A 10-step participatory program for developing, implementing, and evaluating physical activity promoting actions in nursing homes in Germany.

BACKGROUND: Since multidimensional barriers challenge nursing homes, a socio-ecological approach is needed for physical activity promotion in this setting. So far, little is known about how such an approach can be transferred into the successful development and implementation of PA-promoting actions together with stakeholders on-site. We aimed to investigate the actions and dimensions of PA-promoting actions and their sustainable implementation. To contribute to closing this gap, we present a 10-step program for co-developing and co-evaluating PA-promoting actions in nursing homes through an integrated counselling approach. METHODS: We used a multiple case study approach that built upon manifold data sources, collected in 7 nursing homes over 3 years between 2021 and 2023. We collected fieldnotes and photologs from 14 future workshops (2 per home); 7 evaluation workshops (1 per home); 36 individual counsellings (2 sessions per resident), as well as 87 implementation protocols (action type and frequency), 11 evaluation questionnaires (changes among resources, cooperations, and collaborations); 7 goal attainment scales and 18 individual activity schedules. In addition, we retrieved and documented progress information at regular intervals by phone or email. RESULTS: With staff, residents, relatives, and volunteers, we co-developed 112 ideas for PA promotion; from which 54 ideas were implemented and integrated into everyday life, differentiated into "activities of daily living," "structured activities," and "activity-friendly environments."; 18 residents in 4 homes participated in individual counselling to develop individual activity schedules. Eighteen actions were rated as "(much) more successful than expected"; 10 "(much) worse than expected," and 23 "as successful as expected." Three actions were not evaluated. DISCUSSION: The participatory integrated counselling approach led to home-specific actions and promoted implementation into everyday life. The number and dimensions of actions implemented largely depended on the mission and vision of the respective home. The lack of staff could partially be compensated for by involving neighbourhoods, volunteers, and community organisations, such as local clubs. CONCLUSION: To effectively promote PA in nursing homes, a tailored approach considering structural conditions, locations, volunteer engagement, and organisational visions is essential. Long-lasting partnerships and low-threshold opportunities prove promising. Future research should delve into structural-level change processes and outcomes in this context.

IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm.

With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.

Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study.

Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (ß = -0.27, p = .008), body mass index (ß = -0.29, p = .002), Barthel Index (ß = 0.24, p = .040), and hand grip strength (ß = 0.30, p = .048). SB was significantly predicted by body mass index (ß = 0.27, p = .008) and Barthel Index (ß = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.

[Sarcopenia, physical activity and sedentary behavior among nursing home residents in Germany]. / Sarkopenie, körperliche Aktivität und sedentäres Verhalten von Pflegeheimbewohnenden in Deutschland.

BACKGROUND: Residents in nursing homes show a high prevalence of the musculoskeletal syndrome sarcopenia and tend not to achieve current physical activity recommendations. OBJECTIVE: The aim of this study is to identify differences in physical activity and sedentary behavior of sarcopenic residents compared with nonsarcopenic and presarcopenic residents. METHODS: Sarcopenia assessment was performed among 63 nursing home residents in Baden-Wuerttemberg (D) using the European Working Group on Sarcopenia in Older People 2 specifications. Structured activity sessions (per week), accelerometer-based physical activity (steps/day), and sedentary behavior (percentual/day) were examined. The group comparisons were determined with Kruskal-Wallis tests and Dunn-Bonferroni post hoc tests. RESULTS: Significant differences were found for number of steps (p = 0.005) and percentual sedentary behavior (p = 0.019). Moreover, steps per day presented significant results in group comparison for no sarcopenia (2824.4 [423-14275]) with probable sarcopenia (1703.9 [118-5663]) and confirmed/severe sarcopenia (1571.2 [240-2392]) (both p = 0.022; |r| = 0.34). Sedentary behavior demonstrated significant differences in groups with no sarcopenia (87.9% [69.1-94.3]) and with probable sarcopenia (91.7% [80.4-9835]) (p = 0.018; |r| = 0.35). CONCLUSION: Nonsarcopenic residents demonstrated a higher number of steps and lower sedentary behavior compared with presarcopenic and sarcopenic residents. Increasing steps, reducing sedentary behavior and promoting activities of daily living can contribute to the prevention and treatment of sarcopenia in the nursing home setting.

