A comic-based body image intervention for adolescents in semi-rural Indian schools: A randomised controlled trial

IF 5.3 1区心理学 Q1 PSYCHOLOGY, CLINICAL

International Journal of Clinical and Health Psychology Pub Date : 2025-01-01 DOI:10.1016/j.ijchp.2025.100546

Helena Lewis-Smith , Latika Ahuja , Farheen Hasan , Caterina Gentili , Paul White , Phillippa C. Diedrichs

{"title":"A comic-based body image intervention for adolescents in semi-rural Indian schools: A randomised controlled trial","authors":"Helena Lewis-Smith , Latika Ahuja , Farheen Hasan , Caterina Gentili , Paul White , Phillippa C. Diedrichs","doi":"10.1016/j.ijchp.2025.100546","DOIUrl":null,"url":null,"abstract":"<div><div>Adolescents in India experience body dissatisfaction and its associated adverse impacts on physical and mental health and gender equality. However, evidence-based interventions are scarce. Mental health interventions worldwide have traditionally relied upon delivery by expert providers. However, this prevents scalability, particularly in rural settings, where resources are often lacking. Therefore, this study evaluated the efficacy of a low-resource teacher-delivered mixed-gender comic-based body image intervention among adolescents in semi-rural Indian schools. A randomised controlled trial was conducted among 2631 students (50 % girls; classes 6 to 8; <u>M</u>age = 12.03 years, <em>SD</em> = 1.22) across 41 schools around the Jaipur district in Rajasthan. Each school was randomly allocated to receive six comic-based intervention sessions (<em>n</em> = 1347) or lessons-as-usual (<em>n</em> = 1284; control). The primary outcome of body esteem and related secondary and exploratory outcomes assessing mental health and gender stereotyping were assessed at baseline, 1 week-post-intervention, and 3-months follow-up (ClinicalTrials.gov, NCT04317755). Linear Mixed Model analyses revealed that compared to the control group, intervention students reported significantly higher body esteem and skin shade satisfaction, and significantly lower eating pathology, internalisation of appearance ideals, and gender stereotyping, with all effects maintained at follow-up. Compared to control group, boys in the intervention group also demonstrated significantly higher body image-related life engagement and body hair satisfaction at follow-up. Both students and teachers indicated high intervention acceptability via quantitative and qualitative findings. These findings present the first effective teacher-delivered school-based body image intervention in India, which can be implemented at scale using minimal resources, and thus indicates promise regarding broader dissemination across urban and rural settings.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 1","pages":"Article 100546"},"PeriodicalIF":5.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical and Health Psychology","FirstCategoryId":"102","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1697260025000043","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Adolescents in India experience body dissatisfaction and its associated adverse impacts on physical and mental health and gender equality. However, evidence-based interventions are scarce. Mental health interventions worldwide have traditionally relied upon delivery by expert providers. However, this prevents scalability, particularly in rural settings, where resources are often lacking. Therefore, this study evaluated the efficacy of a low-resource teacher-delivered mixed-gender comic-based body image intervention among adolescents in semi-rural Indian schools. A randomised controlled trial was conducted among 2631 students (50 % girls; classes 6 to 8; Mage = 12.03 years, SD = 1.22) across 41 schools around the Jaipur district in Rajasthan. Each school was randomly allocated to receive six comic-based intervention sessions (n = 1347) or lessons-as-usual (n = 1284; control). The primary outcome of body esteem and related secondary and exploratory outcomes assessing mental health and gender stereotyping were assessed at baseline, 1 week-post-intervention, and 3-months follow-up (ClinicalTrials.gov, NCT04317755). Linear Mixed Model analyses revealed that compared to the control group, intervention students reported significantly higher body esteem and skin shade satisfaction, and significantly lower eating pathology, internalisation of appearance ideals, and gender stereotyping, with all effects maintained at follow-up. Compared to control group, boys in the intervention group also demonstrated significantly higher body image-related life engagement and body hair satisfaction at follow-up. Both students and teachers indicated high intervention acceptability via quantitative and qualitative findings. These findings present the first effective teacher-delivered school-based body image intervention in India, which can be implemented at scale using minimal resources, and thus indicates promise regarding broader dissemination across urban and rural settings.

查看原文本刊更多论文

基于漫画的身体形象干预在印度半农村学校的青少年：一项随机对照试验

印度青少年对自己的身体不满意，并因此对身心健康和性别平等产生不利影响。然而，基于证据的干预措施很少。世界各地的精神卫生干预措施传统上依赖于由专家提供服务。然而，这阻碍了可扩展性，特别是在缺乏资源的农村环境中。因此，本研究评估了低资源教师提供的基于混合性别漫画的身体形象干预在半农村印度学校青少年中的效果。一项随机对照试验在2631名学生中进行(50%为女生；第六至第八类；法师= 12.03岁，SD = 1.22)，横跨拉贾斯坦邦斋浦尔地区的41所学校。每所学校被随机分配接受六个基于漫画的干预课程（n = 1347）或照常上课(n = 1284；控制)。在基线、干预后1周和3个月的随访中评估身体自尊的主要结果以及评估心理健康和性别刻板印象的相关次要和探索性结果（ClinicalTrials.gov, NCT04317755）。线性混合模型分析显示，与对照组相比，干预学生报告的身体自尊和肤色满意度显著提高，饮食病理、外表理想内化和性别刻板印象显著降低，所有这些影响在随访中保持不变。与对照组相比，干预组男生在随访中也表现出更高的身体形象相关生活投入和体毛满意度。通过定量和定性的调查结果，学生和教师对干预的接受度都很高。这些发现是印度第一个有效的由教师提供的以学校为基础的身体形象干预，可以使用最少的资源进行大规模实施，因此表明了在城市和农村环境中更广泛传播的希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Clinical and Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

10.70

自引率

5.70%

发文量

审稿时长

33 days

期刊介绍： The International Journal of Clinical and Health Psychology is dedicated to publishing manuscripts with a strong emphasis on both basic and applied research, encompassing experimental, clinical, and theoretical contributions that advance the fields of Clinical and Health Psychology. With a focus on four core domains—clinical psychology and psychotherapy, psychopathology, health psychology, and clinical neurosciences—the IJCHP seeks to provide a comprehensive platform for scholarly discourse and innovation. The journal accepts Original Articles (empirical studies) and Review Articles. Manuscripts submitted to IJCHP should be original and not previously published or under consideration elsewhere. All signing authors must unanimously agree on the submitted version of the manuscript. By submitting their work, authors agree to transfer their copyrights to the Journal for the duration of the editorial process.