Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-27T18:26:11.850Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of a School-Based Disordered Eating Prevention Program in Adolescent Girls: General and Specific Effects Depending on Adherence to the Interactive Activities

Published online by Cambridge University Press:  10 January 2013

Gemma López-Guimerà ,
David Sánchez-Carracedo ,
Jordi Fauquet ,
Mariona Portell  and
Rosa M. Raich
Gemma López-Guimerà*
Affiliation:
Universitat Autònoma de Barcelona (Spain)
David Sánchez-Carracedo
Affiliation:
Universitat Autònoma de Barcelona (Spain)
Jordi Fauquet
Affiliation:
Universitat Autònoma de Barcelona (Spain)
Mariona Portell
Affiliation:
Universitat Autònoma de Barcelona (Spain)
Rosa M. Raich
Affiliation:
Universitat Autònoma de Barcelona (Spain)
*
Correspondence concerning this article should be addressed to Gemma López-Guimerà. Dept. Psicología Clínica y de la Salud, Edificio B, Campus de la Universitat Autònoma de Barcelona. 08193 Bellaterra. Cerdanyola del Vallès. Barcelona. (Spain). Phone: +34-935813855, Fax: +34-935812125. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

This study assessed the impact of a school-based program aimed at preventing disordered eating. The program was based on the media-literacy approach and has interactive format. The program was assessed under strong methodological conditions. Seven schools with 263 Spanish adolescent girls in the area of Barcelona, were randomly assigned to either the complete prevention program condition, the partial program condition or the non-treatment control condition, and assessed at pre, post and 6-month follow-up. The program was effective in generating positive changes at follow-up. The effects sizes (ESd = 0.29 to ESd = 0.38) were greater, on average, than that obtained up to now in selective-universal programs, and similar or greater than that achieved by targeted prevention programs. The results indicate a greater and relevant effect size of the intervention in those participants who completed the inter-session interactive activities (ESd = 0.29 to ESd = 0.45) although the differences were not significant. These results suggest the importance of monitoring adherence to the activities in all programs defined as “interactive”. The implications and limitations of this study are discussed.

Este estudio evaluó el impacto de un programa basado en la escuela dirigido a prevenir las alteraciones del comportamiento alimentario. El programa se fundamentó en la perspectiva de alfabetización en medios de comunicación, tiene un formato interactivo y fue evaluado mediante rigurosas condiciones metodológicas. La muestra del estudio estaba constituida por 263 chicas adolescentes procedentes de siete escuelas del área geográfica de Barcelona, que fueron asignadas aleatoriamente a la condición de programa completo, a la condición de programa parcial o a la condición de grupo control sin tratamiento. La evaluación se realizó en tres momentos: pre, post y seis meses de seguimiento. El programa se ha mostrado eficaz produciendo cambios favorables en el seguimiento. Los tamaños del efecto (ESd = 0.29 a ESd = 0.38), en promedio, son superiores a los obtenidos por programas universal-selectivos, y similares o superiores a los obtenidos por programas de prevención dirigida. Los resultados indican un mayor tamaño del efecto de la intervención en los participantes que completaron las actividades interactivas entre sesiones (ESd = 0.29 a ESd = 0.45), aunque las diferencias no fueron estadísticamente significativas. Estos resultados sugieren la importancia de monitorizar la adhesión a las actividades en los programas definidos como “interactivos”. Se discuten las implicaciones y las limitaciones de este estudio.