Occupational Health Literacy Scale (OHLS): development and validation of a domain-specific measuring instrument.

Occupational health literacy (OHL) is a domain-specific approach that can empower people to make health-appropriate decisions in the work environment. OHL comprises the knowledge, skills and willingness of people to access and process health-related information and to apply it in work situations. The aim of this study was to evolve a conceptual model and validate a scale for OHL, that can be used in many sectors in the Western industrial countries, which does not yet exist. After piloting, item selection and alteration were carried out in a pretest with n = 163 working adults in diverse small- and medium-sized enterprises in Germany. The resulting OHL items were validated in a main survey with n = 828 participants working in small- and medium-sized enterprises and among them 47.5% people with migration background. The final 12-item questionnaire had good structural characteristics and is reliable and valid for measuring OHL. Using exploratory structural equation modeling, good fit indices (root mean square error of approximation = 0.063, comparative fit index = 0.940) confirmed a two-factor structure: (i) knowledge and skill-based processing of health information (internal consistency α = 0.88) and (ii) willingness and responsibility for occupational health (α = 0.74). The OHL scale fills the gap regarding domain-specific OHL questionnaires for working adults in diverse sectors in Western industrial countries. The Occupational Health Literacy Scale can be used to identify the needs of employees and companies and then to adapt and evaluate health promotion measures. Further research could include validation and use in other countries and large companies.

Does Exercise Modality Matter Affectively? Contrasting Type and Sequence of Moderate-Intensity Continuous Training Versus High-Intensity Interval Training in a Randomized Within-Subject Study.

Over the past two decades, affective determinants of exercise behavior have received increasing attention in research on health promotion and prevention. To date, however, little is known about changes in affective exercise determinants during multi-week training programs in insufficiently active individuals. This applies in particular to the currently discussed advantages and disadvantages of high-intensity interval training (HIIT) compared with moderate-intensity continuous training (MICT) with regard to the affective experience of these two training types (e.g., reduced monotony vs. more aversive response during HIIT), which is important for exercise adherence. Referring to the Affect and Health Behavior Framework (AHBF), this within-subject study investigated changes in affective exercise determinants as a function of training type and sequence consisting of MICT and HIIT. Forty insufficiently active healthy adults (M age = 27 ± 6 years; 72% women) underwent two 6-week training periods in a randomized sequence (MICT - HIIT vs. HIIT - MICT) within 15 weeks. Pre-post questionnaires and in-situ measurements, during and after a standardized vigorous-intensity continuous exercise session (VICE), were used to assess affective attitude, intrinsic motivation, in-task affective valence, as well as post-exercise enjoyment. These four affect-related constructs were collected before, between, and after the two training periods. Mixed models revealed a significant effect for training sequence (p = 0.011) - but not for training type (p = 0.045; non-significant after Bonferroni alpha adjustment) - on changes in in-task affective valence in favor of the MICT - HIIT sequence. Moreover, no significant training type or sequence effects were found for the constructs of reflective processing: exercise enjoyment, affective attitude, and intrinsic motivation. Therefore, individual-based training recommendations should consider the effects of variety and training sequence to develop tailored interventions that lead to more positive affective experiences - in particular during exercise - and promote the maintenance of exercise behavior in previously inactive individuals.

Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity.

