The impacts of a justice-focused body image program for early adolescents

To address gaps in universal, diversity-focused eating disorders prevention with early adolescents, our team co-created an evidence-informed body image intervention through a community-engaged, participatory research process. The Body Justice intervention and associated research were co-created by a team of middle school students and staff and undergraduate students and faculty in the Pacific Northwest United States. The intervention includes eight brief lessons (six hours total) with culturally-tailored content rooted in cognitive dissonance and media literacy (e.g., cultural appearance ideals, diversity representation within media, food culture). The intervention was delivered with 7th grade students over three years (N = 333; 49% students of color; 53% cisgender boys, 36% cisgender girls, 12% gender diverse; 27% sexually diverse) using college student leaders (near peers) and middle school student co-leaders. Student satisfaction immediately after the intervention was moderate overall and higher for students of color, sexually diverse students, and cisgender girls and gender diverse students compared to their peers with majority identities. Across the sample, there was a significant reduction in unhealthy weight control behaviors from baseline to two-month follow-up with similar improvement among subgroups except for students of color, who had smaller reductions over time compared to their white peers. Across the sample, there was a significant reduction in internalized appearance norms from pre to post-intervention and through follow-up. These reductions were similar across gender, but the change was significant only for white students and straight students. There was no overall improvement in perceived appearance pressure from social media over time, but subgroup analyses revealed that students of color experienced improvement over time unlike other subgroups. In general, subgroup analyses should be interpreted cautiously due to concerns about adequate power. These results suggest that the Body Justice curriculum was delivered effectively and was well-liked by middle school students with marginalized identities. While aspects of the intervention were beneficial (e.g., a reduction in unhealthy weight control behaviors over time), findings suggest potentially differential results across identity subgroups. This has implications for collaborative school-based research, body image and eating disorders prevention, and community-engaged methods to foster equity.