Keywords

disorders eatingthinness idealadolescent girlsschool-based programalteraciones alimentariasideal de delgadezchicas adolescentesprogramas basados en la escuela
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 14 , Issue 1 , May 2011 , pp. 293 - 303
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agras, W. S. (2001). The consequences and costs of the eating disorders. The Psychiatric Clinics of North America, 24(2), 371–379. doi:10.1016/S0193-953X(05)70232-XCrossRefGoogle ScholarPubMed
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Becker, C. B., Ciao, A. C., & Smith, L. M. (2008). Moving from efficacy to effectiveness in eating disorders prevention: The sorority body image program. Cognitive and Behavioral Practice, 15(1), 18–27. doi:10.1016/j.cbpra.2006.07.006CrossRefGoogle Scholar
Carr, A. (2002). Conclusions. In Carr, A. (Ed.): Prevention: What works with children and adolescents? (pp. 359–372). Hove, UK: Brunner-Routledge.Google Scholar
Castro, J., Toro, J., Salamero, M., & Guimerá, E. (1991). The eating attitudes test: Validation of the Spanish version. Psychological Assessment, 7(2), 175–190.Google Scholar
Cattarin, J. A., Thompson, J. K., Thomas, C., & Williams, R. (2000). Body image, mood, and televised images of attractiveness: The role of social comparison. Journal of Social and Clinical Psychology, 19(2), 220–239. doi:10.1521/jscp.2000.19.2.220CrossRefGoogle Scholar
Center for Media Literacy. (2003). Literacy for the 21st century. An overview & orientation guide to media literacy education. Retrieved from: http://www.medialit.org/sites/default/files/01_MLKorientation.pdf.Google Scholar
Chamay-Weber, C., Narring, F., & Michaud, P. A. (2005). Partial eating disorders among adolescents: A review. Journal of Adolescent Health, 37(5), 417–427. doi:10.1016/j.jadohealth.2004.09.014CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Cole, T. J., Bellizzi, M. C., Flegal, K. M., & Dietz, W. H. (2000). Establishing a standard definition for child overweight andobesity worldwide: international survey. British Medical Journal, 320, 1240–1243. doi:10.1136/bmj.320.7244.1240CrossRefGoogle Scholar
Cole, T. J., Flegal, K. M., Nicholls, D., & Jackson, A. A. (2007). Body mass index cut offs to define thinness in children and adolescents: international survey. British Medical Journal, 335, 194–197. doi: 10.1136/bmj.39238.399444.55CrossRefGoogle ScholarPubMed
Fairburn, C. G., Cooper, Z., Doll, H. A., Norman, P., & O'Connor, M. (2000). The natural course of bulimia nervosa and binge eating disorder in young women. Archives of General Psychiatry, 57(7), 659–665. doi:10.1001/archpsyc.57.7.659CrossRefGoogle ScholarPubMed
Fingeret, M. C., Warren, C. S., Cepeda-Benito, A., & Gleaves, D. H. (2006). Eating disorder prevention research: A meta-analysis. Eating Disorders, 14(3), 191–213. doi:10.1080/10640260600638899CrossRefGoogle Scholar
Garner, D. M., & Garfinkel, P. E. (1979). The eating attitudes test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273–279. doi:0033/2917/79/2828-4060CrossRefGoogle ScholarPubMed
Grissom, R. J., & Kim, J. J. (2005). Effect sizes for research. London: Lawrence Erlbaum Associates, Publishers.Google Scholar
Grupo de Trabajo de la Guía de Práctica Clínica sobre Trastornos de la Conducta Alimentaria(2009). Guía de Práctica Clínica sobre Trastornos de la Conducta Alimentaria. [Clinical practice guideline on eating disorders]. Madrid: Plan de Calidad para el sistema Nacional de Salud del Ministerio de Sanidad y Consumo.Google Scholar
Judd, C. M., & Kenny, D. A. (1981). Estimating the effects of social interventions. Cambridge, MA: Cambridge University Press.Google Scholar