BACKGROUND: A central strategy to tackle the health risks of obesity is regular physical activity (PA), exercising and participating in sports. However, people with obesity regularly experience weight-related stigma and discrimination in sport and exercise settings. Research has indicated that they often cope with such experiences by simply excluding themselves from sport and exercise. Meanwhile, self-exclusion as a coping strategy has not been fully understood and it remains unclear to what extent self-exclusion from PA settings is accompanied by general inactivity among people with obesity. The goal of this interview study was to determine to what extent physical inactivity among adults with obesity is the result of weight stigma-induced self-exclusion in and from sport and PA settings. METHODS: We conducted semi-structured interviews with thirty adult men and women with obesity (average BMI: 40.64) and asked them about experiences with their body, weight stigma and coping behaviours in sport and exercise settings across their lifespans. Employing constant comparative analysis and a thematic network approach, we analysed the interview data to identify the most common reasons for and different strategies of self-exclusion. RESULTS: Participants reported that they excluded themselves from sport and exercise settings due to traumatic weight stigma experiences, self-discrimination and fear of stigma, using a variety of strategies. Exposure to discrimination was prevented by selectively avoiding certain settings or strategically frequenting them at certain times only, but also by exercising in 'safe' spaces, e.g. at home. Furthermore, people with obesity reported strategically managing their social relations in order to avoid stigmatising reactions by others in exercise settings, for example by exercising individually and avoiding social PA. Most notably, our results strongly indicate that not all self-excluding coping strategies result in less exercising. CONCLUSIONS: In order to successfully promote physical activity among people with obesity, the various forms of self-exclusion should be taken into account as pathways of stigma regarding physical activity. People with obesity may exclude themselves from certain PA settings, yet could still be exercising on their own or in other ways. One focus of public health strategies should thus be directed at the potentially socially isolating effects.

Questionnaire choice affects the prevalence of recommended physical activity: an online survey comparing four measuring instruments within the same sample.

BACKGROUND: Since prevalence estimates of recommended physical activity (PA) considerably vary between different surveys, prevalence might be crucially affected by the choice of measuring instrument. The aim of the present study is to compare the results of four PA questionnaires regarding the current moderate- and vigorous-intensity aerobic PA (MVPA) recommendations of the World Health Organization. METHODS: Within an online survey, participants answered the German Health Interview and Examination Survey for Adults (DEGS), the European Health Interview Survey PA Questionnaire (EHIS), the Eurobarometer (EURO), and a single-item measure (SIM). Weekly volume of MVPA was compared via a Friedman test and the prevalence of participants achieving the WHO's MVPA recommendation via Cochran's Q. Agreement between all questionnaire pairs was evaluated via Kappa statistics. RESULTS: One hundred seventy-six participants were included in the analyses (70.5% female, mean age: 33.1 years (SD=12.2)). Between the four questionnaires, the weekly volume of MVPA statistically significant differed (SIM: MED=90.0 (MIN=0.0, MAX=210.0), DEGS: MED=120.0 (MIN=0.0, MAX=420.0), EHIS: MED=24.0 (MIN=0.0, MAX=1395.0), EURO: MED=51.0 (MIN=0.0, MAX=2430.0), p<.001, all pairwise comparisons p<.01), as well as the prevalence of participants achieving the MVPA recommendations (SIM 31.3% (95% CI 24.5-38.7), DEGS 43.2% (95% CI 35.8-50.8), EHIS 67.0% (95% CI 59.6-73.9), EURO 87.5% (95% CI 81.7-92.0), p<.001), except between SIM and DEGS (p=.067). Agreement was weak between all questionnaire pairs (all κ< 0.60). CONCLUSIONS: Questionnaire choice crucially affects the resulting MVPA data and hence the prevalence of achieving recommended PA levels within the same sample. Therefore, for PA surveillance, standardised survey and analysis methods and efforts to harmonise monitoring systems are needed, since whether recommended levels of PA are achieved should not be determined by the choice of one measuring instrument or another.

Individual cardiovascular responsiveness to work-matched exercise within the moderate- and severe-intensity domains.

