Tara M. Cousineau

Motivation, self-efficacy, physical activity and nutrition in college students: Randomized controlled trial of an internet-based education program

OBJECTIVE MyStudentBody.com-Nutrition (MSB-N) is an internet-based nutrition and physical activity education program for college students. METHOD Students from six universities (N=476) in the U.S. were randomly assigned in the fall of 2005 to one of three groups: MSB-N (Experimental I), MSB-N plus Booster (Experimental II), or an attention placebo control group. RESULTS Experimental I and II group participants increased their fruit and vegetable intake by .33 and .24 servings, respectively, relative to the control group at post-test. Both experimental groups improved their motivation to change eating behaviors (p<.05) and were also more likely to increase their social support and self-efficacy for dietary change (ps<.05). Experimental groups also improved their attitude toward exercise (p<.05), but no behavioral changes in physical activity were noted. CONCLUSION MyStudentBody.com-Nutrition is an effective internet-based program that may have wide applicability on college campuses for nutrition education and promoting change in health behaviors.

Text Messaging Intervention for Teens and Young Adults With Diabetes

Background: Adolescents and young adults use text messaging as their primary mode of communication, thus providing an opportunity to use this mode of communication for mobile health (mHealth) interventions. Youth with diabetes are an important group for these mHealth initiatives, as diabetes management requires an enormous amount of daily effort and this population has difficulty achieving optimal diabetes management. Goal setting and self-efficacy are 2 factors in the management of diabetes. We examined the feasibility of a healthy lifestyle text messaging program targeting self-efficacy and goal setting among adolescents and young adults with diabetes. Methods: Participants, ages 16-21, were assigned to either a text messaging group, which received daily motivational messages about nutrition and physical activity, or a control group, which received paper-based information about healthy lifestyle. Both groups set goals for nutrition and physical activity and completed a measure of self-efficacy. Results: Participants’ mean age was 18.7 ± 1.6 years old, with diabetes duration of 10.0 ± 4.6 years, and A1c of 8.7 ± 1.7%. The text messaging intervention was rated highly and proved to be acceptable to participants. Self-efficacy, glycemic control, and body mass index did not change over the course of the short, 1-month pilot study. Conclusions: Positive, daily, motivational text messages may be effective in increasing motivation for small goal changes in the areas of nutrition and physical activity. These interventions may be used in the future in youth with diabetes to improve diabetes care. Utilizing more targeted text messages is an area for future research.

Teaching adolescents about changing bodies: Randomized controlled trial of an Internet puberty education and body dissatisfaction prevention program

This study tested the efficacy of an Internet-based prevention program, Trouble on the Tightrope: In Search of Skateboard Sam, on pubertal knowledge, body esteem, and self-esteem. One hundred and ninety participants (mean age 11.6 years) were randomized to either an intervention or attention placebo control condition and were assessed at baseline, after three Internet-based sessions, and at 3-month follow-up. Although the primary hypotheses were not supported, exploratory moderator analyses indicated that the intervention was beneficial for select students. Specifically, pubertal status moderated the effects on weight-related body esteem and several domains of self-esteem, resulting in positive effects for participants in the intervention group who had begun puberty. Gender differences were found on self-esteem subscales, indicating more robust effects for girls than boys. Tailored Internet programs based on personal characteristics such as gender and pubertal status may be a fruitful area for future research with adolescents.

Web Chatter Before and After the Women's Health Initiative Results: A Content Analysis of On-line Menopause Message Boards

ABSTRACT A content analysis was conducted on two on-line menopause message boards over 18 months, before and after the announcement of the Womens Health Initiative (WHI) study results on hormone therapy risks. Messages (N = 785) were coded based on overall context themes and specific content (N = 1132 codes). Results showed that “seeking symptom advice” about physical symptoms represented half (49%) of all codes. More specific content codes reflected inquiries about taking prescription hormone therapies, (HTs) how to cope with the menopausal transition, checking in with community members, and questions related to menopause onset and changes in menstrual patterns. Chi–square tests showed an increase in pharmaceutical advice codings over time on the medical board (p = .057) and a trend on the community board after the WHI (p = .10). Similarly, after the WHI there was an increase in the frequency of codes on the community board related to “Is this menopause?” suggesting a heightened awareness about menopause as a health issue. In conclusion, analyses of on-line message boards provide a rich, economical method to discern the needs of menopausal women, as well as to observe the potential impact of a widely publicized medical event that can inform innovative strategies in health promotion for this target population.

