who display a generalized sensitivity to sociocultural information as part of their pubertal development (Blakemore & Mills, 2014), are likely to internalize these messages, eventually leading to body dissatisfaction as they fail to live up to the unrealistic standards of physical attractiveness set by society (Dakanalis et al., 2015; Knauss, Paxton, & Alsaker, 2008). Female adolescents are most at risk; girls typically report experiencing more sociocultural appearance pressures, higher levels of internalization, and increased body dissatisfaction, than boys (Al Sabbah et al., 2009; Dakanalis et al., 2015; Karazsia et al., 2017; Zimmer‐Gembeck et al., 2020).</p> <p>Social media is a potent and multi‐faceted source of appearance pressure in contemporary society, and research has linked various aspects of appearance‐related social media use to negative body image (Holland & Tiggemann, 2016; Perloff, 2014; Rodgers & Melioli, 2016; Saiphoo, & Vahedi, 2019). Heavily edited images of models that conform to unrealistic sociocultural appearance ideals can be found across social media platforms (Deighton‐Smith & Bell, 2018; Talbot, Gavin, Van Steen, & Morey, 2017). Engaging with this content has been linked to negative body image in both experimental and cross‐sectional research involving adolescent and young adult samples (Holland & Tiggemann, 2016; Huang, Peng, & Ahn, 2020). In contrast to traditional mass media, social media is also interactive, and this interactivity may have further implications for body image. Adolescents have described how they experience pressure to reproduce unrealistic appearance ideals in their own social media feeds, and consequently invest substantial time and effort in the production of their own self‐images or <emph>selfies</emph> (Bell, 2019; Chua & Chang, 2016). Both creating and viewing edited selfies have been bi‐directionally linked to adolescents' appearance concerns over time (Wang et al., 2021). Additionally, adolescents may receive feedback (e.g., through comments and likes) from other users, usually known peers (Bell, 2019). This feedback serves as a form of social reinforcement, affirming appearance ideals and other beliefs surrounding the importance of appearance (Bell, 2019; Chua & Chang, 2016). Both qualitative and quantitative research indicates that girls are more likely to engage in appearance‐related social media use than boys (Bell, 2019; Wang et al., 2021).</p> <hd id="AN0155146848-4">Interventions to improve adolescent body image</hd> <p>There are multiple existing classroom‐based interventions that aim to reduce the negative impact of the mass media and other sociocultural agents on adolescents' body image (Chua et al., 2020; Lewis‐Smith, Diedrichs, & Halliwell, 2019; Yager et al., 2013). Such interventions typically draw on the principles of critical media literacy and/or cognitive dissonance theory to encourage resistance to problematic sociocultural appearance messages (Lewis‐Smith et al., 2019). This involves verbalizing critiques of environmental appearance pressures and rehearsing behavioural strategies to protect the self against them (Lewis‐Smith et al., 2019). Interventions based on these approaches have shown some efficacy; controlled trials have documented their efficacy in reducing some, but not all, measured dimensions of negative body image, negative body image risk factors (e.g., appearance ideal internalization, appearance‐related teasing), and disordered eating symptoms, relative to a control (Chua et al., 2020). Intervention effects were often, but not always, sustained at follow‐up assessments, taken months later (Chua et al., 2020). Variations in intervention effects likely reflect the substantial heterogeneity in intervention content (e.g., sociocultural factors targeted, activities), delivery mode (teacher‐led vs. expert‐led), audience (e.g., age, gender mix), and duration (Chua et al., 2020; Yager et al., 2013). Despite these variations, reported effect sizes were typically modest, falling within the small‐medium range, with the strongest effects being reported for adolescent girls and multi‐session interventions (Chua et al., 2020; Yager et al., 2013).</p> <p>To date, just one classroom‐based intervention has focused on the unique challenges to body image posed by the social media environment (McLean et al., 2017). Comprised of three sessions, this intervention aimed to increase adolescents' critical awareness of problematic appearance‐related messages on social media (e.g., engaging in critiques of digitally manipulated images) as well as problematic practices (e.g., editing selfies, engaging in appearance‐related commentary), while also developing strategies of resilience (McLean et al., 2017). A recent controlled evaluation of the intervention found that Australian adolescent girls who participated in the intervention reported improved body image, reduced disordered eating, and increased media literacy, in comparison to a control group (McLean et al., 2017). A large cluster randomized controlled trial of the intervention, now named <emph>SoMe</emph>, has recently been pre‐registered (Gordon et al., 2020).</p> <p>However, there may be practical barriers to the delivery of multi‐session interventions such as <emph>SoMe</emph>. UK schools, and those in other Western cultures where marketization models of education prevail, are increasingly judged on the basis of exam performance through publicly available league tables (Leckie & Goldstein, 2017). This has led to the marginalization of subjects that do not contribute to these metrics, including health education (Tancred et al., 2017). While this may improve with the recent introduction of health education as a compulsory subject (Department for Education, 2020), the time pressures faced by teachers to deliver 'core' curricula are unlikely to dissipate anytime soon. Shorter single‐session interventions may therefore offer a more pragmatic solution. Encouragingly, research has shown that single‐session body image interventions can be effective. Most notably, participation in <emph>Dove Confident Me,</emph> a 90‐min intervention led to significant reductions in adolescents' body esteem (girls only), negative affect, eating disorder symptoms, and life engagement immediately post intervention, in a controlled trial (Diedrichs et al., 2015). Similarly, Halliwell, Jarman, McNamara, Risdon, and Jankowski (2015) found significant improvements in body image among adolescents immediately after a one‐hour classroom‐based intervention but did not assess whether this effect was sustained. However, neither of these interventions considered the unique challenges to body image posed by the social media environment. More recently, a single‐session intervention to reduce body talk in on‐ and offline environments was found effectively reduce adolescent girls' engagement in appearance commentary and thin ideal internalization, but not body satisfaction, including at follow‐up (Bell, Taylor, Paddock, Bates, & Orange, 2021).