PURPOSE: We investigated the cardiovascular individual response to 6 weeks (3×/week) of work-matched within the severe-intensity domain (high-intensity interval training, HIIT) or moderate-intensity domain (moderate-intensity continuous training, MICT). In addition, we analyzed the cardiovascular factors at baseline underlying the response variability. METHODS: 42 healthy sedentary participants were randomly assigned to HIIT or MICT. We applied the region of practical equivalence-method for identifying the levels of responders to the maximal oxygen uptake (V̇O2max) response. For investigating the influence of cardiovascular markers, we trained a Bayesian machine learning model on cardiovascular markers. RESULTS: Despite that HIIT and MICT induced significant increases in V̇O2max, HIIT had greater improvements than MICT (p < 0.001). Greater variability was observed in MICT, with approximately 50% classified as "non-responder" and "undecided". 20 "responders", one "undecided" and no "non-responders" were observed in HIIT. The variability in the ∆V̇O2max was associated with initial cardiorespiratory fitness, arterial stiffness, and left-ventricular (LV) mass and LV end-diastolic diameter in HIIT; whereas, microvascular responsiveness and right-ventricular (RV) excursion velocity showed a significant association in MICT. CONCLUSION: Our findings highlight the critical influence of exercise-intensity domains and biological variability on the individual V̇O2max response. The incidence of "non-responders" in MICT was one third of the group; whereas, no "non-responders" were observed in HIIT. The incidence of "responders" was 11 out of 21 participants in MICT, and 20 out of 21 participants in HIIT. The response in HIIT showed associations with baseline fitness, arterial stiffness, and LV-morphology; whereas, it was associated with RV systolic function in MICT.

[Sports Activity and Mental Diseases]. / Sportliche Aktivität und psychische Erkrankungen.

Current meta-analyses demonstrate convincing evidence regarding the efficacy of exercise on depression, insomnia, anxiety disorders, schizophrenia and ADHD. However, exercise and sports therapy approaches for patients with psychological disorders are mostly integrated in psychiatric inpatient or rehabilitation settings, but not applied in the outpatient sector. Thus, the German Health sector does not take the advantage of the compelling therapeutic effects of exercise. This review covers the theoretical and empirical fundamentals of the effects of exercise and illustrates practical implications by means of the presentation of the group-therapeutic exercise program ImPuls, that was specifically designed for patients with psychological disorders in outpatient settings. ImPuls integrates current evidence of the effects of exercise (type of sport, duration, frequency, intensity) and the facilitation of motivational and volitional strategies to support patients to integrate exercise in their daily life routines.

Promotion of physical activity-related health competence in physical education: study protocol for the GEKOS cluster randomized controlled trial.

BACKGROUND: One central goal of physical education in many countries is to empower students to be physically active throughout their lifespan. Physical activity-related health competence (PAHCO) encompasses physical, cognitive, and motivational elements associated with the individuals' ability to be physically active in a health-enhancing way. To date, there is a lack of empirical evidence concerning effective programs and methods to promote PAHCO in physical education. The purpose of this study is to examine to what extent a health and physical fitness-related program that includes learning tasks integrating theoretical and practical elements promotes students' PAHCO in physical education. DESIGN/METHODS: This study is a cluster randomized controlled trial that compares two physical education intervention programs on health and physical fitness (IG-run, IG-game play) with regular physical education lessons (CG-run, CG-game play) in secondary schools in Germany. Forty-eight physical education classes (ninth grade) were recruited and randomly allocated to the four study groups. The intervention programs include six physical education lessons on health and physical fitness and only differ in the type of physical activity that is executed (running and jumping vs. small-sided games). The students' PAHCO is examined both pre- and post-intervention and after 8-12 weeks of follow-up. We also determine various process variables during the intervention period to analyze the intervention fidelity. DISCUSSION: The results of this study provide evidence on whether a combination of theoretical and practical elements in physical education can enhance students' PAHCO. Beyond that, our process analyses will allow differentiated insights into the mechanism of how the intervention programs work. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), DRKS-ID: DRKS00016349 . Retrospectively registered on 10 January 2019.

Why are some groups physically active and others not? A contrast group analysis in leisure settings.

