Evaluating a school-based body image lesson in Indonesia: A randomised controlled trial

Area of Science:

• Public Health
• Psychology
• Education

Background:

• Negative body image is a significant global public health issue affecting adolescents.
• School-based interventions are crucial for addressing adolescent body image concerns in diverse settings.

Purpose of the Study:

• To evaluate the effectiveness, implementation fidelity, and acceptability of a single-session, school-based universal body image intervention in Indonesia.
• To assess the impact of intervention delivery mode (online vs. in-person) on adolescent body image outcomes.

Main Methods:

• A two-arm, open parallel cluster randomized controlled trial involving 1926 adolescents and 12 school guidance counselors across nine Indonesian secondary schools.
• Intervention delivered in-person and online due to the COVID-19 pandemic.
• Assessed body image and secondary outcomes, implementation fidelity, and intervention acceptability.

Main Results:

• The intervention did not significantly improve adolescent body image or secondary outcomes compared to the control group.
• No significant differences in effectiveness were found based on gender or delivery mode (online vs. in-person).
• Implementation fidelity varied, and while content was acceptable, in-person delivery was preferred.

Conclusions:

• The evaluated single-session intervention was not effective in improving adolescent body image in this Indonesian context.
• Findings suggest that future school-based body image programs in low- and middle-income countries should consider lessons learned regarding delivery and fidelity.
• Further research is needed to develop effective strategies for supporting adolescent body image in diverse educational settings.