Reprinted from Eating Disorders Review
May/June 2010 Volume 21, Number 3
©2010 Gürze Books
While recent eating disorders prevention efforts have targeted teens older than 15 years of age, a group felt to be at very high risk for eating disorders, few such programs have been aimed at younger teens. Two Australian researchers recently designed a study to evaluate the effects of a media literacy program aimed at a mixed-sex audience of 8th graders (J Am Acad Child Adolesc Psychiatry. 2009; 48:652).
Psychologists Simon M. Wilksch, PhD and Tracey D. Wade, PhD, of Flinders University, Adelaide, Australia, developed a controlled study of 540 young teens (mean age: 13 years) in which 11 eighth-grade classes (126 girls and 107 boys) received an 8-lesson media literacy program, while 13 comparison classes (147 girls and 160 boys) received normal school lessons. The students were selected from a public school, a Catholic school, and 2 private schools.
The 8 interactive sessions delivered by Dr. Wilksch included two lessons a week in the classroom with the regular teacher present. The literacy program, “Media Smart” (J Am Acad Child Adolesc Psychiatry. 2008; 47:939), was constructed around the key concepts of literacy, activism, and advocacy. All media literacy students received a workbook containing a separate action for each lesson, with a lesson outline, description of learning activities, and a “take-home message.” The program was originally developed to test perfectionism and media literacy. In this study, the primary outcome was concern about shape and weight. The control group had regular class sessions.
Self-report measures evaluated shape and weight concern, dieting, body dissatisfaction, media internalization, perceived pressure and ineffectiveness, depression, and self-esteem. These factors were measured at baseline, immediately after the program ended, and then at 6 months and 30 months after the study.
What follow-up showed
Girls in the media literacy group generally had higher rates of clinically significant improvement than did the control girls—the most pronounced change was a reduction of concern about shape and weight (media literacy group, 38%; control group, 25%). Another important finding was that the rate of increased risk after the program was higher for the control girls than for the media literacy girls on all risk factors for shape and weight concern (media literacy group, 28%; control group, 44%) and dieting (media literacy group, 32%; control group, 48%).
Among the boys, those in the media literacy group were at significantly lower risk for shape and weight concern than were control boys at the post-program and 6-month follow-ups (both boys and girls in the media literacy group scored significantly lower in feelings of ineffectiveness than did their counterparts at the post-program follow-up).
Encouraging results seen among young adolescent males
The authors note that their study provides evidence that young adolescent males are a worthwhile target for eating disorder prevention programs, despite the fact that most studies do not include males because of a “floor effect in achieving statistically significant improvements.” In this study, post-hoc testing revealed significant benefits specific to boys in the media literacy group at one or more time points for shape and weight concern, dieting, body dissatisfaction, and feelings of ineffectiveness. The boys benefited as least as much as did the girls, and perhaps even more so at the post-program and 30-month follow-up assessments.
There were three limitations to the study, according to the authors. First, the control group did not receive a placebo intervention, so the benefits of the media literacy program could be due to nonspecific effects. Second, disordered eating behaviors and disordered eating were not measured, because of concern expressed by a school principal that such questions might inadvertently provide information about disordered eating, and third, data were missing for 45.9% of participants at the 30-month follow-up.