BACKGROUND: This field study aims to investigate the determinants of physical activity of particularly active and inactive groups in their leisure environments. In order to consider the context in which physical activity occurs and to investigate whether cultural settings may influence physical activity, we conducted the study at pools in different cultural environments - Hawai'i and Germany. METHODS: This study presents the quantitative data of a systematic (covert) participant observation. We recorded the physical activity of face-to-face interacting groups and analysed categories such as group size, estimated age of the group members, and verbal communication patterns. Total observation period was eight and a half months. In total, we observed 907 groups with the groups' size varying between 2 and 8 members. For the general statistics, we accessed the significance of differences regarding the degree of physical activity dependent on the target variables. To better understand activity promoting and hindering mechanisms, special attention is given to the identification of contrasting factors that characterise groups which are very active or very inactive. For this, we conducted a classification tree analysis. RESULTS: General statistical analysis shows that, overall, the most differentiating factor regarding physical activity was the body shape of the group members. While obese groups had the lowest average activity level, groups mainly consisting of people with an athletic body shape were the most physically active. Yet, classification tree analysis reveals that obesity itself does not necessarily determine physical inactivity levels. The identification of six contrasting clusters highlights that besides the body shape several factors interact regarding a group's physical level. Such interacting factors were for example the degree of communication within the group, the gender- and age-related composition of the group, but also the equipment that had been brought to the beach/pool. Obese people were particularly inactive when they were members of frequently communicating, age-heterogeneous groups. CONCLUSIONS: Our study shows that several social factors determine the physical activity of very active and very inactive groups. In order to promote physical activity, future health initiatives should target these factors of a person's network.

Eating disorder pathology in elite adolescent athletes.

OBJECTIVE: We aimed to investigate eating disorder pathology in German elite adolescent athletes. Evidence suggests that eating disorder pathology is more common in adult elite sports, especially in female athletes and in sports emphasizing leanness. There is a scarcity of studies in elite adolescent athletes who are in a vulnerable developmental stage and are affected by general as well as sport-specific risk factors. METHOD: Our data was derived from the German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL) which conducted a survey in 1138 elite adolescent athletes. In this sample, we assessed body weight, weight control behavior, body acceptance and screened overall for core symptoms of eating disorders, depression and anxiety. We performed a tree analysis to identify high risk groups for eating disorder pathology. RESULTS: High risk groups comprised (a) athletes competing in weight dependent sports, and among athletes competing in disciplines other than weight dependent sports (b) athletes who are high on negative affectivity, (c) female athletes and (d) male athletes competing in endurance, technical or power sports. Athletes competing in weight dependent disciplines reported wide spread use of compensatory behaviors to influence body weight. Athletes reporting eating disorder pathology showed higher levels of depression and anxiety than athletes without eating disorder pathology. DISCUSSION: Increased psychosocial burden in athletes with eating disorder pathology suggests that eating disorder symptoms should not be accepted as an unproblematic and functional part of elite sports. The prevention and management of eating disorder pathology is especially important in weight dependent sports. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:553-562).

Have adults lost their sense of play? An observational study of the social dynamics of physical (in)activity in German and Hawaiian leisure settings.

BACKGROUND: Physical inactivity is one of the biggest health problems nowadays. Recent research shows that socio-cultural barriers to physical activity are mostly related to modern lifestyles. However, there is a lack of research on how social and group dynamics influence engagement in physical activity. Furthermore, there are few cross-cultural studies that have compared the social dynamics of (in)activity in different cultural settings. This paper therefore aims to analyse how social group dynamics influence physical activity and inactivity in informal social environments and whether physical activity is influenced by the socio-cultural settings. METHODS: The paper presents the qualitative data collected within a covert participant observation study. Data was collected by keeping observational notes in order to record typical, regular patterns regarding physical (in)activity related behaviour of groups at an artificial open air swimming pool in Germany and a natural pond in Hawai'i. The data collection period was eight and a half months. Data was interpreted based on constant comparative analysis in order to identify most generative patterns in the field notes. RESULTS: Group structures appear to play a significant role regarding the activity of the group members. In this study, we identified four key factors that influence group based physical activity: 1) Physical activity seems to be a group disturbing behaviour particularly in larger groups of adults; 2) Physical activity appears to be more functional and less joyful in adults than in children; 3) Group activity is influenced by (in)activity anchors, including 'domestication' of a group's site, obesity, and controlling parents. 4) Physical activity is to a certain extent socially contagious, particularly with regard to playful activities. CONCLUSIONS: Successful promotion of physical activity should target the social structures of inactive individuals' groups. In this regard, one of the main problems is that fun and wellbeing, as very important targets of public health strategies for the adult population, appear not to be compatible with physical activity. Developing strategies to reframe physical activity rather as 'fun' and less as functional may be one way to engage inactive individuals in physical activity in leisure settings.