</p> <hd id="AN0155146848-5">The present study: Digital Bodies</hd> <p>This study evaluates a brief single‐session classroom‐based intervention – <emph>Digital Bodies</emph> – that aims to challenge unrealistic appearance ideals and pressure to conform to these ideals, as they manifest within the social media environment. More specifically, <emph>Digital Bodies</emph> aims to improve adolescents' body satisfaction and reduce their internalization of societal messages surrounding appearance (self‐objectification, thin ideal internalization, and athletic ideal internalization). It is predicted that adolescents who participate in the intervention will report improved body satisfaction, and reduced levels of appearance (thin and athletic) ideal internalization and self‐objectification post‐intervention and at 8‐week follow‐up, than participants assigned to a waiting list control. Furthermore, we predict that intervention effects will be stronger among girls. This prediction is based on existing research demonstrating that girls experience more sociocultural appearance pressures than boys (Zimmer‐Gembeck et al., 2020), engage in more appearance‐related social media behaviours (Bell, 2019; Wang et al., 2021), and are also typically more receptive to classroom‐based interventions than boys (Chua et al., 2020; Yager et al., 2013).</p> <hd id="AN0155146848-6">Method</hd> <p></p> <hd id="AN0155146848-7">Participants</hd> <p>Participants (<emph>N</emph> = 290; Age <emph>M</emph> = 12.81; <emph>SD</emph> = 0.40; <emph>Range</emph> = 12–13; <emph>Female</emph> = 151) were recruited from a co‐educational high school in Northern England. All participants were in the same school year and of this year group, just four adolescents declined to take part. No other demographic information was collected at the individual level, though school‐level data indicate that a higher than average proportion of students attending the school live in low SES households. Adolescents participated in the intervention within their normal class group. To assign groups to condition (experimental or waiting list control), classes were paired according to academic ability by the head teacher, then one class from each pair was randomly allocated to each condition. No participation incentives were provided. Participant recruitment and allocation are outlined in Figure 1.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/6KX/01mar22/bjep12449-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="bjep12449-fig-0001.jpg" title="1 Participant recruitment, allocation, retention, and flow." /> </p> <p></p> <hd id="AN0155146848-9">Intervention</hd> <p>The <emph>Digital Bodies</emph> intervention consisted of one hour‐long interactive session. The session begun with a short self‐affirmations exercise activity, where participants were asked to describe one thing that is important to them and why (adapted from Epton, Harris, Kane, van Koningsbruggen, & Sheeran, 2015). Used at the start of interventions, the technique can help to overcome participants' initial resistance to health promotion messages (Epton et al., 2015). The main body of the intervention was delivered via cognitive dissonance building techniques and critical literacy skills development (Lewis‐Smith et al., 2019) to encourage adolescents' own critical reflections on appearance ideals, and also to develop the skills needed to challenge these ideals. Content focused on (<reflink idref="bib1" id="ref1">1</reflink>) the socially constructed nature of body ideals over time and culture, with a specific focus on social media spaces, (<reflink idref="bib2" id="ref2">2</reflink>) deconstructing myths surrounding the body perfect (e.g., image editing, idealization), again focusing on social media spaces, and (<reflink idref="bib3" id="ref3">3</reflink>) adolescents' own role in the creation, perpetuation, and reinforcement of this ideals using digital technologies, including social media. The session ended with an exercise based on implementation intentions (Gollwitzer & Sheeran, 2006; Wieber, Thürmer, & Gollwitzer, 2015), where participants formulated specific behavioural plans regarding how they would behave in three situations where appearance ideals are most salient in order to challenge/resist them. See Table 1 for an overview of the intervention activities, and their origin.</p> <p>1 TableOverview of Digital Bodies intervention activities</p> <p> <ephtml> <table><thead valign="top"><tr><th align="left">Activity</th><th align="left">Description</th></tr></thead><tbody><tr><td align="left">1. Self‐affirmation</td><td align="left">Participants identify one thing that is important to them and explain why it is important, recorded in workbook [5 min]</td></tr><tr><td align="left">2. Introduction to 'body perfect' ideals</td><td align="left">In groups, participants draw the perfect body including face. Groups then share this with the rest of the class to highlight similarities. The idea of a perfect body is then critiqued as something that is unrealistic and impossible to attain for the majority of people, and the class then discuss where these ideas about the body perfect originate from (including peers, media, social media, and cartoons) [10 min]</td></tr><tr><td align="left">3. The Body Perfect Changes over Time & Culture</td><td align="left">Participants are introduced to the socially constructed nature of body perfect ideals, and then engage in an interactive facilitator‐led whole class discussion of how these ideals change across time and culture (activity adapted from Happy Being Me, Bird et al., 2013). In particular, they are introduced to the fast‐paced and changing nature of appearance ideals in the social media context, including appearance‐related trends popularized by social media (e.g., large lips and the Kylie Jenner lip challenge, contouring) and how body ideals vary across different hashtags (e.g., fitness/muscularity cultures). After some discussion of their own observations of this, participants record the ways in which the body perfect changes over time and culture on social media, and record in workbook [10 min]</td></tr><tr><td align="left">4. The Body Perfect is an Illusion</td><td align="left">Participants are introduced to the artificial nature of body perfect ideals through a range of group‐based interactive tasks including [1i] identifying digital alterations in social media content (spot the difference between pre‐ and post‐ edited images), [ii] identifying hidden messages in media and social media content that equate the body perfect to desirables life outcomes (spot the hidden message). This section ends with a brief explanation of how the body perfect illusion causes body dissatisfaction [10 min]</td></tr><tr><td align="left">5. Recreating the Body Perfect Illusion</td><td align="left">Participants engage in group discussions of how individuals use social media to create the body perfect illusion (e.g., image filtering, body positioning) for themselves in small groups. Groups then share their ideas with the rest of the class, and the facilitator steers discussion towards why adolescents may engage in these practices (e.g., peer pressure, social media site design, likes & comments). Participants record examples of this in their workbook. [10 min]</td></tr><tr><td align="left">6. What can we do about it (implementations intention)?