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Title: The development and pilot testing of a school-based prevention programme for eating disorders
Author: Sharpe, Helen
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2013
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Eating disorders are important candidates for preventative efforts because of their prevalence, consequences and associated costs. Universal interventions could be a valuable part of the overall prevention strategy if they can be widely disseminated with minimal costs. The studies in this thesis developed and evaluated an evidence-based universal prevention programme for eating disorders, which could be delivered by secondary school teachers. To achieve this, four phases of work were carried out. First, a systematic review and meta-analysis revealed evidence in support of ’fat talking’ being a causal risk factor for body dissatisfaction. This could therefore be a valuable target for prevention programmes. Second, a focus group study explored adolescents’ understandings of the causes of body dissatisfaction and eating pathology and their recommendations for the prevention of these problems. Students focused on sociocultural factors and suggested the need for supportive school environments, media literacy and staff training. Third, a consultation period with school staff and review of risk factors for eating disorders was used to guide the development of the intervention’s form and content. Based on this, a six session intervention was developed that targeted body dissatisfaction, thin-ideal internalisation, appearance conversations, negative affect and self-esteem. Finally, this intervention was evaluated by means of clustered randomised controlled trial with 446 adolescent girls from three secondary schools. Significant improvements were observed in those receiving the intervention for body esteem, thin-ideal internalisation and self-esteem. In contrast, no changes were seen for peer support, depressive symptoms or eating pathology. Acceptability, fidelity and efficacy varied across the three school sites. In conclusion, these results suggest that universal teacher-delivered prevention has promise, although a continued focus on developing interventions that are efficacious across a range of school settings will be an essential next step.
Supervisor: Schmidt, Ulrike; Treasure, Janet Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available