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      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

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          Abstract

          Background

          Globally, girls disengage from sports at an earlier age and higher rate than boys. This is, in part, due to the unique body image challenges that girls face, relative to their male peers. Existing intervention efforts that aim to reduce girls’ negative body image and movement experiences have proven marginally effective, if not ineffective. This paper outlines the co-creation, initial piloting and protocol for a cluster randomised controlled trial of Body Confident Athletes (BCA); an in-person, coach-led intervention that aims to foster positive body image and sports enjoyment among girls.

          Methods

          Following co-creation and an initial pilot, a two-armed cluster randomised controlled trial will assess the immediate (post-intervention) and short-term (1-month and 3-month follow-up) impact of BCA on girls’ ( N = 1,036; 11–17 years old) body image, sports enjoyment, and affect. Sport organisations will be randomly allocated (1:1) into either an intervention or waitlist control condition. Girls and coaches in the intervention condition will complete three 60-minute sessions over three consecutive weeks. The primary outcome will be the immediate change in girls’ body esteem, with secondary outcomes assessing the immediate and short-term changes in girls’ body appreciation, self-objectification, attuned self-care, sports enjoyment, and affect.

          Discussion

          This research is the first to utilise an international multi-stakeholder partnership to co-create and evaluate an intervention that addresses the intersection of girls’ body image and sport experiences. The theoretical and methodological considerations of this research have led to a feasible intervention and trial protocol, and if proven effective, BCA may assist in reducing the global gender disparity in sports participation.

          Trial registration number

          NCT05594524, registered 25 th October 2022.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-023-16360-w.

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          Most cited references44

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          How we design feasibility studies.

          Deborah Bowen, Matthew K Kreuter, Bonnie Spring … (2009)
          Public health is moving toward the goal of implementing evidence-based interventions. To accomplish this, there is a need to select, adapt, and evaluate intervention studies. Such selection relies, in part, on making judgments about the feasibility of possible interventions and determining whether comprehensive and multilevel evaluations are justified. There exist few published standards and guides to aid these judgments. This article describes the diverse types of feasibility studies conducted in the field of cancer prevention, using a group of recently funded grants from the National Cancer Institute. The grants were submitted in response to a request for applications proposing research to identify feasible interventions for increasing the utilization of the Cancer Information Service among underserved populations.
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            The Body Appreciation Scale-2: item refinement and psychometric evaluation.

            Nichole L Wood-Barcalow, Tracy Tylka (2015)
            Considered a positive body image measure, the 13-item Body Appreciation Scale (BAS; Avalos, Tylka, & Wood-Barcalow, 2005) assesses individuals' acceptance of, favorable opinions toward, and respect for their bodies. While the BAS has accrued psychometric support, we improved it by rewording certain BAS items (to eliminate sex-specific versions and body dissatisfaction-based language) and developing additional items based on positive body image research. In three studies, we examined the reworded, newly developed, and retained items to determine their psychometric properties among college and online community (Amazon Mechanical Turk) samples of 820 women and 767 men. After exploratory factor analysis, we retained 10 items (five original BAS items). Confirmatory factor analysis upheld the BAS-2's unidimensionality and invariance across sex and sample type. Its internal consistency, test-retest reliability, and construct (convergent, incremental, and discriminant) validity were supported. The BAS-2 is a psychometrically sound positive body image measure applicable for research and clinical settings.
            Article 0 comments Cited 206 times – based on 0 reviews     Review now
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              What is and what is not positive body image? Conceptual foundations and construct definition

              Tracy Tylka, Nichole L Wood-Barcalow (2015)
              A decade ago, research on positive body image as a unique construct was relatively nonexistent, and now this area is flourishing. How and why did positive body image scholarship emerge? What is known about this contemporary construct? This article situates and contextualizes positive body image within Cash's scholarship, eating disorder prevention efforts, feminist influences, strength-based disciplines within psychology, and Buddhism. Extracting insights from quantitative and qualitative research, this article demonstrates that positive body image is (a) distinct from negative body image; (b) multifaceted (including body appreciation, body acceptance/love, conceptualizing beauty broadly, adaptive investment in appearance, inner positivity, interpreting information in a body-protective manner); (c) holistic; (d) stable and malleable; (e) protective; (f) linked to self-perceived body acceptance by others; and (g) shaped by social identities. Complementing what positive body image is, this article further details what positive body image is not to provide a more nuanced understanding of this construct.
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                Author and article information

                Contributors
                E. L. Matheson: emily.matheson@uwe.ac.uk
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 31 July 2023
                Publication date PMC-release: 31 July 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 1467
                Affiliations
                [1 ]GRID grid.6518.a, ISNI 0000 0001 2034 5266, Centre for Appearance Research, School of Social Sciences, College of Health, Science and Society, , University of the West of England, ; Coldharbour Lane, Bristol, BS16 1QY UK
                [2 ]GRID grid.268154.c, ISNI 0000 0001 2156 6140, Department of Sport, Exercise, and Performance Psychology, , West Virginia University, ; Morgantown, WV 26506 USA
                [3 ]GRID grid.17635.36, ISNI 0000000419368657, Tucker Center for Research on Girls & Women in Sport, , University of Minnesota, ; 1900 University Avenue SE, Minneapolis, MN 55455 USA
                Article
                Publisher ID: 16360
                DOI: 10.1186/s12889-023-16360-w
                PMC ID: 10391850
                PubMed ID: 37525161
                SO-VID: 3440f8c9-d197-49cb-8551-e1bff657c43e
                Copyright © © The Author(s) 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 25 January 2023
                Date accepted : 20 July 2023
                Funding
                Funded by: Dove, Unilever
                Award ID: RHSS0180
                Award ID: RHSS0180
                Award ID: RHSS0180
                Award ID: RHSS0180
                Award ID: RHSS0180
                Award Recipient :
                Funded by: Nike Inc
                Award ID: CON000000089960
                Award ID: CON000000089960
                Award Recipient :
                Categories
                Subject: Study Protocol
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2023

                ScienceOpen disciplines: Public health
                Keywords: adolescent,girls,body image,sports participation,intervention development,cluster randomised controlled trial,study protocol
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: adolescent, girls, body image, sports participation, intervention development, cluster randomised controlled trial, study protocol

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