Golan Moria, Ahmad Wiessam Abu
Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel; Shahaf, Community Services for the Management of Weight-Related Problems, Tel Aviv, Israel.
Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel; Brown School of Public Health and Community Medicine, the Hebrew University - Hadassah, Jerusalem, Israel.
Eat Behav. 2018 Dec;31:41-47. doi: 10.1016/j.eatbeh.2018.08.003. Epub 2018 Aug 10.
Positive self-image and body image as well as high self-esteem and media literacy are considered protective factors against health-compromising behaviours. Investigation of the optimal setting for body image prevention programmes is important to maximize outcomes from such programmes. Most universal wellness programmes are school based and thus delivered to a "captive" population. Only a few reports have been published about wellness programmes delivered in after-school settings, and none of them compared delivery after school to delivery in a school-based setting.
To assess the acceptability, feasibility and efficacy of an interactive wellness preventive programme (In Favour of Myself) when delivered in a school-based setting versus an after-school setting.
A randomized controlled multi-arm trial with 224 adolescent girls aged 13-15 years old was conducted. There were 102 girls participating in the after-school setting and 102 girls in the school-based setting. The programme contained nine 90-minute lessons, delivered weekly over 2 months. An intention-to-treat assessment was performed three times: at baseline, at the programme's conclusion (two months) and at follow-up (3 months).
At programme termination and follow-up, the impact of In Favour of Myself was higher among participants in the after-school setting than in the school-based setting with respect to advertisement strategies, media pressure, gap between current and ideal body image, drive for thinness and self-esteem.
This study provides support for a community-led approach to promote health behaviours, an approach that currently is a significant feature of health improvement policy and practice.
积极的自我形象和身体形象以及较高的自尊和媒体素养被认为是预防损害健康行为的保护因素。研究身体形象预防项目的最佳实施环境对于最大化此类项目的效果至关重要。大多数普遍的健康项目以学校为基础，因此是针对“无法选择的”人群开展的。关于在课后环境中开展的健康项目的报道很少，而且没有一篇将课后开展的项目与以学校为基础开展的项目进行比较。
评估在学校环境与课后环境中开展互动式健康预防项目（“支持自己”）的可接受性、可行性和效果。
对224名13 - 15岁的青春期女孩进行了一项随机对照多组试验。102名女孩参与课后环境组，102名女孩参与学校环境组。该项目包括9节90分钟的课程，在2个月内每周授课一次。进行了三次意向性分析：在基线时、项目结束时（两个月）和随访时（3个月）。
在项目结束和随访时，“支持自己”项目对课后环境组参与者在广告策略、媒体压力、当前与理想身体形象的差距、追求瘦身和自尊方面的影响高于学校环境组。
本研究为社区主导的促进健康行为的方法提供了支持，这种方法目前是健康改善政策和实践的一个重要特征。
