Digital Interventions for Improving Body Dissatisfaction in Children and Emerging Adults: Systematic Review and Meta-Analysis.

Abstract

Background: Body dissatisfaction is a condition where individuals are dissatisfied with their physical appearance. It has become a global issue, especially among children and emerging adults. A growing number of digital interventions have been developed to address body dissatisfaction in children and emerging adults; however, controversies remain regarding their efficacy, underscoring the need for a comprehensive synthesis of current evidence.

Objective: This systematic review aimed to explore the effectiveness of digital interventions in improving body image-related outcomes among children and emerging adults.

Methods: From inception to April 24, 2024, a literature search was performed across 7 databases-PubMed, Web of Science, MEDLINE, EBSCO (Elton B Stephens Company), Cochrane Library, CNKI (China National Knowledge Infrastructure), and WANFANG-to identify randomized controlled trials (RCTs) with a predefined set of inclusion criteria. This systematic review was reported in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Study selection, data extraction, and risk of bias assessment using the Cochrane Risk-of-Bias Tool 2.0 were conducted independently by 2 researchers. Standardized mean differences (SMDs) and 95% CIs from the included RCTs were calculated for the meta-analysis. Heterogeneity was assessed with I² values. A fixed-effects model was used when I²≤50%, and a random-effects model was selected when I²>50%.

Results: Twenty RCTs with 5251 participants (2610 in intervention groups and 2641 in control groups) met the inclusion criteria. Digital interventions included web pages, mobile apps, computer-based videos, computer-based sessions, internet-based sessions, internet games, chatbots, podcasts, and social media. Our results indicate that digital interventions could significantly improve body dissatisfaction (SMD=0.38, 95% CI -0.63 to -0.13; I2=55%; P=.003), physical appearance comparison (SMD=-0.24, 95% CI -0.45 to -0.03; I2=0%; P=.003), thin-ideal internalization (SMD=-0.28, 95% CI -0.36 to -0.2; I2=41%; P<.001), self-esteem (SMD=0.14, 95% CI 0.07-0.21; I2=21%; P<.001), self-compassion (SMD=0.55, 95% CI 0.33-0.78; I2=35%; P<.001), and depression (SMD=-0.59, 95% CI -0.97 to -0.21; I2=0%; P=.002), with small to medium effect sizes.

Conclusions: While digital interventions improved body dissatisfaction among children and emerging adults, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the effectiveness of digital interventions on body dissatisfaction.