Improving body image at scale among Brazilian adolescents: study protocol for the co-creation and randomised trial evaluation of a chatbot intervention

E L Matheson, H G Smith, A C S Amaral, J F F Meireles, M C Almeida, G Mora, C Leon, G Gertner, N Ferrario, L Suarez Battan, J Linardon, M Fuller-Tyszkiewicz, P C Diedrichs, E L Matheson, H G Smith, A C S Amaral, J F F Meireles, M C Almeida, G Mora, C Leon, G Gertner, N Ferrario, L Suarez Battan, J Linardon, M Fuller-Tyszkiewicz, P C Diedrichs

Abstract

Background: Body image concerns are prevalent among Brazilian adolescents and can lead to poor psychological and physical health. Yet, there is a scarcity of culturally-appropriate, evidence-based interventions that have been evaluated and made widely available. Chatbot technology (i.e., software that mimics written or spoken human speech) offers an innovative method to increase the scalability of mental health interventions for adolescents. The present protocol outlines the co-creation and evaluation of a body image chatbot for Brazilian adolescents via a partnership between academics, industry organisations and the United Nations Children's Fund (UNICEF).

Methods: A two-armed fully remote randomised controlled trial will evaluate the chatbot's effectiveness at improving body image and well-being. Adolescent girls and boys (N = 2800) aged 13-18 years recruited online will be randomly allocated (1:1) into either: 1) a body image chatbot or 2) an assessment-only control condition. Adolescents will engage with the chatbot over a 72-hour period on Facebook Messenger. Primary outcomes will assess the immediate and short-term impact of the chatbot on state- and trait-based body image, respectively. Secondary outcomes will include state- and trait-based affect, trait self-efficacy and treatment adherence.

Discussion: This research is the first to develop an evidence-informed body image chatbot for Brazilian adolescents, with the proposed efficacy trial aiming to provide support for accessible, scalable and cost-effective interventions that address disparities in body image prevalence and readily available resources.

Trial registration number: NCT04825184 , registered 30th March 2021.

Keywords: Adolescent; Body image; Brazil; Chatbot; Low- and middle-income countries; Mental health; Micro-intervention; Randomised controlled trial; Study protocol.

Conflict of interest statement

This research was externally funded by a commercial funder (Dove Self-Esteem Project; Unilever). PD is an independent consultant to the Dove Self-Esteem Project global education initiative. PD was on the Dove Self-Esteem Project Global Advisory Board from 2013 to 2016. The authors declare no other conflicts of interest in relation to this work.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
The research design according to the CONSORT EHealth guidelines
Fig. 2
Fig. 2
Schedule of enrolment, interventions, and assessments according to the SPIRIT guidelines

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