Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls.

Body dissatisfaction is distressing and a risk factor for adverse consequences including eating disorders. However, data pertaining to the prevalence of body dissatisfaction in adolescence, a key period for its emergence, are lacking. This is a substantial barrier to tailored assessment and early intervention. This study addresses this gap and provides the prevalence of body dissatisfaction and associations with depressive symptoms and body change strategies. Adolescent boys (n = 367; Mage = 12.8, SD = 0.7) and girls (n = 368; Mage = 12.7, SD = 0.7) completed measures of body dissatisfaction and depressive symptoms with established cut-off levels. They also completed measures of dietary restraint and strategies to increase muscle size. Of boys and girls, 37.9% and 20.7%, respectively experienced moderate, and 6.8% and 19.6% experienced clinically significant body dissatisfaction, with higher rates among girls than boys and among adolescents aged 13 and 14 than aged 12. More than one-quarter of boys (26.70%) and one-third of girls (33.15%) reported subthreshold depressive symptoms or possible, probable or major depressive episodes. Girls revealed a higher prevalence of possible-, probable-, or major depressive episode than boys. Relative to those with no or low body dissatisfaction, adolescents with clinically significant body dissatisfaction were 24 times more likely to also report possible-, probable-, or major depressive episodes. Among boys and girls, clinically significant body dissatisfaction was associated with higher levels of dietary restraint and engagement in strategies to increase muscle size. Greater attention to identification and early intervention for body dissatisfaction is needed, especially for girls.

A Biopsychosocial Model of Social Media Use and Body Image Concerns, Disordered Eating, and Muscle-Building Behaviors among Adolescent Girls and Boys.

Social media use is associated with body image concerns, disordered eating and body change behaviors in adolescents. This study aimed to examine these relationships within a biopsychosocial framework and test an integrated model. A sample of 681 adolescents (49% female), mean age = 12.76 years (SD = 0.74), completed a questionnaire assessing social media use, depression, self-esteem, body mass index, social media and muscular ideal internalization, appearance comparison, body dissatisfaction, disordered eating, and muscle-building behaviors. Path analysis was used to test the hypothetical model, which after modification revealed good fit to the data, although gender differences emerged. The findings suggest that biopsychosocial frameworks are useful for conceptualizing relationships between social media use and body image, eating, and muscle building outcomes.

'You could get sick, disgusting': an analysis of alcohol counter-advertisements created by children.

Advertisements are persuasive texts designed to communicate ideas explicitly and implicitly through visual grammar. Counter-advertisements allow students to engage with advertising texts as creators rather than consumers and challenge media messages. Based in critical media literacy theory, this paper explores how elementary students interpret and redesign advertisements to create meaning. This study focused on the messages upper-elementary school students created about alcohol following a 10-lesson alcohol media literacy programme. Text from the counter-advertisements (n = 161) was analysed using discourse analysis. The counter-advertisements were also content analysed for message content, persuasion strategies and production components using a media literacy framework. The content of male-targeted, female-targeted and gender-neutral ads was compared using chi-square analyses. The four main themes identified in the discourse and content analysis were 'vomit', 'sick', 'danger' and 'poison', highlighting an emphasis on short-term consequences of alcohol misuse. Sensory (un)appeal was the most frequently used persuasion strategy, while objects/symbols and colour were the most frequently used production components. The use of these devices differed depending upon the advertisement's target gender. Involving elementary students in the redesign of advertisements is a powerful pedagogy that enables students to demonstrate their understanding of media literacy practices and create health promotion messages.

A systematic review of children's alcohol-related knowledge, attitudes and expectancies.

