Improving body image at scale among Brazilian adolescents: study protocol for the co-creation and randomised trial evaluation of a chatbot intervention

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Abstract

Background

Body image concerns are prevalent among Brazilian adolescents and can lead to poor psychological and physical health. Yet, there is a scarcity of culturally-appropriate, evidence-based interventions that have been evaluated and made widely available. Chatbot technology (i.e., software that mimics written or spoken human speech) offers an innovative method to increase the scalability of mental health interventions for adolescents. The present protocol outlines the co-creation and evaluation of a body image chatbot for Brazilian adolescents via a partnership between academics, industry organisations and the United Nations Children’s Fund (UNICEF).

Methods

A two-armed fully remote randomised controlled trial will evaluate the chatbot’s effectiveness at improving body image and well-being. Adolescent girls and boys ( N = 2800) aged 13–18 years recruited online will be randomly allocated (1:1) into either: 1) a body image chatbot or 2) an assessment-only control condition. Adolescents will engage with the chatbot over a 72-hour period on Facebook Messenger. Primary outcomes will assess the immediate and short-term impact of the chatbot on state- and trait-based body image, respectively. Secondary outcomes will include state- and trait-based affect, trait self-efficacy and treatment adherence.

Discussion

This research is the first to develop an evidence-informed body image chatbot for Brazilian adolescents, with the proposed efficacy trial aiming to provide support for accessible, scalable and cost-effective interventions that address disparities in body image prevalence and readily available resources.

Trial registration number

NCT04825184, registered 30th March 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12129-1.

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Most cited references 50

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Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework

Mandeep Sekhon, Martin Cartwright, Jill Francis (2017)

Background It is increasingly acknowledged that ‘acceptability’ should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Methods Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. Results From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Conclusion Despite frequent claims that healthcare interventions have assessed acceptability, it is evident that acceptability research could be more robust. The proposed definition of acceptability and the TFA can inform assessment tools and evaluations of the acceptability of new or existing interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2031-8) contains supplementary material, which is available to authorized users.

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CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials

Kenneth F Schulz, Douglas G. Altman, David Moher … (2010)

The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.

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An effect size primer: A guide for clinicians and researchers.

Christopher J Ferguson (2009)

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Author and article information

Contributors

E. L. Matheson:

ORCID: http://orcid.org/0000-0001-9692-0597

emily.matheson@uwe.ac.uk

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 20 November 2021

Publication date PMC-release: 20 November 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 2135

Affiliations

[1 ]GRID grid.6518.a, ISNI 0000 0001 2034 5266, Centre for Appearance Research, Department of Health and Social Sciences, , University of the West of England, Coldharbour Lane, ; Bristol, BS16 1QY UK

[2 ]Federal Institute of Education, Science and Technology of Southeast of Minas Gerais, 204 Monsenhor José Augusto, Barbacena, 36205018 Brazil

[3 ]GRID grid.258509.3, ISNI 0000 0000 9620 8332, Department of Exercise Science and Sport Management, , Kennesaw State University, ; Kennesaw, GA USA

[4 ]GRID grid.411249.b, ISNI 0000 0001 0514 7202, Department of Psychiatry, , Universidade Federal de São Paulo, ; São Paulo, Brazil

[5 ]UNICEF Brasília, Office of the Representative of UNICEF in Brazil, SEPN 510, Block A – 2nd floor, Brasília, DF 70750-521 Brazil

[6 ]Talk2U LLC, 777 Brickell Ave Ste 1210, Miami, Florida 33131 USA

[7 ]GRID grid.1021.2, ISNI 0000 0001 0526 7079, School of Psychology, , Deakin University, ; Geelong, Australia

Author information

E. L. Matheson http://orcid.org/0000-0001-9692-0597

Article

Publisher ID: 12129

DOI: 10.1186/s12889-021-12129-1

PMC ID: 8605542

PubMed ID: 34801002

SO-VID: f60c7ee8-348f-4bf3-8691-e7c58f30245e

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 7 April 2021

Date accepted : 29 October 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100007190, Unilever;

Award ID: HAS-HSS-19-097

Custom metadata

ScienceOpen disciplines: Public health

Keywords: adolescent,body image,mental health,chatbot,micro-intervention,brazil,low- and middle-income countries,randomised controlled trial,study protocol

Data availability:

ScienceOpen disciplines: Public health

Keywords: adolescent, body image, mental health, chatbot, micro-intervention, brazil, low- and middle-income countries, randomised controlled trial, study protocol

Improving body image at scale among Brazilian adolescents: study protocol for the co-creation and randomised trial evaluation of a chatbot intervention

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Abstract

Background

Methods

Discussion

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Supplementary Information

Related collections

Chinese Journal of School Health

Most cited references 50

Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework

CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials

An effect size primer: A guide for clinicians and researchers.

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