The meaning of injury to the elite athlete: A systematic review.

In the pursuit of a successful career in elite sports, athletes mostly rely on their physical abilities. An injury can threaten such a career, thereby representing a potentially critical life event that carries considerable meaning to the affected athlete. Qualitative literature exploring injury experiences in elite athletes is therefore seeking to frame injury through the athlete's own voice. With this systematic review, we aimed to answer the research question What is the meaning of injuries to the elite athlete? by reviewing existing qualitative research exploring the meaning of injury as told from the athlete's perspective. We constructed five overarching themes of meaning through thematic synthesis of 29 original studies: (1) unwelcome disruption - Injury as potential career threat; (2) destruction - My life (as an athlete) is over; (3) reinforcement - Relighting the fire; (4) going through the motions - Injury as an inherent part of elite sport; and (5) time-out - Respite and perspective. These meanings were neither exclusive nor static but constructed according to the situation at the moment of injury and could later be adapted depending on social context and specific circumstances. To better support injured athletes, practitioners need to be aware of the importance of the subjective meaning that athletes construct for individual injuries. Understanding these meanings enables practitioners to aid athletes in changing previously negative meanings into more positive ones. Our findings therefore call for improvements in the individualized support of elite athletes that leaves space for open communication about the meanings that athletes attach to their injury experiences.

Correlates of physical activity enjoyment in children and adolescents for a new perspective on the treatment of overweight: A systematic literature review.

The purpose of this systematic literature review was to systematically compile the state of knowledge on correlates of physical activity enjoyment in children and adolescents to influence the perspective of future physical activity promotion approaches especially for children and adolescents affected by overweight or obesity. The electronic database search was executed in the five databases PubMed, PsychINFO, SPORTDiscus, Web of Science, and BISp-SURF, from inception to December 6, 2021. A semi-quantitative method was used for summarizing the resulted correlates. For final analysis, 85 studies comprising 48,144 children and adolescents were included. Fifty-seven variables could be coded for their relationship with physical activity enjoyment. Of these, 12 psychological variables, for example, the basic psychological needs, task orientation, or self-efficacy; six interpersonal variables, for example, peer/group acceptance, parental support, and autonomy support; and one behavioral variable, the higher self-reported physical activity, are consistent positively associated to physical activity enjoyment. A scientifically based overview could be extracted for the promotion of physical activity enjoyment in children and adolescents. There is a gap in literature focusing the perception of physical activity enjoyment in the subgroup of children and adolescents affected by overweight or obesity. Therefore, recommendations were made to enable the development of further innovative research approaches in this population.

Body dissatisfaction in female adolescents: extent and correlates.

This study aimed to assess the extent, patterns, and predictors of feelings of body dissatisfaction experienced by female German adolescents. Using 3D-avatar software, a sample population of 144 girls between 14 and 17 years of age was asked to estimate their actual body image, their desired body image (individual ideal), and the body image they believed their parents and their best female friend considered to be the ideal body image for them. The participants estimated their actual body mass index (BMI) to be 18.82 ± 3.01. The individual ideal body shape reported was significantly thinner, with a BMI score of 16.84 ± 2.51. Given a girl who stands 1.65 m and weighs 55 kg, this corresponds to a difference in weight of about 5.5 kg. After adjustment for the participant's self-reported BMI, participating in an esthetic sport was correlated with a significantly lower body dissatisfaction. Conversely, low socio-economic status and the amount of time spent watching TV was correlated with a significantly higher body dissatisfaction. Negative body image-related comments made by parents were significantly associated with body dissatisfaction. The girls who participated in this study would like to be an average of 1.97 BMI units thinner. The findings presented here suggest that future intervention measures should focus on the risk groups of physically inactive girls, those who smoke, and those with a lower social status and high rates of TV consumption. Intervention measures would be especially effective in German schools which offer lower education levels and should include the pupils' parents, who should be informed about the negative effects weight- and diet-related comments have on their children's body images.