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Trial registered on ANZCTR
Registration number
ACTRN12619000851167
Ethics application status
Approved
Date submitted
28/05/2019
Date registered
17/06/2019
Date last updated
17/06/2019
Date data sharing statement initially provided
17/06/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
A randomised controlled trial of an efficacious school-based eating disorder risk reduction program: A comparison of 2, 4 and 8 lessons
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Scientific title
A randomised controlled trial of an efficacious school-based eating disorder risk reduction program: A comparison of 2, 4 and 8 lessons
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Secondary ID [1]
298355
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
eating disorders
313012
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body image
313013
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Condition category
Condition code
Mental Health
311518
311518
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0
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Eating disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Media Smart (MS) is a school-based program for girls and boys in Grade 7 and 8. The full program is 8 X 50 minute lessons. Given the constraints on school lesson time, this trial will evaluate how a 2- and 4- lesson version compares to the 8-lesson version that has been evaluated in previous research. The lessons will be taught by postgraduate psychology students, under the supervision of Dr Wilksch.
The standard 8-lesson version runs for a total of 400 minutes (2 X 50 minute lessons per week for 4 weeks). The 4-lesson version runs for a total of 200 minutes (2 X 50 minute lessons for 2 weeks). The 2-lesson version runs for a total of 100 minutes (2 X 50 minute lessons in 1 week).
The program includes interactive lesson content such as small group work, class discussions and watching of educational videos and PowerPoint presentations (made especially for the program). Students learn to question some of the messages they see in both traditional media (print, TV) and social media through interactive activities that educate about airbrushing and other techniques of image manipulation, stereotypes, peer pressure and identifying personal values. Adherence will be monitored through class attendance logs.
Within each school all 4 conditions will be represented (i.e.., MS-8 lessons, MS-4 lessons, MS-2 lessons, and controls). This will be done by all classes in one year level (e.g., Year 7 in School A) being allocated to the respective intervention conditions and all classes in the other year level (Year 8 in school A) being allocated to controls. In school B, this process is reversed (i.e., Year 8 is the intervention year level and Year 7 is the control year level). This randomisation will be completed using computer software.
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Intervention code [1]
314597
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Prevention
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Comparator / control treatment
Control group will be classes who receive their usual school lessons plus a 1-page handout on tips for positive body image. This will be given to control classes when the intervention classes start their MS program. These tips for positive body image are not a standard reference that is publicly available.
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Control group
Active
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Outcomes
Primary outcome [1]
320219
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Disordered eating cognitions will be measured using the Eating Disorder Examination - Questionnaire. This is a 22-item self-report measure.
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Assessment method [1]
320219
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Timepoint [1]
320219
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Baseline, post-program, 6-month follow-up and 12 month follow-up (primary time point).
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Secondary outcome [1]
370910
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Disordered eating behaviours as assessed by 8-items from the self-report Project Eating Amongst Teens measure.
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Assessment method [1]
370910
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Timepoint [1]
370910
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Baseline, post-program, 6-month follow-up and 12 month follow-up
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Secondary outcome [2]
370911
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Media internalisation will be measured using the Sociocultural Attitudes Towards Appearance Questionnaire-3 scale. This is a 9-item, self-report questionnaire.
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Assessment method [2]
370911
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Timepoint [2]
370911
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Baseline, post-program, 6-month follow-up and 12-month follow-up.
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Secondary outcome [3]
370912
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Depressive symptoms will be measured using the 10-item Child Depression Inventory –Short Form, a self-report measure.
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Assessment method [3]
370912
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Timepoint [3]
370912
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Baseline, post-program, 6-month follow-up and 12-month follow-up.
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Secondary outcome [4]
370913
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Weight-based teasing will be measured using the self-report McKnight Risk Factor Survey for Grades 6-12 (8-items).
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Assessment method [4]
370913
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Timepoint [4]
370913
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Baseline, post-program, 6-month follow-up and 12-month follow-up
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Secondary outcome [5]
370914
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Screen time will be assessed using the 8-item Growing Up Today scale (self-report).
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Assessment method [5]
370914
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Timepoint [5]
370914
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Baseline, post-program, 6-month follow-up and 12-month follow-up.
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Eligibility
Key inclusion criteria
Any student in Grade 7 or 8 in participating schools will be eligible to participate. Up to 10 schools will be invited to participate based on previous participation in similar school-based research or having expressed an interest to the research group for assistance with body image education.