</td><td align="left">The facilitator describes three examples of the things people have done to challenge body perfect pressures, including engaging with body positive accounts, reminding oneself of what the body can do rather than what it looks like, and verbally challenging body perfect ideals when with friends. Participants are provided with three scenarios where they may encounter body ideals/problematic appearance‐related messaging in social media settings (including [i] Body perfect models dominating social media feed, [ii] Attempting to create own body perfect selfies to share, [iii] A friend who frequently shares body perfect selfies, and instructed to discuss how they might respond to each scenario in a way that would challenge and/or resist body ideals/problematic appearance messaging. They then write their preferred action for each scenario (as an implementation intention) in their workbook and make a pledge to try and enact these plans over the next week. [15 min]</td></tr></tbody></table> </ephtml> </p> <p> <emph>Digital Bodies</emph> was initially developed as a suggested lesson plan, given to teachers as part of a professional development course about body image. It was designed by the first author in collaboration with an experienced teacher (Author 4), who has over 20 years of experience delivering personal, health, and sex education in schools. It had received excellent evaluations from teachers, who had attended the course and subsequently used it in the classroom, in terms of Interest/Enjoyment (<emph>M</emph> = 4.60; <emph>SD</emph> = 0.52; <emph>Scale</emph> = 1 <emph>low</emph>–5 <emph>high</emph>) and Impact/Learning (<emph>M</emph> = 4.40; <emph>SD</emph> = 0.70; <emph>Scale</emph> = 1 <emph>low</emph>–5 <emph>high</emph>). Prior to the current delivery, the <emph>Digital Bodies</emph> session was piloted with 25 adolescent boys and girls in a local youth group (aged 11–14 years old), and qualitative feedback was obtained on each of the activities. This feedback was generally positive, though some small modifications were made to the session in response to it (e.g., adjusting implementation intentions scenarios). Pilot data and session materials are available on OSF https://osf.io/detr9/?view_only=8495dc9574304b69856d2704558f809a).</p> <hd id="AN0155146848-10">Measures</hd> <p>Demographic information was collected prior to study commencement, at the same time as consent was acquired. Additionally, measures of the following constructs were completed at all time points:</p> <hd id="AN0155146848-11">Body satisfaction</hd> <p>The Body Satisfaction Scale (BSS; Bird, Halliwell, Diedrichs, & Harcourt, 2013) was used to assess how adolescents feel about their body. The scale comprises five items (e.g., Do you feel satisfied with your appearance?), which participants responded to on a 5‐point scale (<emph>1</emph> = <emph>neve</emph>r, <emph>5</emph> = <emph>very often</emph>). Items were summed to calculate an overall score of body satisfaction, ranging from 1 to 25, with higher scores indicating high body satisfaction. By focusing on body satisfaction rather than dissatisfaction through its positively worded questions, the BSS is particularly appropriate for use with younger samples. It has shown good validity and reliability in past intervention research (Bird et al., 2013). In this study, good internal reliability was observed across time points (Time 1 ω = .89, 95% CI = 0.85–0.91; Time 2 ω = .90, 95% CI = 0.88–0.92; Time 3 ω = .91, 95% CI = 0.86–0.93).</p> <hd id="AN0155146848-12">Appearance ideal internalization</hd> <p>The extent to which adolescents had internalized societal appearance ideals as personal goals was assessed using the thinness and athletic internalization subscales of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ‐4; Schaefer et al., 2015). Each subscale comprises five items (e.g., 'I want my body to look very lean' and 'I think a lot about looking muscular') that participants rate on a 5‐point scale (<emph>1</emph> = <emph>Definitely disagree</emph>, <emph>5</emph> = <emph>Definitely agree</emph>). Mean scores were calculated for each subscale independently to create separate scores for thin ideal and athletic ideal internalization, with higher scores reflecting higher endorsement. The internalization subscales of the SATAQ‐4 have shown good construct validity and reliability when used with adolescent and young adult samples across cultures (Frisén & Berne, 2020; Schaefer et al., 2015; Yamamiya et al., 2016, 2019). Both subscales demonstrated good internal reliability across all time points in this study (Time 1 <emph>ω </emph>= .79, 95% CI = 0.74–0.83; Time 2 ω = .79, 95% CI = 0.73–0.84; Time 3 ω = .85, 95% CI = 0.81–0.88; Time 1 <emph>ω </emph>= .86, 95% CI = 0.82–0.88; Time 2 ω = .89, 95% CI = 0.86–0.92; Time 3 ω = .90, 95% CI = 0.87–0.92).</p> <hd id="AN0155146848-13">Self‐objectification</hd> <p>The Self‐Objectification Questionnaire (Noll & Fredrickson, 1998) requires participants to rank a selection of 10 body attributes according to how important they are to their self‐concept (<emph>1 = Not at all important to me, 10 = Very important to me</emph>). Five of the attributes are appearance‐based (e.g., sex appeal and physical attractiveness) and five are competence‐based (e.g., health and stamina). Scores are calculated by subtracting the sum of the appearance attributes from the sum of the competence attributes (<emph>Range</emph> = −25 to 25). Low scores reflect a greater emphasis on the importance of appearance‐based physical attributes over competency‐based attributes, that is, high levels of self‐objectification. The measure has demonstrated validity and reliability in young female samples (Noll & Fredrickson, 1998), and is widely used among male and female adolescents across Western cultures (Slater & Tiggemann, 2011; Vandenbosch & Eggermont, 2014).</p> <hd id="AN0155146848-14">Fidelity</hd> <p>Adolescents recorded intervention activities in a workbook (available on OSF, https://osf.io/detr9/?view%5fonly=8495dc9574304b69856d2704558f809a). One point was awarded for each 'correct' response in the workbook. Correct responses were defined as those that were consistent with intervention content, regardless of depth. Points were summed to create a total score (max score = 7), which was used as a proxy of intervention fidelity that is, to indicate that all intervention content had been delivered in all classes. Workbook grading was performed by the first author, then a subsample of 48 (eight from each of the six experimental group classes) were independently scored by an undergraduate research assistant, resulting in a 98% agreement rate.</p> <hd id="AN0155146848-15">Procedure</hd> <p>Informed consent was first gained from the school head teacher, then opt‐out consent was obtained from parents/guardians, and finally opt‐in consent was obtained from students on the day of baseline testing. After providing consent, participants provided demographic information and completed measures of body satisfaction, appearance ideal internalization, and self‐objectification. During the following week, participants in the experimental condition received the intervention, which was delivered to each individual class by two trained research assistants (one male and one female). The research assistants all had prior experience of working in schools and received four hours of training in intervention delivery. One week after the intervention (Time 2), participants completed a second questionnaire containing the same measures as the first. Eight weeks after the intervention, all participants completed the same questionnaire again (Time 3). The following week, the waiting list control condition received the intervention.</p> <p>At the end of the study, all participants were provided with a short paper‐based debrief reminding them of the purpose of the study that also contained details of information services and support organizations. The school also received a short report detailing the study findings. The study adhered to the British Psychological Society ethical guidelines and received approval from York St John University ethics committee. Intervention delivery and data collection took place between May and July 2019. The study was not pre‐registered, however all study materials (pilot work, intervention materials, data, and analysis code) are available on OSF (https://osf.io/detr9/?view_only=8495dc9574304b69856d2704558f809a).</p> <hd id="AN0155146848-16">Statistical analysis</hd> <p>Of the recruited participants, 268 were in school on the day of baseline testing and, for the intervention group only, the day of intervention delivery. These 268 participants (Age <emph>M</emph> = 12.80; <emph>SD</emph> = 0.40; <emph>Range</emph> = 12–13; <emph>Female</emph> = 142) comprise the sample on which our analyses are based (see Figure 1 for details of participant recruitment, retention and flow). SPSS 25 was used to structure the dataset and calculate scale reliabilities, descriptive statistics, and baseline group differences. Then R version 4.0.0 (R Foundation for Statistical Computing, Vienna, Austria) was used to assess between‐group differences in outcomes at post‐intervention and follow‐up with multi‐level linear models to account for the hierarchical nature of the data (repeated measures nested within participants). All attrition was due to student absences from school on the day of testing and so missing data were handled within the model using the maximum likelihood estimation method (i.e., under the assumption of missing at random). This method has been shown to be superior to multiple imputation for handling missing data in multilevel linear models (Allison, 2012; Shin, Davison, & Long, 2017).</p> <p>A random intercept‐only model was fitted for each outcome that allowed intercepts to vary across participants. Next, a random slope was fitted. However, adding the slope to the model did not significantly improve the model fit (assessed via the likelihood‐ratio test) for any of our models, and so it was removed, and the model was re‐run with a random intercept only. Fixed effects entered into the model were: time (coded as: baseline = 0, post‐intervention = 1, follow‐up = 2), group (control = 0, experimental = 1), gender (boys = 0, girls = 1), the two‐way interaction between group and time, and the three‐way interaction between gender, group, and time. All group x time interaction effects were followed up with <emph>a priori</emph> planned pairwise comparisons between‐groups at each post‐intervention time‐point. Gender × group × time interactions were further explored by conducting separate pairwise comparisons for girls and boys. The <emph>p</emph>‐values and 95% confidence intervals (CIs) from pairwise comparisons were adjusted with a Bonferroni correction to reduce the family‐wise error rate (i.e., by multiplying the <emph>p</emph>‐value by 2). Model assumptions (e.g., normality, outliers) were verified by visual inspection of residuals via histograms, boxplots, and Q–Q plots. Statistical significance was set at <emph>p</emph> < .05. We also calculated Cohen's d as a measure of standardized effect size between‐groups using the formula: ([mean change intervention group − mean change control group]/pooled <emph>SD</emph> of change scores). Standardized effect sizes were rated as trivial (<0.2), small (0.2–0.49), medium (0.50–0.79), or large (≥0.8; Cohen, 1988). R Code and Data available on OSF (https://osf.io/detr9/?view_only=8495dc9574304b69856d2704558f809a).</p> <hd id="AN0155146848-17">Results</hd> <p></p> <hd id="AN0155146848-18">Participant baseline characteristics</hd> <p>Demographic characteristics of the final sample are shown in Table 1. A series of 2x2 ANOVAs were run to assess whether there were any differences between participants at baseline according to condition (intervention vs. control) or gender (boys vs. girls). There were no significant differences according to condition, <emph>F</emph>(<reflink idref="bib1" id="ref4">1</reflink>, 264) = 0.00–3.01, all <emph>p</emph> > .05, however there were significant differences according to gender. As Table 2 shows, girls reported significantly higher levels of thin appearance ideal internalization and self‐objectification, but lower levels of athletic ideal internalization and body satisfaction, <emph>F</emph>(<reflink idref="bib1" id="ref5">1</reflink>, 264) = 9.14–21.49, all <emph>p</emph> < .01. There were no gender differences in relation to age, <emph>F</emph>(<reflink idref="bib1" id="ref6">1</reflink>, 264) = 0.94, <emph>p</emph> = .33.