BodiMojo: effective Internet-based promotion of positive body image in adolescent girls.

This study tested the efficacy of an Internet-based health promotion program, BodiMojo, designed to promote positive body image in adolescents. Participants were 178 students (mean age 15.2 years, 67.6% ethnic minority) in three public high schools. Intervention groups used BodiMojo for four weekly health class periods, while controls participated in their usual health curriculum. Body image measures were given at baseline, post-intervention, and 3 months. Girls reported decreased body dissatisfaction (p<.05), decreased physical appearance comparison (p<.05), and increased appearance satisfaction (p<.05), relative to controls. Effects were not maintained at 3-month follow-up. No significant differences were found between the intervention and control groups with boys. Moderation analyses suggested positive effects for diverse adolescents as well as those who were overweight or indicated baseline high body dissatisfaction. BodiMojo appears to be modestly effective in decreasing body image concerns among adolescent girls in the short term.

Body image in emerging adults: The protective role of self-compassion

Self-compassion is thought to protect from body image concerns. However, the mechanisms of this effect remain unclear. This study examined three positive dimensions of self-compassion as moderators of the mediated relationship between perceived overweight status, appearance comparison, and appearance esteem. A sample of 232 youth aged 13-18 years, mean=18.36 (SD=1.5) years, reported on appearance esteem, appearance comparison, perceived weight status, and self-compassion dimensions including self-kindness, common humanity, and mindfulness. Among boys, mindfulness and common humanity moderated the perceived weight status to appearance comparison pathway of the mediation (ps=.01), such that this relationship was weaker among boys with higher levels of these dimensions of self-compassion. These findings were not replicated among girls. None of the self-compassion dimensions moderated the appearance comparison to appearance esteem pathway. Self-compassion dimensions that decrease the focus on the self may protect against body image concerns among boys.

Brief report: Feasibility of a mindfulness and self-compassion based mobile intervention for adolescents.

The aim of the study was to test the feasibility of a mindfulness and self-compassion based program for adolescents, to be delivered though mobile phones. Twenty racially and ethnically diverse US adolescents enrolled in a study to use the app for 30 days, after which they provided satisfaction data and participated in focus groups to describe their experiences and offer suggestions for improving the app. Usage data were also captured. Results indicated that participants used the app on the majority of days over the intervention period, reported finding it helpful for managing stress, and provided suggestions for substantive areas for improvement. These findings suggest that a mobile app may be a feasible way to disseminate a mindfulness and selfcompassion based program widely among adolescents.

BodiMojo : Efficacy of a Mobile-Based Intervention in Improving Body Image and Self-Compassion among Adolescents

Mobile interventions promoting positive body image are lacking. This study presents a randomized controlled evaluation of BodiMojo, a mobile application (app) intervention grounded in self-compassion to promote positive body image. A sample of 274 adolescents, mean (SD) age = 18.36 (1.34) years, 74% female, were allocated to a control group or used BodiMojo for 6 weeks. Appearance esteem, body image flexibility, appearance comparison, mood, and self-compassion were assessed at baseline, 6, and 12 weeks. Significant time by group interactions emerged for appearance esteem and self-compassion, with appearance esteem and self-compassion increasing in the intervention relative to the control group. These findings provide preliminary support for BodiMojo, a cost-effective mobile app for positive body image.

BodiMojo: an internet-based body image promotion program

BodiMojo, an Internet program designed to promote positive body image in adolescents, was tested with 178 high school students (mean age 15.2 years, 67.6% ethnic minority) in 3 public high schools in the U.S. The BodiMojo group used the program for 4 class periods, while controls participated in their usual health curriculum. Body image measures were given at baseline, post-intervention, and 3-months. Girls reported decreased body dissatisfaction (p < .05), decreased physical appearance comparison (p < .05), and increased appearance satisfaction (p < .05), relative to controls. No effects were found for boys. Moderator analyses revealed a significant Group x Time x Overweight status interaction for body dissatisfaction among girls, with overweight girls reporting greater decreases in body dissatisfaction, p = .012, partial η2 =.15. Among girls, there was a significant Group x Time x Ethnic minority status interaction for the Body Esteem Scale (Appearance subscale), p = .004, partial η2 =.14, and body dissatisfaction, p = .029, partial η2 =.10 with ethnic minority girls reporting greater increases in body appearance esteem than Caucasian girls. BodiMojo appears to be effective in decreasing body image concerns and appearance comparisons among adolescent girls and may be particular effective with some groups. This abstract was presented in the Prevention stream of the 2013 ANZAED Conference.