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

Intervention Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05316610
• Other study ID #: HAS.21.03.120a
• Status: Completed
• Phase: N/A
• Start date: June 1, 2022
• Est. completion date: October 1, 2022

Study information

• Verified date: August 2023
• Source: University of the West of England
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 18
• Est. completion date: October 1, 2022
• Est. primary completion date: October 1, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 11 Years to 17 Years

Eligibility

Inclusion Criteria:

• Girls aged 11-17 years old

• English speaking

• US resident

Exclusion Criteria:

• n/a

Related Conditions & MeSH terms

• Intervention
• Waitlist Control

Intervention

Behavioral:
• Body Confident Athletes
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.

Locations

Country	Name	City	State
United Kingdom	Centre for Appearance Research, University of the West of England	Bristol

Sponsors (5)

Lead Sponsor	Collaborator
University of the West of England	Laureus, Nike, Tucker Center for Research on Girls & Women in Sport, Unilever R&D

Country where clinical trial is conducted

United Kingdom, 

References & Publications (7)

Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1.6 million participants. Lancet Child Adolesc Health. 2020 Jan;4(1):23-35. doi: 10.1016/S2352-4642(19)30323-2. Epub 2019 Nov 21. — View Citation

Matheson EL, Schneider J, Tinoco A, Gentili C, Silva-Breen H, LaVoi NM, White P, Diedrichs PC. The co-creation, initial piloting, and protocol for a cluster randomised controlled trial of a coach-led positive body image intervention for girls in sport. BM — View Citation

Neumark-Sztainer D, MacLehose RF, Watts AW, Pacanowski CR, Eisenberg ME. Yoga and body image: Findings from a large population-based study of young adults. Body Image. 2018 Mar;24:69-75. doi: 10.1016/j.bodyim.2017.12.003. Epub 2017 Dec 27. — View 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.

Sabiston, C., Pila, E., Vani, M., & Thogersen-Ntoumani, C. (2019). Body image, physical activity, and sport: A scoping review. Psychology Of Sport And Exercise, 42, 48-57. doi: 10.1016/j.psychsport.2018.12.010

Slater A, Tiggemann M. Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns. J Adolesc. 2011 Jun;34(3):455-63. doi: 10.1016/j.adolescence.2010.06.007. Epub 2010 Jul 31. — View 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. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Total acceptability of the intervention (assessed via a self-report questionnaire)	Girls and coaches will complete feasibility and acceptability measures via a self-report questionnaire. Firstly, girls and coaches will respond using a 1-5 scale (Strongly Disagree to Strongly Agree) on questions, such as: 1) The program was interesting; 2) The program was easy to understand; 3) The program was enjoyable; and 4) The program discussed things that are important to me. Secondly, girls and coaches will be able to provide further feedback using open-ended responses on questions such as: 1) What did you like about the program and why? 2) What would you change about the program and why? 3) What did you think about the design of the materials? 4) Please tell us anything else you think will help improve the program for girls.	Immediately after the intervention
Other	Total intervention fidelity (assessed via investigator observation of recorded intervention sessions)	Total intervention fidelity will be assessed by the investigators through observing the program sessions as delivered by coaches and completing a pre-determined checklist to ensure the program was delivered to girls as intended.	Immediately after the intervention
Other	Total intervention adherence (assessed through session completion)	Total intervention adherence will be assessed by the investigators as number of participants who complete the full intervention.	Immediately after the intervention
Primary	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	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)
Secondary	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)