</p> <p>2 TableBaseline characteristics of sample overall, and according to condition and gender</p> <p> <ephtml> <table><thead valign="top"><tr><th align="left" /><th align="left">Intervention</th><th align="left">Control</th><th align="left">Overall</th></tr><tr><th align="left">Girls <italic>n</italic> = 76</th><th align="left">Boys <italic>n</italic> = 58</th><th align="left">All <italic>n</italic> = 134</th><th align="left">Girls <italic>n</italic> = 66</th><th align="left">Boys <italic>n</italic> = 68</th><th align="left">All <italic>n</italic> = 134</th><th align="left">Girls <italic>n</italic> = 142</th><th align="left">Boys <italic>n</italic> = 126</th><th align="left">All <italic>n</italic> = 268</th></tr><tr><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th><th align="left"><italic>M</italic></th><th align="left"><italic>SD</italic></th></tr></thead><tbody><tr><td align="left">Age</td><td align="char" char=".">12.87</td><td align="char" char=".">0.34</td><td align="char" char=".">12.81</td><td align="char" char=".">0.40</td><td align="char" char=".">12.84</td><td align="char" char=".">0.37</td><td align="char" char=".">12.77</td><td align="char" char=".">0.34</td><td align="char" char=".">12.74</td><td align="char" char=".">0.44</td><td align="char" char=".">12.84</td><td align="char" char=".">0.37</td><td align="char" char=".">12.82</td><td align="char" char=".">0.38</td><td align="char" char=".">12.77</td><td align="char" char=".">0.42</td><td align="char" char=".">12.80</td><td align="char" char=".">0.40</td></tr><tr><td align="left">BS</td><td align="char" char=".">14.48</td><td align="char" char=".">4.90</td><td align="char" char=".">16.41</td><td align="char" char=".">4.92</td><td align="char" char=".">15.31</td><td align="char" char=".">4.99</td><td align="char" char=".">13.89</td><td align="char" char=".">4.33</td><td align="char" char=".">16.62</td><td align="char" char=".">4.14</td><td align="char" char=".">15.28</td><td align="char" char=".">4.43</td><td align="char" char=".">14.21</td><td align="char" char=".">4.64</td><td align="char" char=".">16.52</td><td align="char" char=".">4.50</td><td align="char" char=".">15.29</td><td align="char" char=".">4.71</td></tr><tr><td align="left">TII</td><td align="char" char=".">2.98</td><td align="char" char=".">0.87</td><td align="char" char=".">2.64</td><td align="char" char=".">0.84</td><td align="char" char=".">2.83</td><td align="char" char=".">0.87</td><td align="char" char=".">2.88</td><td align="char" char=".">0.88</td><td align="char" char=".">2.58</td><td align="char" char=".">0.85</td><td align="char" char=".">2.73</td><td align="char" char=".">0.87</td><td align="char" char=".">2.93</td><td align="char" char=".">0.87</td><td align="char" char=".">2.61</td><td align="char" char=".">0.84</td><td align="char" char=".">2.78</td><td align="char" char=".">0.87</td></tr><tr><td align="left">AII</td><td align="char" char=".">2.21</td><td align="char" char=".">0.78</td><td align="char" char=".">2.84</td><td align="char" char=".">1.07</td><td align="char" char=".">2.49</td><td align="char" char=".">0.97</td><td align="char" char=".">2.39</td><td align="char" char=".">0.67</td><td align="char" char=".">2.66</td><td align="char" char=".">0.76</td><td align="char" char=".">2.53</td><td align="char" char=".">0.88</td><td align="char" char=".">2.29</td><td align="char" char=".">0.87</td><td align="char" char=".">2.74</td><td align="char" char=".">0.92</td><td align="char" char=".">2.51</td><td align="char" char=".">0.92</td></tr><tr><td align="left">SO</td><td align="char" char=".">4.00</td><td align="char" char=".">13.24</td><td align="char" char=".">11.18</td><td align="char" char=".">9.81</td><td align="char" char=".">7.08</td><td align="char" char=".">12.38</td><td align="char" char=".">5.33</td><td align="char" char=".">11.41</td><td align="char" char=".">11.28</td><td align="char" char=".">10.35</td><td align="char" char=".">8.26</td><td align="char" char=".">11.26</td><td align="char" char=".">4.62</td><td align="char" char=".">12.40</td><td align="char" char=".">11.23</td><td align="char" char=".">10.06</td><td align="char" char=".">7.66</td><td align="char" char=".">11.83</td></tr></tbody></table> </ephtml> </p> <p>1 Note</p> <p>4 AII = Athletic ideal internalization; BS = Body Satisfaction; SO = Self‐objectification; TII = Thin ideal internalization.</p> <hd id="AN0155146848-19">Intervention effects</hd> <p>As Table 3 shows, there were significant interaction effects between group and time for body satisfaction only (<emph>p</emph> < .05). Subsequent pairwise comparisons revealed that the adolescents who received the intervention reported significantly improved body satisfaction post‐intervention (<emph>M</emph> = 16.45, <emph>SE</emph> = 0.37) and at 8‐week follow‐up (<emph>M</emph> = 16.12, <emph>SE</emph> = 0.37), compared with the control group (<emph>M</emph> = 15.22, <emph>SE</emph> = 0.37; <emph>M</emph> = 14.92, <emph>SD</emph> = 0.37, respectively). Effect sizes were small (post <emph>d</emph> = −0.38, follow‐up <emph>d</emph> = −0.37) indicating that the intervention had a positive and lasting, yet small, impact on adolescents' body image.</p> <p>3 TableAdjusted means and standard errors by group and time, with adjusted between‐group differences and corresponding 95% confidence intervals (CIs)</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Outcome</th><th align="left">Post‐intervention</th><th align="left">Follow‐up</th></tr><tr><th align="left">Intervention</th><th align="left">Control</th><th align="left">Between‐group difference</th><th align="left"><italic>p</italic>‐Value</th><th align="left"><italic>d</italic></th><th align="left">Intervention</th><th align="left">Control</th><th align="left">Between‐group difference</th><th align="left"><italic>p</italic>‐Value</th><th align="left"><italic>d</italic></th></tr></thead><tbody><tr><td align="left">BS</td><td align="char" char="(">16.45 (0.37)</td><td align="char" char="(">15.22 (0.37)</td><td align="char" char="[">−1.23 [−2.28, −0.18]</td><td align="char" char=".">.02</td><td align="char" char=".">−0.38</td><td align="char" char="(">16.17 (0.37)</td><td align="char" char="(">14.92 (0.37)</td><td align="char" char="[">−1.25 [−2.31, −0.12]</td><td align="char" char=".">.02</td><td align="char" char=".">−0.37</td></tr><tr><td align="left">TII</td><td align="char" char="(">2.64 (0.07)</td><td align="char" char="(">2.70 (0.07)</td><td align="char" char="[">0.06 [−0.15, 0.27]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.32</td><td align="char" char="(">2.75 (0.07)</td><td align="char" char="(">2.74 (0.07)</td><td align="char" char="[">0.01 [−0.22, 0.20]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.08</td></tr><tr><td align="left">AII</td><td align="char" char="(">2.45 (0.08)</td><td align="char" char="(">2.58 (0.07)</td><td align="char" char="[">0.13 [−0.08, 0.34]</td><td align="char" char=".">.32</td><td align="char" char=".">0.01</td><td align="char" char="(">2.56 (0.07)</td><td align="char" char="(">2.62 (0.07)</td><td align="char" char="[">0.05 [−0.16, 0.27]</td><td align="char" char=".">1.00</td><td align="char" char=".">−0.07</td></tr><tr><td align="left">SO</td><td align="char" char="(">7.68 (0.96)</td><td align="char" char="(">8.88 (0.95)</td><td align="char" char="[">1.20 [−1.59, 3.99]</td><td align="char" char=".">.67</td><td align="char" char=".">−0.16</td><td align="char" char="(">8.33 (0.96)</td><td align="char" char="(">7.98 (0.96)</td><td align="char" char="[">−0.35 [−3.18, 2.47]</td><td align="char" char=".">1.00</td><td align="char" char=".">−0.26</td></tr></tbody></table> </ephtml> </p> <ulist> <item>2 Note</item> <item>5 AII = Athletic ideal internalization; BS = Body Satisfaction; <emph>d</emph> = Cohen's <emph>d</emph>; SO = Self‐objectification; TII = Thin ideal internalization.