Premium
Research Review: Effectiveness of universal eating disorder prevention interventions in improving body image among children: a systematic review and meta‐analysis
Author(s) -
Chua Joelle Yan Xin,
Tam Wilson,
Shorey Shefaly
Publication year - 2020
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.13164
Subject(s) - psychological intervention , meta analysis , eating disorders , funnel plot , systematic review , publication bias , psychology , clinical psychology , strictly standardized mean difference , medicine , medline , psychiatry , political science , law
Background Increasingly, children are at risk of developing eating disorders. A systematic review and a meta‐analysis were conducted to examine the effectiveness of universal eating disorder prevention interventions in improving body image, internalization of appearance ideals, and self‐esteem among children aged 5–17 years old. Methods Nine electronic databases were systematically searched from each database’s point of inception to March 2019. The Cochrane Risk of Bias tool assessed each study’s risk of bias, while the GRADE approach judged the overall evidence for each review outcome. A meta‐analysis was conducted using the random‐effect model to obtain standardized mean differences with 95% confidence intervals under the inverse variance method. Heterogeneity was assessed using I 2 statistic and Cochran’s Q chi‐squared test. Publication bias was assessed using funnel plots. Results A total of 24 studies (22 trials) were included in this review. Universal interventions were found to be effective in improving children’s body esteem, self‐esteem, and internalization of appearance ideals at postintervention and at follow‐up timepoints. Subgroup analyses found that girls benefited more from these interventions than boys. Multisessional interventions with an optimal duration of approximately one month were found to be more effective. Conclusions The findings encourage the incorporation of universal preventive interventions into school curricula to benefit most children. Laypeople such as teachers can deliver these interventions, but content experts should address topics on body dissatisfaction. Due to the low quality of evidence, as accorded by the GRADE approach, current findings should be validated by future research.