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Minimum age
12
Years
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Maximum age
14
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
All students in the relevant grades of participating schools (Grade 7 or 8) will be eligible to participate. No exclusion criteria exists beyond the student or parent not providing consent.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Computer randomisation will be used, thus the researchers will not be involved in this process
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using computer software.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Within each school all 4 conditions will be represented (i.e.., MS-8 lessons, MS-4 lessons, MS-2 lessons, and controls). This will be done by all classes in one year level (e.g., Year 7 in School A) being allocated to the respective intervention conditions and all classes in the other year level (Year 8 in school A) being allocated to controls. In school B, this process is reversed (i.e., Year 8 is the intervention year level and Year 7 is the control year level).
This process is to ensure that demographic and other possible confounds are evenly represented across conditions.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The primary analyses of comparison between groups on changes in disordered eating will be based upon linear mixed-effects models (LMM) with random intercepts. Models will include fixed effects for group (MS-2, MS-4, MS-8, control), time (post-program, 6-month follow-up and 12-month follow-up) and gender (girls, boys), as well as interaction effects. Baseline scores will be used as a covariate and the model will adjust for the effect of clustering at a class level. Between group effect sizes and 95% confidence intervals will inform the relative effectiveness of the different versions of MS. Secondary analyses will be conducted with all continuous variables using LMM analyses as described above. Finally, to explore clinical significance, logistic regression analyses will be used to examine differences in binary outcomes (e.g., new cases of disordered eating behaviours at study endpoint).
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
7/05/2018
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Date of last participant enrolment
Anticipated
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Actual
1/06/2018
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Date of last data collection
Anticipated
28/06/2019
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Actual
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Sample size
Target
912
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Accrual to date
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Final
996
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Recruitment in Australia
Recruitment state(s)
SA,WA
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Funding & Sponsors
Funding source category [1]
302893
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Charities/Societies/Foundations
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Name [1]
302893
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Australian Rotary Health
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Address [1]
302893
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Australian Rotary Health
PO Box 3455, Parramatta NSW 2124
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Country [1]
302893
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Australia
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Primary sponsor type
University
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Name
Flinders University
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Address
Dr Simon Wilksch
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide SA 5001
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Country
Australia
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Secondary sponsor category [1]
302847
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None
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Name [1]
302847
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Address [1]
302847
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Country [1]
302847
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303467
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Flinders University Social and Behavioural Research Ethics Committee
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Ethics committee address [1]
303467
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Flinders University Social and Behavioural Research Ethics Committee Flinders University GPO Box 2100 | Adelaide SA 5001
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Ethics committee country [1]
303467
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Australia
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Date submitted for ethics approval [1]
303467
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01/05/2017
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Approval date [1]
303467
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11/07/2017
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Ethics approval number [1]
303467
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7674
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Summary
Brief summary
Media Smart (MS) is an 8-lesson school-based program that was developed by Dr Wilksch and Prof Wade and has been evaluated in a systematic program of research with over 2,000 participants. MS is now considered the leading ED risk reduction program worldwide for school-based, universal settings (i.e., given to all students regardless of risk status rather than selecting those at high-risk of an ED). However, many schools find 8 lessons difficult to timetable within the busy school program and given competing demands. Therefore the overall aim is to conduct an RCT to assess the efficacy of MS when it is delivered in shortened formats, namely a 2- and 4-lesson version, compared to the full 8-lesson program. The study design will include school class randomisation to: MS–2 lessons (MS-2); MS–4 lessons (MS-4); the full 8-lesson MS program (MS-8) and control group (normal school lessons with provision of a 1-page tip sheet on improving body image). Consistent with previous RCTs, MS will be delivered by trainee psychologists who will receive 5-hours of training in the program. Students will complete measures at baseline, post-program, 6- and 12-month follow-up. Measures will assess disordered eating and ED risk factors. This research is important in assisting with dissemination of the program given greater uptake is likely with a shorter curriculum. The rationale is not to replace MS-8 but to provide schools with informed, evidence-based alternatives for shorter versions that can better fit into the school program.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
93758
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Dr Simon Wilksch
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Address
93758
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Senior Research Fellow
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide, SA, 5001
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Country
93758
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Australia
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Phone
93758
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+61 8 8201 7996
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Fax
93758
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Email
93758
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[email protected]
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Contact person for public queries
Name
93759
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Simon Wilksch
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Address
93759
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Senior Research Fellow
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide, SA, 5001
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Country
93759
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Australia
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Phone
93759
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+61 8 8201 7996
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Fax
93759
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Email
93759
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[email protected]
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Contact person for scientific queries
Name
93760
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Simon Wilksch
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Address
93760
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Senior Research Fellow
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide, SA, 5001
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Country
93760
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Australia
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Phone
93760
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+61 8 8201 7996
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Fax
93760
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Email
93760
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This has not been applied for or approved by the Ethics Committee.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
2202
Informed consent form
377675-(Uploaded-28-05-2019-15-46-21)-Study-related document.pdf
2203
Informed consent form
377675-(Uploaded-28-05-2019-15-46-40)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF