Body Confident Athletes: Acceptability Testing of a Coach-Led Body Image Intervention for Adolescent Girls in Sport

According to the World Health Organization, only 15% of 11-17-year-old girls meet the recommended daily physical movement guidelines (e.g., 60-minutes per day). Despite extensive research highlighting the protective factors associated with sport on both mental and physical health, body image concerns are a key barrier to girls' participation in and enjoyment of sport. Sports-related environments and society more broadly further exacerbate these concerns through harmful gender stereotypes that perpetuate female objectification, discrimination, and harassment. This includes the promotion of unrealistic and sexualized appearances of female athletes, uncomfortable and objectifying uniforms, and appearance and competence-related teasing from male and female peers, as well as coaches.

The magnitude of this issue and how best to address it, can be understood from a socioecological perspective. Researchers suggest developing multi-faceted and multi-tiered approaches that have scope for targeting the individual, interpersonal, organizational, and societal levels. The current research will test the first coach delivered embodying sports program for girls that will be implemented through sporting organizations. The Body Confident Athletes program was co-created with girls and coaches through an international multi-disciplinary partnership between academics, health professionals, industry, and community organizations. Multi-disciplinary partnerships can create a supportive landscape by upskilling girls and influential community members (e.g., coaches) in dealing with body image concerns, which will likely lead to sustained sports participation and biopsychosocial benefits.

As such, the aim of the present study is to conduct a randomized controlled trial (RCT) to evaluate the effectiveness, feasibility, and acceptability of the Body Confident Athletes program. The program consists of five 60-minute sessions delivered by coaches to adolescent girls. Each session tackles a distinct theme related to body image in the sporting context. Outcomes will be assessed at pre- and post-intervention (5 weeks later) and include body image (primary outcome), sport enjoyment and embodied experiences (secondary outcomes), and feasibility, acceptability, and adherence (process outcomes). The comparison control arm will be a waitlist control condition.

To undertake this project, sporting organizations will be cluster-randomized into the intervention group or the control group, with 80 girls anticipated in each arm. Those in the intervention condition will complete baseline assessments (target outcomes and demographic information), take part in the five-week intervention, and then complete the post-intervention assessments (target outcomes and feasibility and acceptability measures). Those in the waitlist control condition will complete the baseline assessments (target outcomes and demographic information) and a second assessment five weeks later (target outcomes only), after which they will get access to the intervention. However, their engagement with the intervention will not be monitored or assessed. At completion of the post-intervention survey, all participants will receive a debrief form, outlining the study aims and objectives, and additional resources for body image and eating concerns. Lastly, to compensate participants for their time, girls and coaches will receive an electronic voucher to the value of $60 dollars.

The investigators hypothesize that girls who take part in the Body Confident Athletes intervention will report better body image, greater sport enjoyment, and higher levels of embodiment at post-intervention than girls who do not take part in the intervention.