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Chudyk AM, Kullman S, Pool D, Duhamel TA, Ashe M, Strachan S. Engaging patient and community stakeholders in the optimization of the Compassionate And Loving Mindset towards heart health risk (CALM Hearts) physical activity intervention: a description of initial work and protocol for future engagement activities. Res Involv Engagem 2024; 10:42. [PMID: 38693591 PMCID: PMC11062915 DOI: 10.1186/s40900-024-00577-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Participatory research approaches systematically integrate the perspectives of individuals, organizations, or communities that have a direct interest in a study's processes and outcomes (i.e., stakeholders) in research design and implementation. This supports interventions that are developed "by, not for" end-users, thereby increasing acceptability, uptake, and adherence. However, participatory approaches are relatively under-utilized in intervention development and behavioral change intervention research, in part, due to inadequate reporting of methodology. Therefore, to improve transparency in planning and reporting, we (a) describe how we engaged patients and community organizations (i.e., patient and community partners) in grant development for a self-compassion and physical activity behaviour change intervention for women with cardiovascular risk factors and (b) present a protocol for engaging patient and community partners in the optimization and implementation of the intervention moving forward. METHODS Our participatory research approach was guided by the Strategy for Patient-Oriented Research patient engagement framework and our prior stakeholder engagement work. Four patients and three community partners were engaged at the level of Involve, meaning their perspectives informed directions, processes, and decisions at major project milestones. Specifically, patient and community partners engaged in three separate meetings during grant development wherein they: (a) established a Terms of Reference to guide engagement activities and expectations; (b) shaped the grant through guided conversations about research priorities, outcomes, and intervention delivery components that could be targeted for optimization and (c) co-developed a protocol that specifies how relationships will be initiated with future patient partners, proposes engagement activities across the research cycle, and includes plans for formal evaluation of engagement processes. CONCLUSIONS Participatory research approaches provide valuable insights into the development of behavioural interventions, especially when stakeholders can partner early and have a meaningful impact. By detailing our engagement activities to date, we hope to model an approach to engaging stakeholders in behavioral intervention development and demonstrate the impacts of doing so.
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Affiliation(s)
- Anna Maria Chudyk
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Sasha Kullman
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | | | - Todd Ashley Duhamel
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Maureen Ashe
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
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Lucibello KM, Goldfield GS, Alberga AS, Leatherdale ST, Patte KA. Exploring the association between internalized weight bias and mental health among Canadian adolescents. Pediatr Obes 2024:e13118. [PMID: 38676448 DOI: 10.1111/ijpo.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Internalized weight bias (IWB) has been identified as a correlate of higher depressive and anxiety symptoms in adolescents with higher weights. However, there has been limited investigation into how IWB relates to positive mental health and whether these associations differ across genders. OBJECTIVES To examine the associations between IWB and mental health (depression, anxiety, flourishing) in adolescents with higher weights, and to test the potential moderating role of gender. METHODS Canadian adolescents with higher weights (N = 7538, 60% boys, 36% girls, 4% gender diverse, ages 12-19) from the COMPASS study completed a survey during the 2021-2022 school year. Data were analysed using generalized linear models. RESULTS Highest IWB and poorest mental health were noted within gender diverse adolescents, followed by girls then boys. Gender moderated the relationship between higher IWB and higher depression, higher anxiety and lower flourishing, with the strongest relationships noted among girls. CONCLUSION IWB interventions should be tailored to gender subgroups that may be particularly vulnerable to maladaptive mental health outcomes associated with IWB. System-level changes that mitigate perpetuation of weight bias and discrimination which lead to IWB are also essential, particularly for girls.
