Research
BodySense was created through funding from the Women's Health Council of Ontario in January 2001. This original funding was provided to develop and evaluate a program aimed at building positive body image in athletes that would ultimately prevent disordered eating in high-risk, appearance-demand sport settings.
The team that led the project included: Dr. Gail McVey (Research-Scientist, Hospital for Sick Children) as the primary investigator, Dr. Annick Buchholz (Psychologist, Children's Hospital of Eastern Ontario) as the research consultant and Ms. Heidi Mack (education consultant) as the project coordinator and primary curriculum developer. The work accomplished by this group created the foundation for the BodySense program.
A national advisory committee was formed with representatives from relevant associations (i.e., Coaching Association of Canada; Canadian Association for the Advancement of Women and Sport and Physical Activity) and experts from the fields of sport nutrition, body image and prevention of eating disorders. The project was steered by a multi-disciplinary group of professionals from the Children's Hospital of Eastern Ontario, the Pinecrest –Queensway Community Health Centre and the Child and Youth Mental Health Network. The program objectives included: developing a secondary prevention curriculum to help reduce disordered eating and other associated risky behaviours; to facilitate the process for parents and coaches to learn about the potential influence of their own values, beliefs and behaviours regarding weight and shape; to raise awareness and knowledge amongst coaches and parents about the prevalence of and health risks associated with disordered eating and; to guide parents and coaches to embrace their potential role in promoting positive body image in girls and women. The main research objectives included: (1) inviting coaches and parents to become partners in helping reduce disordered eating among girls and women through a participatory approach to research, (2) evaluating the prevention program designed to build healthy body image in girls in sport, and (3) evaluating risk factors associated with disordered eating in young competitive female athletes.
A participatory research approach was used in this study, which relied on dialogue with the athletes, parents and coaches to determine the course of the intervention, rather than on a predetermined, professional curriculum. Participants in the study included competitive female athletes ages 12 to 18, parents and coaches from seven gymnastic clubs across Ontario. All competitive clubs across Ontario were invited to participate and encouraged to do so by Gymnastics Canada. Seven clubs in Eastern Ontario and the Toronto region agreed to participate in the research project. In order to assess and compare whether the BodySense prevention program had an effect, only half of the clubs received the BodySense program. Prior to the program, all participants completed a questionnaire assessing pressures to be thin in the sport clubs (i.e., sport climate), eating attitudes and behaviours, as well as a questionnaire related to body image and pressures around dieting.
The multi-faceted prevention program featured the 10 BodySense Basics which provided education in the areas of: eating attitudes and beliefs ('What We Believe'); accurate information about body health ('The Facts'); unique body size and shape ('Respect for the Individual'); resisting pressures to diet ('A Positive Approach to Food'); physical activity for enjoyment ('Natural and Healthy Bodies'); helping an athlete feel good about herself ('Positive Self-Esteem')'; encouraging assertion in athletes ('Speaking Up'); stress management ('Coping in Healthy Ways')'; modeling attitudes and behaviours ('Role Modeling'); promoting balance between sport participation and life outside of sport ('Balance'). Two workshops were held at each club (one for parents and coaches, one for athletes) introducing participants to the 10 BodySense Basics, our core prevention model for promoting positive body image and preventing disordered eating in the sport. A BodySense binder was given to coaches and club staff, that included brochures on the 10 BodySense Basics, ways to prevent and detect disordered eating, and ways to promote positive body image in the sport environment. A BodySense Basics poster was provided to each club as well as a mini-resource library of books and videos on topics relating to self-esteem, body image, disordered eating, and sport nutrition. In addition, a "fuel tank" box, stocked with high-energy snacks that the clubs could provide to athletes at a low-cost, along with a list of fuel tank item ideas were also given to clubs. Finally, eight issues of the BodySense newsletter were made available to the clubs and mailed directly to the athletes' homes, on topics relating to disordered eating, positive body image, the Female Athlete Triad, sport nutrition, and healthy coping skills. The intervention took place over a three-month period in the gymnastics clubs. Throughout the life of the project, athletes, parents, coaches, and support staff were provided with opportunities to communicate with the BodySense coordinator either through email or by telephone.
In total, 106 gymnasts, 64 mothers, 33 fathers, and 34 coaches participated in the study. The average age of the athletes in the study was 13.4 years, and the athletes had been in gymnastics on average, 8.1 years, and trained on average, 6.3 hours per week. The mean age of the coaches in the study was 31.3 years, and the coaches reported on average 9.7 years of coaching experience. The average Body Mass Index of the athletes in the study was 19.14 kg/m2 (as calculated by their reported height and weight), which is lower than national averages for youth of that age group. From the questionnaires, 10.5% of gymnasts saw themselves as overweight, 27 % of the athletes reported worrying about the way they look, and 39% of athletes surveyed reported dieting behaviours. It was found that girls who perceived pressures to be thin in the sport clubs were more likely to report poorer body image and disturbed eating behaviours. The intervention program demonstrated a few modest changes in athlete's perceived pressures to be thin in their sport clubs, as well as dieting behaviours. More specifically, athletes who were involved in the prevention program were more likely to report reduced pressures to be thin in their clubs, and reduced dieting behaviours over time, as compared to the athletes who did not receive the prevention program. Finally, a satisfaction measure administered at the end of the program demonstrated that 100% of athletes, 97% of mothers, and 100% of coaches who completed the questionnaire reported that the quality of the information in the BodySense brochures were "good to excellent", and over 95% of athletes, coaches, and mothers reported that they would recommend other sport environments use the BodySense model to promote positive body image in athletes.
As a result of the encouraging outcome of the initial pilot, BodySense attained additional funding through the Ontario Trillium Foundation to support this important Ontario-based program. The objective of this phase BodySense Program was to share information with the Ontario sporting community, including athletes, parents, coaches and officials by:
- Providing presentations on the BodySense Basics to groups of male and female athletes.
- Providing presentations on promoting the BodySense Basics to groups of parents, coaches, officials and sport leaders.
- Incorporating the BodySense model into the code of ethics in each sport and coaching organization within Canada and/or identifying and declaring the existence of the information within the code of ethics in any specific sport or coaching organization.
- Implementing a BodySense website which provides reliable information on healthy body image, self-esteem and nutrition in sport.
In January 2008 the Ontario Trillium Fund phase of the project was completed. During the 2.5 years the following results were achieved:
- 261 presentations across Ontario
- 6249 athletes and key influencers attended presentations
- 69 clubs participated in the program
- 60 events held BodySense sessions
Over the course of the 2.5 years pre and post knowledge surveys with athletes scored 2.69 out of a possible 5 points on the knowledge measure prior to the presentation, and scored 4.90 out of 5 post-presentation - adults scored 3.22 out of a possible 6 points on the knowledge measure prior to the presentation, and scored 5.42 out of 6 post-presentation. Overall, 96% of athletes and adults responded that they found BodySense information 'important' or 'very important' for their sport.