The co-creation, initial piloting, and protocol for a cluster randomised controlled trial of a coach-led positive body image intervention for girls in sport

E L Matheson, J Schneider, A Tinoco, C Gentili, H Silva-Breen, N M LaVoi, P White, P C Diedrichs, E L Matheson, J Schneider, A Tinoco, C Gentili, H Silva-Breen, N M LaVoi, P White, P C Diedrichs

Abstract

Background: Globally, girls disengage from sports at an earlier age and higher rate than boys. This is, in part, due to the unique body image challenges that girls face, relative to their male peers. Existing intervention efforts that aim to reduce girls' negative body image and movement experiences have proven marginally effective, if not ineffective. This paper outlines the co-creation, initial piloting and protocol for a cluster randomised controlled trial of Body Confident Athletes (BCA); an in-person, coach-led intervention that aims to foster positive body image and sports enjoyment among girls.

Methods: Following co-creation and an initial pilot, a two-armed cluster randomised controlled trial will assess the immediate (post-intervention) and short-term (1-month and 3-month follow-up) impact of BCA on girls' (N = 1,036; 11-17 years old) body image, sports enjoyment, and affect. Sport organisations will be randomly allocated (1:1) into either an intervention or waitlist control condition. Girls and coaches in the intervention condition will complete three 60-minute sessions over three consecutive weeks. The primary outcome will be the immediate change in girls' body esteem, with secondary outcomes assessing the immediate and short-term changes in girls' body appreciation, self-objectification, attuned self-care, sports enjoyment, and affect.

Discussion: This research is the first to utilise an international multi-stakeholder partnership to co-create and evaluate an intervention that addresses the intersection of girls' body image and sport experiences. The theoretical and methodological considerations of this research have led to a feasible intervention and trial protocol, and if proven effective, BCA may assist in reducing the global gender disparity in sports participation.

Trial registration number: NCT05594524 , registered 25th October 2022.

Keywords: Adolescent; Body image; Cluster randomised controlled trial; Girls; Intervention development; Sports participation; Study protocol.

Conflict of interest statement

This research was externally funded by two commercial funders (Dove Self-Esteem Project, Unilever and Nike Inc). PCD is an independent consultant for Dove (Unilever). PCD and ELM are independent consultants for Nike Inc. The remaining authors declare that they have no other conflicts of interest in relation to this work.

© 2023. The Author(s).

Figures

Fig. 1
Fig. 1
The main trial research design according to the Consolidated Standards of Reporting Trials (CONSORT)
Fig. 2
Fig. 2
Screenshots of the Body Confident Athletes materials including the coaches’ session guide (a), presentation deck (b), and athletes’ workbook (c)

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