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Affiliation(s)
| | - Gary S Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Angela S Alberga
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
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Marques CC, Palmeira L, Castilho P, Rodrigues D, Mayr A, Pina TS, Pereira AT, Castelo-Branco M, Goss K. Online Compassion Focused Therapy for overeating: Feasibility and acceptability pilot study. Int J Eat Disord 2024; 57:410-422. [PMID: 38124655 DOI: 10.1002/eat.24118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This pilot study aims to investigate the feasibility, acceptability, and potential effectiveness of online Compassion Focused Therapy for overeating (CFT-OE). METHOD Eighteen Portuguese women seeking treatment for overeating were enrolled in this study, and 15 participants completed the CFT-OE. This was a single-arm study. Participants were assessed at pre- and post-intervention and 3-month follow-up. All participants completed measures assessing binge eating, cognitive restraint, uncontrolled eating, emotional eating, general eating psychopathology, general and body shame, self-criticism, self-compassion, and fears of self-compassion. RESULTS The treatment attrition rate was 16.7%, which is relatively low compared to other similar online interventions. Participants gave positive feedback on the program and indicated they would recommend it to people with similar difficulties. CFT-OE improved self-compassion and reduced eating psychopathology symptoms, general and body shame, self-criticism, and fears of self-compassion. Clinical significance analysis showed that the majority of participants were classified as in recovery in all measures at post-intervention and 3-month follow-up. DISCUSSION Preliminary results suggest that the online CFT-OE program is an acceptable and feasible intervention. Results also suggest that CFT-OE is beneficial for the treatment of women with difficulties with overeating. A future randomized controlled trial is necessary to establish the effectiveness of the CFT-OE. PUBLIC SIGNIFICANCE This study indicates that online CFT-OE is a feasible and adequate intervention for women who struggle with overeating. This therapy showed promising results in reducing eating disorder symptoms, shame, and self-criticism and improving self-compassion. As an online intervention, CFT-OE may be more accessible and offer an alternative to in-person therapy.
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Affiliation(s)
- Cristiana C Marques
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Institute of Psychological Medicine, University of Coimbra, Coimbra, Portugal
| | - Lara Palmeira
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Portucalense Psychology Institute (I2P), Portucalense University, Porto, Portugal
| | - Paula Castilho
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Dírcea Rodrigues
- Department of Endocrinology, Diabetes and Metabolism, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Andreas Mayr
- Department of Medical Biometrics, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Tiago Soares Pina
- Department of Nutrition and Dietetics, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Ana Telma Pereira
- Faculty of Medicine, Institute of Psychological Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Kenneth Goss
- Coventry & Warwickshire Partnership Trust, Coventry Eating Disorder Service, Coventry, UK
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Wang W, Ding X. A pilot randomized trial of self-compassion writing for young adult women engaged in emotional eating in the context of appearance-related cyberbullying. Int J Eat Disord 2023; 56:1520-1533. [PMID: 37080948 DOI: 10.1002/eat.23967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To investigate the effectiveness of a 10-min self-compassion writing in alleviating body dissatisfaction, self-objectification, and emotional eating in young adult women engaged in emotional eating in the context of appearance-related cyberbullying. METHOD A total of 175 Chinese young adult women (Mage = 20.90, SD = 1.65) were randomly assigned to one of the three groups: self-compassion, distraction, or control group. At baseline, participants completed assessments of trait and state body dissatisfaction, trait self-objectification, trait self-compassion, emotional eating, and positive and negative affect. Then they needed to recall an appearance-related cyberbullying victimization experience, after which state body dissatisfaction, state self-objectification, and positive and negative affect were measured. After the intervention, participants completed measures of state body dissatisfaction, state self-objectification, positive and negative affect, state self-compassion, and a food-choosing task. At 1-month follow-up, participants completed measures of trait body dissatisfaction, trait self-objectification, trait self-compassion, and emotional eating. RESULTS At post-intervention, state body dissatisfaction and negative affect were significantly lower, and positive affect was significantly higher in both the self-compassion and distraction groups compared to control. State self-objectification was significantly lower in the self-compassion group than in the other two groups. At 1-month follow-up, the self-compassion group showed significantly lower levels of body dissatisfaction than the control group. DISCUSSION The findings provide initial evidence for the potential of self-compassion writing in reducing state self-objectification and state body dissatisfaction in the context of appearance-related cyberbullying. PUBLIC SIGNIFICANCE Appearance-related cyberbullying, a common phenomenon in social networking sites, has been documented to associate with appearance-related concerns and disordered eating in young adult women. However, effective interventions that can reduce these negative associations are scarce. This study preliminarily found that a brief self-compassion writing could be a potential intervention for reducing state self-objectification and state body dissatisfaction in young adult women who had suffered appearance-related cyberbullying.