Levine, M. P., & Smolak, L. (2006). The prevention of eating problems and eating disorders: Theory, research, and practice. Mahwah, NJ: Lawrence Erlbaum Associates.CrossRefGoogle Scholar
Lewinsohn, P. M., Striegel-Moore, R. H., & Seeley, J. R. (2000). Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 39(10), 1284–1292. doi:10.1097/00004583-200010000-00016CrossRefGoogle ScholarPubMed
Littleton, H. L., & Ollendick, T. (2003). Negative body image and disordered eating behavior in children and adolescents: What places youth at risk and how can these problems be prevented? Clinical Child and Family Psychology Review, 6(1), 51–66.doi:1096-4037/03/0300-0051/0CrossRefGoogle ScholarPubMed
López-Guimerà, G., & Sánchez-Carracedo, D. (2010). Prevención de las alteraciones alimentarias: Fundamentos teóricos y recursos prácticos. [Disordered eating prevention: Theoretical basis and practical resources]. Madrid: Pirámide.Google Scholar
López-Guimerà, G., Levine, M. P., Sánchez-Carracedo, D., & Fauquet, J. (2010). Influence of mass media on body image and eating disordered attitudes and behaviors in females: a review of effects and processes. Media Psychology, 13, 387–416. doi: 10.1080/15213269.2010.525737CrossRefGoogle Scholar
López-Guimerà, G., Fauquet, J., Portell, M., Sánchez-Carracedo, D., & Raich, R. M. (2008). Dieting in Spanish adolescent girls. European Eating Disorders Review, 16(3), 234–240. doi:10.1002/erv.831CrossRefGoogle ScholarPubMed
Manly, B. F. J. (1992). The design and analysis of research studies. New York, NY: Cambidge University Press.CrossRefGoogle Scholar
Martinez-Gonzalez, M. A., Gual, P., Lahortiga, F., Alonso, Y., de Irala-Estevez, J., & Cervera, S. (2003). Parental factors, mass media influences, and the onset of eating disorders in a prospective population-based cohort. Pediatrics, 111(2), 315–320. doi:10.1542/peds.111.2.315CrossRefGoogle Scholar
Moher, D., Schulz, K. F., & Altman, D. G. (2001). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials. Annals of Internal Medicine, 134(8), 657–662.CrossRefGoogle Scholar
Morris, M. L., & Katzman, D. K. (2003). The impact of the media on eating disorders in children and adolescents. Paediatrics and Child Health, 8, 287–289.CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D., Levine, M. P., Paxton, S. J., Smolak, L., Piran, N., & Wertheim, E. H. (2006). Prevention of body dissatisfaction and disordered eating: What next? Eating Disorders, 14(4), 265–285. doi:10.1080/10640260600796184CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D., Sherwood, N. E., Coller, T., & Hannan, P. J. (2000). Primary prevention of disordered eating among preadolescent girls: Feasibility and short-term effect of a community-based intervention. Journal of the American Dietetic Association, 100(12), 1466–1473. doi:10.1016/S0002-8223(00)00410-7CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D., Wall, M., Guo, J., Story, M., Haines, J., & Eisenberg, M. (2006). Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? Journal of the American Dietetic Association, 106(4), 559–568. doi:10.1016/j.jada.2006.01.003CrossRefGoogle Scholar
Neumark-Sztainer, D., Wall, M., Story, M., & Perry, C. L. (2003). Correlates of unhealthy weight-control behaviors among adolescents: Implications for prevention programs. Health Psychology, 22(1), 88–98. doi:10.1037/0278-6133.22.1.88CrossRefGoogle ScholarPubMed
Newman, D. L., Moffitt, T. E., Caspi, A., Magdol, L., Silva, P. A., & Stanton, W. R. (1996). Psychiatric disorder in a birth cohort of young adults: Prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. Journal of Consulting and Clinical Psychology, 64(3), 552–562. doi:10.1037/0022-006X.64.3.552CrossRefGoogle Scholar