Understanding the nature of, and transitions in, young children's alcohol-related knowledge and attitudes is important to determining the age at which we should start educating children about alcohol and informing our understanding of the focus of such education. This paper aimed to explore current literature on the alcohol-related knowledge, beliefs, attitudes and expectancies of children aged 12years and under. Electronic databases were searched for papers published from January 2000-August 2016. Further papers were identified by a manual review of reference lists, and contacting corresponding authors of included papers. Papers that reported on children's knowledge or beliefs about alcohol, attitudes towards alcohol and/or expectancies regarding alcohol consumption were included. Seventeen cross-sectional, experimental or observational studies and seven longitudinal studies met the inclusion criteria. Data on key measures was tabulated. From a very young age children are aware of and able to identify alcohol, and have some knowledge of its effects; their attitudes become more positive with increasing age and these shifts appear to precede drinking initiation by some years. The small number of available studies, with different measures of knowledge, attitudes and expectancies, made assessment of bias unfeasible. Only three studies were published in the last five years. Children's knowledge of, and attitudes towards, alcohol form before they initiate alcohol use, and are likely acquired through observation. Alcohol-related education should commence before children begin drinking, and should encourage the delay of alcohol initiation, address social norms, and reduce positive expectancies.

Qualitative process evaluation of an Australian alcohol media literacy study: recommendations for designing culturally responsive school-based programs.

BACKGROUND: Alcohol media literacy programs seek to mitigate the potentially harmful effects of alcohol advertising on children's drinking intentions and behaviours through equipping them with skills to challenge media messages. In order for such programs to be effective, the teaching and learning experiences must be tailored to their specific cultural context. Media in the Spotlight is an alcohol media literacy program aimed at 9 to 12 year old Australian children. This study evaluates the process and implementation of the program, outlining the factors that facilitated and inhibited implementation. From this evaluation, a pedagogical framework has been developed for health professionals implementing culturally responsive programs in school settings. METHODS: Process measures included: semi-structured interviews with teachers before and after the program was implemented (n = 11 interviews), program evaluation questionnaires completed by children (n = 166), lesson observations completed by teachers (n = 35 observations), and reflective journal entries completed by the researcher (n = 44 entries). A thematic analysis approach was used to analyse all of the data sets using NVivo. Inductive coding was used, whereby the findings were derived from the research objectives and multiple readings and interpretations of the data. RESULTS: Five key pedagogical considerations were identified that facilitated implementation. These were: connecting to the students' life worlds to achieve cultural significance; empowering students with real-world skills to ensure relevance; ensuring programs are well structured with strong connections to the school curriculum; creating developmentally appropriate activities while providing a range of assessment opportunities; and including hands-on and interactive activities to promote student engagement. Three potential inhibitors to implementing the alcohol media literacy program in upper-elementary school classrooms were identified. These included topic sensitivities, classroom management challenges, and fitting new programs into already busy school schedules. CONCLUSION: Overall, the program content and individual lessons were well received by the teachers and students. The lessons learned from the development, implementation and evaluation of this program can provide health professionals with key pedagogical strategies for designing culturally responsive educational programs. Culturally responsive programs are critical for ensuring interventions are effective for their specific context.

Effectiveness of alcohol media literacy programmes: a systematic literature review.

Alcohol media literacy is an emerging field that aims to address the link between exposure to alcohol advertising and subsequent expectancies and behaviours for children and adolescents. The design, rigour and results of alcohol media literacy programmes vary considerably, resulting in a number of unanswered questions about effectiveness. To provide insight into some of these questions, a systematic literature review of alcohol media literacy studies was conducted. The review was guided by the following research question: What considerations are needed to develop an effective school-based alcohol media literacy programme? On the basis of a critical synthesis of 10 interventions (published in the period 1997 to May 2014), our findings provide a comprehensive understanding of the descriptive, methodological and outcome characteristics of this small body of significant research. The review provides considerations for future alcohol media literacy programmes, including the need for an interactive pedagogical approach within the naturalistic school setting, implementation fidelity and a holistic approach to programme evaluation, a means for maintaining relevance, consideration of gender differences, relevance for an international audience and use of follow-up and longitudinal data.

Autistic Women's Experience of Motherhood: A Qualitative Analysis of Reddit.