</item> </ulist> <hd id="AN0155146848-20">Moderating effects of gender</hd> <p>There were significant group x time x gender interaction effects for thin ideal internalization only (<emph>p</emph> < .05). Subsequent pairwise comparisons demonstrated different effects of the intervention for girls and boys (Table 4). For girls only, the intervention significantly reduced thin ideal internalization post‐intervention (<emph>M</emph> = 2.73, <emph>SE</emph> = 0.09) in comparison with the control (<emph>M</emph> = 3.01, <emph>SE</emph> = 0.10). The effect was medium‐sized (<emph>d</emph> = 0.78) and was not sustained at eight‐week follow‐up.</p> <p>4 TableAdjusted means and standard errors by group and time, with adjusted between‐group differences and corresponding 95% confidence intervals (CIs)</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Outcome</th><th align="left">Post‐intervention</th><th align="left">Follow‐up</th></tr><tr><th align="left">Intervention</th><th align="left">Control</th><th align="left">Between‐group difference</th><th align="left"><italic>p</italic>‐Value</th><th align="left"><italic>d</italic></th><th align="left">Intervention</th><th align="left">Control</th><th align="left">Between‐group difference</th><th align="left"><italic>p</italic>‐Value</th><th align="left"><italic>d</italic></th></tr></thead><tbody><tr><td align="left">Girls</td></tr><tr><td align="left">BS</td><td align="char" char="(">15.08 (0.46)</td><td align="char" char="(">13.78 (0.49)</td><td align="char" char="[">−1.30 [−2.69, 0.10]</td><td align="char" char=".">.07</td><td align="char" char=".">−0.37</td><td align="char" char="(">15.07 (0.46)</td><td align="char" char="(">13.69 (0.49)</td><td align="char" char="[">−1.39 [−2.79, 0.02]</td><td align="char" char=".">.05</td><td align="char" char=".">−0.36</td></tr><tr><td align="left">TII</td><td align="char" char="(">2.73 (0.09)</td><td align="char" char="(">3.01 (0.10)</td><td align="char" char="[">0.28 [−0.00, 0.56]</td><td align="char" char=".">.05</td><td align="char" char=".">0.77</td><td align="char" char="(">2.99 (0.09)</td><td align="char" char="(">2.95 (0.10)</td><td align="char" char="[">−0.04 [−0.33, 0.24]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.08</td></tr><tr><td align="left">AII</td><td align="char" char="(">2.16 (0.09)</td><td align="char" char="(">2.48 (0.10)</td><td align="char" char="[">0.32 [0.03, 0.60]</td><td align="char" char=".">.03</td><td align="char" char=".">0.01</td><td align="char" char="(">2.30 (0.09)</td><td align="char" char="(">2.44 (0.10)</td><td align="char" char="[">0.14 [−0.15, 0.60]</td><td align="char" char=".">.54</td><td align="char" char=".">−0.15</td></tr><tr><td align="left">SO</td><td align="char" char="(">4.44 (1.20)</td><td align="char" char="(">5.85 (1.27)</td><td align="char" char="[">1.42 [−2.28, 5.12]</td><td align="char" char=".">.78</td><td align="char" char=".">−0.50</td><td align="char" char="(">4.88 (1.21)</td><td align="char" char="(">6.30 (1.27)</td><td align="char" char="[">1.42 [−2.31, 5.16]</td><td align="char" char=".">.78</td><td align="char" char=".">−0.44</td></tr><tr><td align="left">Boys</td></tr><tr><td align="left">BS</td><td align="char" char="(">17.83 (0.55)</td><td align="char" char="(">16.67 (0.48)</td><td align="char" char="[">−1.16 [−2.72, 0.40]</td><td align="char" char=".">.19</td><td align="char" char=".">−</td><td align="char" char="(">17.27 (0.55)</td><td align="char" char="(">16.15 (0.49)</td><td align="char" char="[">−1.12 [−2.70, 0.46]</td><td align="char" char=".">.22</td><td align="char" char=".">−0.36</td></tr><tr><td align="left">TII</td><td align="char" char="(">2.55 (0.11)</td><td align="char" char="(">2.40 (0.09)</td><td align="char" char="[">−0.16 [−0.47, 0.16]</td><td align="char" char=".">.52</td><td align="char" char=".">−</td><td align="char" char="(">2.50 (0.11)</td><td align="char" char="(">2.53 (0.10)</td><td align="char" char="[">−0.03 [−0.33, 0.34]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.09</td></tr><tr><td align="left">AII</td><td align="char" char="(">2.73 (0.11)</td><td align="char" char="(">2.68 (0.10)</td><td align="char" char="[">−0.05 [−0.37, 0.27]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.03</td><td align="char" char="(">2.82 (0.11)</td><td align="char" char="(">2.79 (0.10)</td><td align="char" char="[">−0.03 [−0.34, 0.43]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.01</td></tr><tr><td align="left">SO</td><td align="char" char="(">10.92 (1.44)</td><td align="char" char="(">11.91 (1.27)</td><td align="char" char="[">0.99 [−3.19, 5.17]</td><td align="char" char=".">1.00</td><td align="char" char=".">0.29</td><td align="char" char="(">11.78 (1.44)</td><td align="char" char="(">9.65 (1.31)</td><td align="char" char="[">−2.13 [−6.38, 2.13]</td><td align="char" char=".">.52</td><td align="char" char=".">−0.03</td></tr></tbody></table> </ephtml> </p> <ulist> <item>3 Note</item> <item>6 AII = Athletic ideal internalization; BS = Body Satisfaction; <emph>d</emph> = Cohen's <emph>d</emph>; SO = Self‐objectification; TII = Thin ideal internalization.</item> </ulist> <hd id="AN0155146848-21">Fidelity</hd> <p>Mean workbook scores were high (<emph>M</emph> = 6.30, <emph>SD</emph> = 1.17) indicating that intervention content had been delivered and adolescents had attended to the content. A two‐way ANOVA was performed to examine whether there were any differences in workbook completion according to gender and school class. No differences were found for gender, <emph>F</emph>(<reflink idref="bib1" id="ref7">1</reflink>, 122) = 0.02, <emph>p</emph> = .88, school class, <emph>F</emph>(<reflink idref="bib5" id="ref8">5</reflink>, 122) = 2.20, <emph>p</emph> = .06, or gender × school class interaction, <emph>F</emph>(<reflink idref="bib5" id="ref9">5</reflink>, 122) = 0.18, <emph>p</emph> =.97.