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.
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.