Autistic mothers remain under-represented in parental and autism research despite the associated physical and psychosocial challenges that accompany the transition to motherhood. Extant literature suggests autistic mothers experience sensory difficulties, communication challenges, stigma, and comorbidities as difficulties, but these studies have focused on autistic women in the perinatal period. The aim of this study was to examine reflections on motherhood from a Reddit community for autistic parents. Identified themes were Autistic Mothering is Different, Autistic Mothers Need Autistic Mothers, Autistic Mothers Experience Stigma, and Learnings from Lockdown. Findings extend existing research by offering insight into the ways autism impacts mothers beyond the perinatal period and have important implications for the future design and delivery of support services for autistic mothers.

Representation of autism in fictional media: A systematic review of media content and its impact on viewer knowledge and understanding of autism.

LAY ABSTRACT: The way autism is represented in fictional media can impact people's views of autistic people. For example, representations may contribute to negative views of autistic people as being unusual or dangerous, or they may challenge stereotypes and instead highlight the strengths of autistic people. This work aimed to review previous research to understand how autistic people have been represented in fictional media (Part A). It also sought to understand whether viewing fictional portrayals of autism has an impact on people's knowledge of autism and attitudes towards autistic people (Part B). Of 14 studies that were included in Part A, several unhelpful and stereotypical portrayals of autism emerged. Positive portrayals were those that highlighted the strengths of autistic people and reflected nuance. There is a need for greater diversity in representation of autism in fictional media. For example, not all autistic people are white heterosexual males. Across the five studies included in Part B, there were no improvements in people's knowledge of autism after watching or reading a short segment from a fictional TV series or novel that depicts an autistic person. Although there was a significant improvement in people's attitudes towards autistic people, these findings do not provide a complete picture given the short length of the media exposure and small number of studies. Future studies should investigate how multiple exposures to the representation of autistic people in both fictional and non-fictional sources can affect people's understanding of autism. There is also a need to develop more accurate and respectful ways of measuring people's knowledge of, and attitudes towards, autism.

Inclusion, Exclusion and Isolation of Autistic People: Community Attitudes and Autistic People's Experiences.

There is limited research examining the inclusion of autistic people in their local communities. This paper reports on two Australian studies which explored this gap, focusing on both autistic people's experiences and non-autistic people's attitudes towards autistic individuals. Study One was conducted with primarily non-autistic people (n = 2,383), and Study Two with primarily parents and carers of autistic people (n = 1,297 people). The majority of non-autistic adults perceived discrimination against autistic people in the community; consistent with the experiences of autistic people and their carers. Of particular concern was more negative attitudes towards, and experiences of, autistic adults. There is an urgent need to improve society's acceptance and inclusion of autistic people of all ages.

Autism in Australia: Community Knowledge and Autistic People's Experiences.

This paper presents two studies that explored community attitudes to autism in Australia; and autistic people and their families' perspectives of community attitudes. In Study One 2424 (primarily non-autistic) people completed a survey on autism-related knowledge and attitudes; identifying a number of misperceptions and knowledge gaps in the general community. In Study Two 1353 people (primarily parents and carers of autistic people) completed a survey on autism-related experiences; identifying that the community's awareness of autism does not appear to extend to understanding how to support autistic people. There is a need for more research which integrates the perspectives of both autistic people and the broader community; and the development of communication and education interventions, with rather than about autistic people.

Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls.

Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; Mage = 12.77, SD = 0.74; range 11-15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.

Children and tutor's perspectives on a homework support program in Melbourne: A university-school partnership.

This study focuses on a homework program where an Australian University partnered with a school to support children from culturally and linguistically diverse backgrounds. Undergraduate tutors, paired with a child each semester, provided weekly learning support. This exploratory study aimed to understand the experiences of the children participating in the program and any benefits received. Nineteen children participated in activity-based focus groups, and seven undergraduate tutors participated in one-on-one interviews. Overarching themes identified were as follows: making homework club enjoyable, program outcomes, tutor-child relationship and transitioning to a new tutor. Although children were required to do homework they usually avoided, the task was made less onerous and even enjoyable because of the relationship the children had with their tutor, the support received and new skills learnt. The tutor-child relationship was deeply valued, with the tutor's role going beyond instructional support to also providing social and emotional support and a sense of belonging in line with Social Support Theory. Both the children and tutors expressed contrasting views about the experience of children transitioning to a new tutor each semester and this departs from the extant literature. The challenges related to the loss of connection, while positive aspects concerned the opportunity to make new friends and learn from different teaching styles. Given these contrasting findings, it is worth considering how the transition process can be managed and explained to children and increase the chances of positive adaptation. Despite the relatively short-term nature of the tutor-child relationship, the children expressed clear academic, social and emotional benefits. The findings suggest that semester-based university-school homework tutoring programs can be effective despite their short-term nature, provided due consideration is given to the transition process. These findings address the paucity of research exploring short-term programs of this nature.

