Evaluation of the Impact of a Comic-based Programme to Promote Body Confidence Among Adolescents in India

Summary

Body dissatisfaction is a leading concern for young people and can have serious health consequences. Emerging approaches for improving body image are effective among adolescents in the school setting. However, the majority of trials are conducted in high-income westernised countries, despite body dissatisfaction being increasingly recognised as a global concern. As such, it is important to develop and disseminate interventions to promote body confidence among adolescents in in low-to-middle income countries, too.

One country where body image concerns are becoming an increasing issue is India. The investigators recently finished developing and evaluating a body image programme among adolescents in New Delhi, India; which found immediate and 3-month improvements in body image, disordered eating, self-esteem, and other related outcomes. Whilst these findings offer an effective body image programme for school students in urban areas of India, this may not be feasible for schools in more rural and lower socio-economic areas in India.

The aim of the present study is therefore to conduct an acceptability study, followed by a randomised controlled trial (RCT), of a comics-based body image programme among adolescents in a semi-rural area of India (Rajasthan), in order to understand its acceptability, feasibility, and preliminary efficacy. This comic-based programme will be based on Dove Confident Me, which was found to be effective among adolescents in Delhi, India.

To assess the acceptability of the comic-book-based programme, interviews and focus groups will be conducted with students and teachers. This in-depth feedback will be used to optimise the programme. Next, an RCT will compare body image and well-being of students who take part in the programme to students who do not take part (classes as usual) to examine the programme's efficacy. The investigators will recruit students and teachers from schools in a rural and lower socio-economic area of India (Rajasthan). Students will complete questionnaire assessments of body image and well-being before and after the 6-session intervention (across 4 weeks), and again at 3-month follow-up to assess longer-term benefits.

It is hypothesised that students who receive the intervention will have better body image and wellbeing relative to the control group at both post-intervention and follow-up.

Conditions

• Body Image
• Eating Disorder Symptom

Interventions

BEHAVIORAL

AdhaFULL body image comics

The comics were co-created with the expertise of four stakeholders: the investigators, UNICEF, BBC Media Action, and the Dove Self-Esteem Project. There are six different comics, which target issues relating to gender stereotypes and appearance concerns amongst adolescents in rural India. Based on 'Dove Confident Me', each comic tells a story which targets a specific established risk factor for body dissatisfaction. Specifically, they focus on gender prejudice (Comic 1), societal appearance ideals (Comic 2), media literacy (Comic 3), appearance comparisons (Comic 4), appearance-related conversations and teasing (Comic 5), and promoting 'body activism' (Comic 6). In each session, students will read the respective comic as a class. At the end of each comic, the teacher will facilitate one or two activities with the students based on the key learnings from the comics. These activities will encourage students to think critically about what they have read and consolidate their learning.

Sponsors & Collaborators

• Unilever R&D

  collaborator INDUSTRY

• UNICEF

  collaborator OTHER

• BBC

  collaborator UNKNOWN

• University of the West of England

  lead OTHER

Principal Investigators

• Phillippa C Diedrichs, PhD · University of the West of England

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

11 Years

Max Age

14 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2022-03-01

Primary Completion

2022-12-15

Completion

2022-12-15

Countries

• United Kingdom

Study Locations