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Affiliation(s)
- Wenying Wang
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
| | - Xinfang Ding
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
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Nightingale BA, Cassin SE. Self-Compassion May Have Benefits for Body Image among Women with a Higher Body Mass Index and Internalized Weight Bias. Healthcare (Basel) 2023; 11:healthcare11070970. [PMID: 37046897 PMCID: PMC10094015 DOI: 10.3390/healthcare11070970] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
Negative attitudes towards one’s own body are common among women and are linked to adverse consequences including negative affect, low self-esteem, and eating pathology. Self-compassion has been found effective in improving body image; however, few published studies have examined self-compassion in populations with higher BMIs despite the positive correlation between weight and body dissatisfaction. The current study examined the efficacy of a self-compassion letter-writing exercise versus two active control groups in response to a negative body image induction. The sample of college-aged females (M age = 20.91 years; SD = 5.47) was split between higher and lower BMI to determine whether self-compassion affects body image, affect, and self-esteem differently across weight groups. Weight bias internalization (WBI: i.e., internalization of society’s negative stigma against those with higher BMIs) was examined as a moderator of this relationship in the higher BMI group. Results suggest that letter writing improved body image regardless of condition (p < 0.001). The self-compassion exercise promoted more adaptive body image (p = 0.007) and self-compassion (p = 0.013) than one control condition for those with high WBI. Results suggest that self-compassion can be helpful in ameliorating negative body image for females of all sizes, and that levels of WBI may alter the effect of body image interventions.
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Webb JB, Padro MP, Thomas EV, Davies AE, Etzel L, Rogers CB, Heredia NI. Yoga at Every Size: A Preliminary Evaluation of a Brief Online Size-Inclusive Yoga and Body Gratitude Journaling Intervention to Enhance Positive Embodiment in Higher Weight College Women. Front Glob Womens Health 2022; 3:852854. [PMID: 35720811 PMCID: PMC9199427 DOI: 10.3389/fgwh.2022.852854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
The present pilot randomized controlled trial (RCT) evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week online yoga and body gratitude journaling intervention for strengthening positive embodiment among racially-diverse higher weight college women. Seventy-five participants were initially randomized to either the yoga condition (n = 36) or to a wait-list control (n = 39). Participants completed measures of positive and negative body image, weight bias internalization, self-compassion, drive for leanness, and physical activity acceptance at both baseline and post. Preliminary results among the 42 analyzed completers (mean age = 20.9, SD = 2.4; 30% Black or African American) revealed acceptable feasibility given the low-intensity nature of the intervention reflected in a 36% attrition rate. Self-reported adherence was strong for the yoga component with 81% of participants indicating that they practiced with the videos ≥3–4 times per week as suggested. Although 71% reported completing the body gratitude journal ≥1–2 times per week, daily adherence was minimal. Acceptability was also high among participants randomized to the yoga condition as indicated by 86% expressing at least moderate levels of satisfaction with the overall program. Qualitative feedback from participants further supported the acceptability of the program and pointed to important areas in further refining the protocol in the future. Preliminary efficacy was supported by significant reductions in internal body shame and gains in body appreciation, functional body appreciation, functional body satisfaction, functional body awareness, and behavioral commitment to physical activity engagement among the yoga vs. wait-list control participants. These promising findings once replicated in larger, higher-powered trials may have important implications for extending the reach and accessibility of mind-body wellness practices like yoga to benefit racially-/ethnically-diverse college women of higher weight. This research is further responsive to the growing need for efficacious remotely-delivered, and scalable behavioral health interventions in the ongoing era of the COVID-19 pandemic. However, additional research is warranted to explore ways of enhancing engagement of participants with lower levels of positive embodiment and to further incentivize the journaling component of the intervention.
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Affiliation(s)
- Jennifer B. Webb
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, United States
- *Correspondence: Jennifer B. Webb
| | - Meagan P. Padro
- Department of Education, UNC Chapel Hill, Chapel Hill, NC, United States
| | - Erin Vinoski Thomas
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Alexandria E. Davies
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Lena Etzel
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, United States
| | | | - Natalia I. Heredia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
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