An Australian study on the benefits of pastoral care to aged care residents in Christian affiliated homes.

This study aimed to understand the experience of pastoral care (PC), that is, the provision of support, comfort and spiritual counselling, from the perspective of Australian aged care residents. A survey research design captured feedback on participants' PC experience. Outcomes were reported by 575 residents (aged 53-102) across 41 sites. The majority perceived that they received a high quality of care (92%) and benefited from their meeting with the pastoral practitioner (80%), 'often' or 'all of the time'. A few significant differences were found based on participants' gender, spirituality (i.e. connection and meaning), religiosity (i.e. faith beliefs and religious practices) and well-being. Females and participants who identified as both religious and spiritual were more likely to feel that their faiths/beliefs were valued. Those with greater psychological well-being, as defined by the World Health Organisation (1998), were more likely to report receiving a high quality of care and greater benefits from receiving PC than those with poorer well-being. Three overarching themes and eight subthemes were identified from the open-ended responses: 1) personal qualities of the pastoral practitioner; caring, supportive, understanding and empathetic; 2) pastoral practitioner met specific needs; spiritual and religious, friendship and company and assistance, advice and help; and 3) positive impact on the participant; feeling listened to, peaceful and valued, accepted and respected. The qualitative findings resonate with Maslow's Hierarchy of Needs, to feel safe, belong and have self-esteem. There was a synergy between what participants desire in the care they receive, as expressed in the open-ended questions, and what the pastoral practitioners provide, as indicated in the quantitative findings. A study strength was its mixed-method, multi-site and cross-organisational context, enabling PC to be explored across a diverse sample. Future research should consider a pre- and post-test survey to more comprehensively capture the impact and benefits of PC.

A cluster randomized controlled trial of the SoMe social media literacy body image and wellbeing program for adolescent boys and girls: Study protocol.

Youth spend substantial time on social media, which can foster self-critical processes that increase risk of body dissatisfaction, disordered eating, and depressed mood. To date, there have been few investigations of interventions to decrease the negative impacts of social media engagement in adolescent boys and girls. This paper outlines the protocol for a cluster randomized controlled trial (RCT) of a four-lesson social media literacy program that was developed based on pilot results and aims to decrease body dissatisfaction, dietary restraint, and strategies to increase muscles. The RCT will be conducted with grades 7-8 students from Australian secondary schools. Using block randomization, grade levels within schools will be assigned to either the SoMe program (intervention) or health lessons as usual (control). Primary outcomes will be body satisfaction, dietary restraint, and strategies to increase muscles. Secondary outcomes will be self-esteem and depressed mood. Participants will complete assessments on four occasions - baseline, five-weeks post-baseline, and six- and 12-month post-baseline. Analyses will compare outcomes in the intervention compared to the control group. This study will be the first to implement a RCT design to evaluate the impact of a school-based social media literacy program designed to mitigate negative impacts of social media.

"I see so much in them": Australian Chaplains telling an alternative narrative of adolescents in the justice system.

