Implementing an Eating Disorder Prevention Program for Youth in Nova Scotia

All participants will complete a focus group with their fellow Body Project group members immediately following their final session. The focus group will follow a semi-structured guide based on a framework for assessing acceptability of health interventions.

Participants will be coded as a 'dropout' from the intervention if they stop attending sessions (determined with session attendance records from group facilitators). Acceptability based on dropout rate will be indicated if the dropout rate in the final session is equal to, or less than, the 20-30% rate reported in effectiveness trials for the BP.

Acceptability in terms of satisfaction with the program will be measured using an investigator-created questionnaire based on the Client Satisfaction Questionnaire - an 8-item self-report measure of the quality and effectiveness of a health service. Item responses are on a 4-point scale. Scores range from 8-32, with higher scores indicating higher satisfaction. Acceptability based on satisfaction questionnaire scores will be demonstrated if participants, on average, report at least moderate satisfaction (defined as a score of 24).

Demand feasibility will be met if there are enough participants to run 3-5 rounds of Body Project groups per cohort (totaling 96-120 youth) during the recruitment period.

The TIIS is the modernized version of the Ideal Body Stereotype Scale and is an 8-item self-report measure assessing internalization of the thin beauty ideal. Response options range from 1 = strongly disagree to 5 = strongly agree. Scores range from 8-40, with higher scores indicating higher internalization of the thin ideal. Feasibility will be met if there are significant within-group reductions of at least a moderate effect size (Cohen's d > 0.5).

Nine items from the Body Image Satisfaction Scale will be used to assess satisfaction with nine body parts, in line with previous Body Project research. Responses range from 1 = extremely satisfied to 6 = extremely dissatisfied. Scores range from 9-54, with higher scores indicating greater dissatisfaction. Feasibility will be met if there are significant within-group reductions of at least a moderate effect size (Cohen's d > 0.5).

In line with previous BP research, 20 items from the PANAS-X subscales for sadness, guilt, and fear/anxiety will be used to assess negative affect. Responses range from 1 = not at all to 5 = extremely. Scores range from 20-100, with higher scores indicating greater negative affect. Feasibility will be met if there are significant within-group reductions of at least a moderate effect size (Cohen's d > 0.5).

The EDE-Q global score is calculated from 22 attitudinal questions regarding eating restraint and concerns, weight concerns, and shape concerns. EDE-Q global scores range from 0-6, with higher scores indicating increased severity of ED psychopathology. Feasibility will be met if there are significant within-group reductions of at least a moderate effect size (Cohen's d > 0.5).

Facilitators will complete an open-ended feedback survey to ascertain what went well, what alterations (if any) are needed, and what barriers facilitators encountered or identified.