</p> <hd id="AN0155146848-22">Discussion</hd> <p>This study aimed to evaluate the efficacy of <emph>Digital Bodies;</emph> a brief classroom‐based intervention that aims to increase adolescents' body satisfaction and reduce their internalization of problematic sociocultural messages related to appearance (thin ideal internalization, athletic ideal internalization, and self‐objectification). We found that adolescents who participated in <emph>Digital Bodies</emph> reported significantly higher body satisfaction 1‐week post‐intervention and at 8‐week follow‐up, in comparison to the control group. Furthermore, girls in the intervention group reported lower thin ideal internalization 1‐week post‐intervention, but this effect was not sustained at follow‐up. No further intervention effects were found.</p> <p>Our findings show that participation in <emph>Digital Bodies</emph> was successful in achieving its primary aim of improving adolescents' body satisfaction. Thus, <emph>Digital Bodies</emph> contributes to the pool of existing single‐session classroom‐based interventions that have demonstrated efficacy improving body image related outcomes among adolescents (Bell et al., 2021; Diedrichs et al., 2015; Halliwell et al., 2015). Crucially, improvements in body satisfaction were observed among all adolescents, irrespective of gender. This is a promising finding, given that meta‐analyses have typically found stronger intervention effects in girls than boys (Chua et al., 2020; Yager et al., 2013). Boys have also been less studied in intervention research. For example, the only other existing effective body image intervention focused specifically on social media pressures has not been evaluated among boys (McLean et al., 2017).</p> <p>The effect of the intervention on body satisfaction was sustained at follow‐up. This compares favourably to existing single‐session interventions where effects have either not been sustained at follow‐up (Diedrichs et al., 2015) or no follow‐up measures were taken (Halliwell et al., 2015). It may be that some of the unique features of <emph>Digital Bodies</emph>, such as the use of implementation intentions to encourage repetition of the intervention message beyond the classroom, may account for the longevity of the effect on body satisfaction. In support of this, a recent classroom‐based intervention to reduce appearance‐related interactions in online environments that similarly used implementation intentions (Bell et al., 2021) found a similar long‐standing impact of the intervention on girls' body talk and thin ideal internalization. That said, the intervention effect size in this study was small. While this is consistent with previous interventions (Chua et al., 2020), more research is needed to understand the meaningfulness of these changes in terms of adolescents' physical and mental health outcomes, for example, the extent to which they reduce adolescents' eating disorder risk or improve quality of life.</p> <p>A more gendered and partial effect of the intervention was found on adolescents' internalization of societal messages surrounding appearance. Post‐intervention, girls reported significant reductions in thin ideal internalization, but not athletic ideal internalization or self‐objectification. This effect size was medium‐sized but did not persist to follow‐up. No intervention effects were found for boys in terms of appearance ideal internalization or self‐objectification either post‐intervention or at follow‐up. Measurement may have been an issue here. The measures of appearance ideal internalization of appearance ideals used in this study focused on specific dimensions of body‐related internalization. Given the heavy focus of the social media environment on facial attractiveness (e.g., through viewing and posting selfies, Bell, 2019; Wang et al., 2021), a measure of more general beauty ideal internalization may have been more appropriate to capture adolescents' internalization of these standards. Furthermore, in terms of self‐objectification, researchers have recently raised critical concerns about the current scoring procedure of the Self‐Objectification Questionnaire (for discussion, see Wollast, Klein, VanLeeuwen, Gervais, & Bernard, 2021). These issues, which affect the reliability and validity of the scale, may account for the null findings. Alternatively, it may just be that the intervention did not do enough to dismantle internalized societal beliefs that a person's value is derived from their appearance. As such, the impact of the intervention on body image may be due to some other mechanism (e.g., altered perceptions of social norms in relation to body image) that could be explored in future research.</p> <hd id="AN0155146848-23">Implications</hd> <p>As a single session intervention, <emph>Digital Bodies</emph> provides a pragmatic and highly feasible means of addressing the role of social media in adolescents' body image concerns in time‐pressured school environments. Indeed, the intervention was originally developed as a lesson plan for teachers and has already been used in classrooms by teachers with limited training. Given that social media and body image is now a compulsory part of the UK health education curriculum (Department for Education, 2020), <emph>Digital Bodies</emph> has much potential in the UK classroom as both a tool for education and intervention. That said, <emph>Digital Bodies</emph> did not have a sustained effect on the measured risk factors for negative body image (i.e., appearance ideal internalization and self‐objectification), suggesting that multi‐session body image interventions that address a range of risk factors still have an important role to play.</p> <p>In demonstrating the partial efficacy of <emph>Digital Bodies</emph>, we contribute to the wealth of existing research demonstrating the utility of media literacy building techniques in reducing body image risk among both adolescent boys and girls (Lewis‐Smith et al., 2019). The intervention also incorporated multiple additional change techniques (self‐affirmation and implementation intentions) to enhance efficacy, meaning that we are unable to identify the 'active ingredients' (Abraham & Michie, 2008). Moving forwards, using active control groups in the evaluation, wherein the effectiveness of <emph>Digital Bodies</emph> is compared with a media literacy only, self‐affirmation only, and an implementation‐intentions only condition, should enable us to disentangle this question.