This qualitative study aims to provide insight into the impact of chaplaincy in the Australian juvenile justice system. Semi-structured qualitative interviews were conducted with six chaplains and managers of chaplaincy services in the juvenile justice system in Victoria, Australia. Interviews were analysed thematically using deductive and inductive coding. Four themes emerged relating to the role and impact of the chaplain: to establish a safe and trusting relationship with the adolescents, to convey love and belonging, to engage the adolescents in meaning making, and to help adolescents to realise their full potential. These themes are consistent with Maslow's Hierarchy of Needs. Two themes emerged regarding how to increase the reach of chaplaincy: through recognising chaplaincy as an integral part of the justice system and enabling chaplains to work with the adolescents and their families post-release. While limited by a small sample, this study represents all organisations that provide chaplaincy in the juvenile justice system in Victoria, Australia. Future research could include the voices of the adolescents in juvenile justice, to gain their perspective on the role and impact of chaplaincy services.

'It's like a drink you'd have before you go to a party': Analysis of a Vodka Cruiser advertising campaign.

INTRODUCTION AND AIMS: The aim of the present study was to explore young women's understandings of, and interactions with, an advertising campaign for a pre-mixed alcohol product that appeared to be promoting pre-drinking. This campaign was the subject of complaints to the Alcohol Advertising Review Board, revealing an inconsistency between the way the company responded to such complaints (arguing that the campaign does not encourage pre-drinking) and the way it described the campaign in trade press (the pre-drink enjoyed by the 'girls' while getting ready …). DESIGN AND METHODS: Twelve focus groups were conducted with 72 young women, aged 15-25 years in Melbourne, Australia. These young women's interpretations of the messages communicated in this advertising campaign were analysed thematically. RESULTS: The young women identified, without prompting, the main message of the campaign as being a reference to pre-drinking. Most notably, the women saw the target audience as young (including underage) women. DISCUSSION AND CONCLUSIONS: Given that young women who drink are increasingly doing so at harmful levels, a marketing campaign, which is interpreted by the target audience to encourage pre-drinking among young (including underage) women, appears to be inconsistent with the industry's own code for alcohol advertising. We renew the call for effective regulation of alcohol advertising to better protect young Australians. [Jones SC, Francis KL, Gordon CS. 'It's like a drink you'd have before you go to a party': Analysis of a Vodka Cruiser advertising campaign. Drug Alcohol Rev 2018;37:36-41].

Gender Effects in a Multischool Alcohol Media Literacy Study With Preadolescents.

OBJECTIVE: Alcohol media literacy (AML) programs have achieved positive results for alcohol prevention; however, gender may moderate program effectiveness. This study investigated gender differences for an Australian AML intervention. METHOD: Fifth and sixth graders ( N = 165), allocated to an intervention or wait-list control group, participated in an AML program. Student questionnaires were administered at three time points. RESULTS: The intervention resulted in significantly higher media deconstruction skills but did not lead to less preference for branded merchandise or greater understanding of persuasive intent, and these effects did not differ by gender. Gender differences were present in social norms for drinking and alcohol expectancies. CONCLUSIONS: AML education likely has appeal and benefit to both genders as it connects with students' lifeworlds. Social norms may be more difficult to shift for males due to a more ingrained drinking culture. Future research could explore contextual factors responsible for gender differences.

What is 'binge drinking'? Perceptions of Australian adolescents and adults, and implications for mass media campaigns.

OBJECTIVE: While the term 'binge drinking' has no definitive definition, it is commonly used in lay conversation and mass media communication campaigns. It is important to understand how the general population interprets the term, and their positive and negative perceptions of this behaviour. METHODS: A convenience sample of 549 participants from two Australian towns completed a survey on perceptions of binge drinking; 221 adolescents, 104 parents of adolescents and 224 adult community members. RESULTS: Across all three groups, binge drinking was defined using broad descriptors; few respondents referred to specific consumption levels and those who did varied widely in the quantities specified. The majority of respondents described binge drinking negatively and, in most cases, more negatively for adolescents than adults. However, both adult groups perceived binge drinking to be more enjoyable and pleasant for adolescents than for adults, and more enjoyable and pleasant than adolescents did themselves. CONCLUSIONS AND IMPLICATIONS: There is a need for shared understanding of terms to ensure that educational interventions and communication campaigns are using the same definitions as their target audiences. There is also a need to ensure adults are not providing young people with mixed messages about excessive alcohol consumption.