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预防年轻女性进食障碍:同伴实施的身体项目的 RCT 和混合方法评估。

Preventing eating disorders in young women: An RCT and mixed-methods evaluation of the peer-delivered Body Project.

机构信息

Department of Psychiatry, Massachusetts General Hospital.

Department of Psychology and Neuroscience, University of Colorado Boulder.

出版信息

J Consult Clin Psychol. 2020 Dec;88(12):1105-1118. doi: 10.1037/ccp0000609.

Abstract

OBJECTIVES

Young women are at increased risk for eating disorders during adolescence (age range = 16-19), and there is the need for effective, sustainable prevention programs delivered during this critical window of development. The Body Project is a dissonance-based program that reduces key risk factors for disordered eating. Few studies have evaluated the program or the participant experience when peer-delivered at the high school level. The objective of this study was to evaluate using mixed-methods the Body Project program when peer-delivered among high school women.

METHOD

Three studies were conducted among young women in high school in the United States: (a) an open trial evaluation of a peer-delivered Body Project program (n = 112), (b) a pilot randomized controlled trial (RCT) comparing the Body Project with assessment-only control (n = 74), and (c) a qualitative investigation of participants' experiences (n = 131).

RESULTS

Open trial participants reported significant reductions in eating disorder risk factors and improvements in mood and self-attitude constructs over the intervention period (ds = .32-.77, ps < .01). Intervention effects for Body Project participants in the RCT compared with control were significant for body dissatisfaction, thin ideal internalization, dietary restraint, self-compassion, body surveillance, and loneliness (ds = .55-1.38, ps < .02). Thematic analyses of qualitative data highlight considerations for program delivery and engagement, including insights about why women join the program and perspectives on peer leaders.

CONCLUSIONS

Findings support the effectiveness of the peer-delivered Body Project with high school-aged women and highlight key recommendations for increasing engagement and strengthening prevention programs among young women. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

目的

青少年(年龄范围为 16-19 岁)时期女性罹患饮食失调的风险增加,因此需要在这一关键发育期提供有效且可持续的预防方案。身体项目(Body Project)是一种基于不和谐的方案,可以降低饮食失调的关键风险因素。很少有研究评估过该方案,或在高中阶段由同龄人实施时的参与者体验。本研究的目的是使用混合方法评估同龄人在高中阶段实施的身体项目方案。

方法

在美国的高中女性中进行了三项研究:(a)对同伴实施的身体项目方案进行开放性试验评估(n = 112);(b)一项与仅评估组对照的身体项目方案的先导随机对照试验(RCT)(n = 74);(c)对参与者体验的定性研究(n = 131)。

结果

开放性试验参与者报告称,在干预期间,饮食失调风险因素显著减少,情绪和自我态度结构得到改善(ds =.32-.77,p <.01)。与对照组相比,RCT 中身体项目方案的干预效果在身体不满、瘦理想内化、饮食克制、自我同情、身体监测和孤独感方面具有显著差异(ds =.55-1.38,p <.02)。定性数据分析的主题分析突出了方案实施和参与的注意事项,包括关于女性参加该方案的原因以及对同龄人的看法的见解。

结论

研究结果支持同伴实施的身体项目方案对高中年龄段女性的有效性,并强调了增加年轻女性参与度和加强预防方案的关键建议。(APA,2020)

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