</p> <hd id="AN0155146848-24">Limitations</hd> <p>Just one school was involved in the present evaluation of <emph>Digital Bodies</emph>. While using the same school for both the intervention and control group ensures closely matched groups for comparison of intervention effects and is widely used in the field (McLean et al., 2017), it does allow for possible contamination between groups. As a consequence, intervention effects may have been underestimated. The school involved was a state‐funded academy in a predominantly white low SES area, and so testing the programme with a more diverse ethnic, socioeconomic, and geographic mix of adolescents is important. Large scale evaluation of D<emph>igital Bodies</emph>, including with multiple diverse schools, is needed to assess whether the intervention is effective for groups beyond this original sample. Timing of measurement might also have affected findings. Follow‐up measures were taken 8‐weeks post intervention, as this fit best within the school timetable, but a more long‐term evaluation (6–12 months) would provide better insight into how lasting intervention effects are. Therefore, more long‐term evaluation that makes use of separate yet well‐matched schools for intervention and control group, and encompasses more diverse groups of adolescents, is needed.</p> <hd id="AN0155146848-25">Conclusions</hd> <p>Our findings suggest that <emph>Digital Bodies</emph> can be an effective and feasible means of improving adolescent boys' and girls' body satisfaction. However, more evaluation work, involving more diverse groups is needed to understand the extent to which these findings can generalized beyond the present sample. Future research should also focus on the delivery of the intervention to larger, more diverse groups than were used in this study. It should also aim to overcome the limitations in measurement that were present within this study, by including more generalized measures of beauty ideal internalization and a more valid and reliable measure of objectification.</p> <hd id="AN0155146848-26">Acknowledgements</hd> <p>The authors thank Limor Augustin and Jonathan Dudley for their assistance with intervention delivery and data collection, as well as the teachers and adolescents from the school involved. This research was funded by the York St John University impactful research fund.</p> <hd id="AN0155146848-27">Conflicts of interest</hd> <p>All authors declare no conflict of interest.</p> <hd id="AN0155146848-28">Author contributions</hd> <p> <bold>Beth T. Bell:</bold> Conceptualization (equal); Formal analysis (equal); Methodology (equal); Writing – original draft (equal); Writing – review & editing (equal). <bold>Caitlin Taylor:</bold> Data curation (equal); Investigation (equal); Project administration (equal); Writing – original draft (equal). <bold>Danielle Paddock:</bold> Investigation (equal); Writing – original draft (equal). <bold>Adam Bates:</bold> Conceptualization (equal); Investigation (equal).</p> <hd id="AN0155146848-29">Code availability</hd> <p>Code available on OSF https://osf.io/detr9/?view_only=8495dc9574304b69856d2704558f809a</p> <hd id="AN0155146848-30">Data availability statement</hd> <p>Available on OSF https://osf.io/detr9/?view_only=8495dc9574304b69856d2704558f809a</p> <ref id="AN0155146848-31"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Al Sabbah, H., Vereecken, C. A., Elgar, F. J., Nansel, T., Aasvee, K., Abdeen, Z., ... Maes, L. (2009). 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Bell; Caitlin Taylor; Danielle Paddock and Adam Bates</p> <p>Reported by Author; Author; Author; Author</p> </aug>
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  Data: 'Digital Bodies': A Controlled Evaluation of a Brief Classroom-Based Intervention for Reducing Negative Body Image among Adolescents in the Digital Age
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  Data: <searchLink fieldCode="AR" term="%22Bell%2C+Beth+T%2E%22">Bell, Beth T.</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6587-0336">0000-0002-6587-0336</externalLink>)<br /><searchLink fieldCode="AR" term="%22Taylor%2C+Caitlin%22">Taylor, Caitlin</searchLink><br /><searchLink fieldCode="AR" term="%22Paddock%2C+Danielle%22">Paddock, Danielle</searchLink><br /><searchLink fieldCode="AR" term="%22Bates%2C+Adam%22">Bates, Adam</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Concept%22">Self Concept</searchLink><br /><searchLink fieldCode="DE" term="%22Human+Body%22">Human Body</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Media%22">Social Media</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Satisfaction%22">Satisfaction</searchLink>
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  Data: 10.1111/bjep.12449
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  Data: Background: A growing body of research has linked social media use to negative body image. Aims: The present research aimed to evaluate the efficacy of "Digital Bodies," a brief classroom-based intervention that aims to improve adolescents' body image. Methods: British adolescents (N = 290; Age M = 12.81; SD = 0.40; Range = 12-13; Female = 151) were cluster randomized to intervention or waiting list control groups. Measures of body satisfaction, appearance ideal internalization (thin and athletic ideal internalization) and self-objectification were completed at baseline (T1), 1-week post-intervention (T2) and 8-week follow-up (T3). Results: Multi-level modelling showed adolescents in the intervention group reported improved body satisfaction at T2, in comparison to the control, and crucially this effect was sustained at T3. Additionally, girls reported less thin ideal internalization at T2 relative to the control, but this effect was not sustained at T3. No other intervention effects were found. Conclusions: Overall, the findings provide initial support for the efficacy of "Digital Bodies" as an intervention for improving adolescents' body satisfaction.
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      – SubjectFull: Self Concept
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      – SubjectFull: Human Body
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      – SubjectFull: Adolescents
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      – TitleFull: 'Digital Bodies': A Controlled Evaluation of a Brief Classroom-Based Intervention for Reducing Negative Body Image among Adolescents in the Digital Age
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      – PersonEntity:
          Name:
            NameFull: Bell, Beth T.
      – PersonEntity:
          Name:
            NameFull: Taylor, Caitlin
      – PersonEntity:
          Name:
            NameFull: Paddock, Danielle
      – PersonEntity:
          Name:
            NameFull: Bates, Adam
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 03
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 0007-0998
          Numbering:
            – Type: volume
              Value: 92
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: British Journal of Educational Psychology
              Type: main
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