Peláez Fernandez, M. A., Labrador, F. J., & Raich, R. M. (2007). Prevalence of eating disorders among adolescent and young adult scholastic population in the region of Madrid (Spain). Journal of Psychosomatic Research, 62(6), 681–690. doi:10.1016/j.jpsychores.2006.12.010CrossRefGoogle Scholar
Pratt, B. M., & Woolfenden, S. R. (2002). Interventions for preventing eating disorders in children and adolescents. Cochrane Database of Systematic Reviews, 2. doi:10.1002/14651858.CD002891Google Scholar
Raich, R. M., Sánchez-Carracedo, D., & López-Guimerà, G. (2008). Alimentación, modelo estético femenino y medios de comunicación. Cómo formar alumnos críticos en educación secundaria. [Eating, feminine beauty ideal and the media. How to train secondary school students to be critical]. (2nd ed.). Barcelona: Graó.Google Scholar
Raich, R. M., Sánchez-Carracedo, D., López-Guimerà, G., Portell, M., Moncada, A., & Fauquet, J. (2008). A controlled assessment of school-based preventive programs for reducing eating disorder risk factors in adolescent Spanish girls. Eating Disorders, 16(3), 255–272. doi:10.1080/10640260802016852CrossRefGoogle ScholarPubMed
Rojo, L., Livianos, L., Conesa, L., García, A., Domínguez, A., Rodrigo, G., … Vila, M. (2003). Epidemiology and risk factors of eating disorders: A two-stage epidemiologic study in a Spanish population aged 12-18 years. The International Journal of Eating Disorders, 34(3), 281–291. doi:10.1002/eat.10179CrossRefGoogle Scholar
Shapiro, S. S., Wilk, M. B., & Chen, H. J. (1968). A comparative study of various tests for normality. Journal of the American Statistical Association, 63(324), 1343–1372. doi:10.2307/2285889CrossRefGoogle Scholar
Stice, E., & Shaw, H. (2004). Eating disorder prevention programs: A meta-analytic review. Psychological Bulletin, 130(2), 206–227. doi:10.1037/00332909.130.2.206CrossRefGoogle ScholarPubMed
Stice, E., Shaw, H., & Marti, C. N. (2007). A meta-analytic review of eating disorder prevention programs: Encouraging findings. Annual Review of Clinical Psychology, 3, 207–231. doi:10.1146/annurev.clinpsy.3.022806.091447CrossRefGoogle ScholarPubMed
Thompson, J. K., & Stice, E. (2001). Thin-ideal internalization: Mounting evidence for a new risk factor for body-image disturbance and eating pathology. Current Directions in Psychological Science, 10(5), 181–183. doi:10.1111/1467-8721.00144CrossRefGoogle Scholar
Thompson, J. K., van den Berg, P., Roehrig, M., Guarda, A., & Heinberg, L. (2004). The Sociocultural Attitudes Towards Appearance Scale-3 (SATAQ-3): Development and Validation. International Journal of Eating Disorders, 35(3), 293–304. doi:10.1002/eat.10257CrossRefGoogle ScholarPubMed
Toro, J., Salamero, M., & Martinez, E. (1994). Assessment of sociocultural influences on the aesthetic body shape model in anorexia nervosa. Acta Psychiatrica Scandinavica, 89(3), 147–151. doi:10.1111/j.1600-0447.1994.tb08084.xCrossRefGoogle ScholarPubMed
Wade, T. D., Davidson, S., & O'Dea, J. A. (2003). A preliminary controlled evaluation of a school-based media literacy program and self-esteem program for reducing eating disorder risk factors. International Journal of Eating Disorders, 33(4), 371–383. doi:10.1002/eat.10136CrossRefGoogle ScholarPubMed
Wilcox, R. R. (2003). Applying contemporary statistical techniques. New York, NY: Academic Press.Google Scholar
Wilksch, S. M., Durbridge, M. R., & Wade, T. D. (2008). A preliminary controlled comparison of programs designed to reduce risk of eating disorders targeting perfectionism and media literacy. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 939–947. doi:10.1097/ CHI.0b013e3181799f4aCrossRefGoogle ScholarPubMed