Protocol of a cluster randomised trial of BodyKind: a school-based body image programme for adolescents.

BACKGROUND: Poor body image is prevalent among adolescents and associated with several negative outcomes for their physical and psychological health. There is a pressing need to address this growing public health concern, yet there are few evidence-informed universal programmes for older adolescents that address contemporary body image concerns (i.e., social media). BodyKind is a four lesson, school-based, teacher led, universal body image programme that incorporates empirically supported principles of cognitive dissonance, self-compassion, compassion for others and social activism, to support positive body image development. Building on previous pilot trials in the USA, this paper outlines the protocol for a cluster randomised control trial (cRCT) and implementation evaluation of the BodyKind programme which was culturally adapted for the Irish cultural context. METHODS: We aim to recruit 600 students aged 15-17 years in Transition Year (4th year) across 26 second-level schools in Ireland. Using minimisation, schools will be randomly assigned to receive BodyKind (intervention condition, n=300) or classes as usual (waitlist control, n=300). Teachers in intervention groups will receive training and deliver the programme to students over four weeks, at a rate of one lesson per week. Primary outcomes of body appreciation, body dissatisfaction and psychological wellbeing and secondary outcomes of self-compassion, compassion for others, body ideal internalisation, social justice motives and appearance-based social media use will be assessed at pre-, post- and 2 month follow up. Mediation and moderation analyses will be conducted to identify how and for whom the intervention works best. An implementation evaluation will assess the quality of programme implementation across schools and how this may influence intervention outcomes. Waitlist control schools will receive the programme after the 2-month follow up. CONCLUSION: This study will be the first to implement a cRCT and an implementation evaluation to assess the impact of this multicomponent school-based body image programme designed to support healthy body image development. If shown to be effective, BodyKind will have the potential to improve adolescent body image and wellbeing and inform efforts to implement sustainable and scalable programmes in schools. TRIAL REGISTRATION: The trial was retrospectively registered on 10/10/2023 on ClinicalTrials.gov NCT06076993 .

Enhancing body image in motherhood: A randomised controlled trial of Expand Your Horizon among mothers of young children.

Motherhood can increase vulnerability to body dissatisfaction, but positive body image interventions may mitigate this. Expand Your Horizon (Alleva et al., 2015), an online writing intervention, enhances functionality appreciation, an aspect of positive body image. The intervention's demonstrated efficacy and focus on body functionality indicate its potential use among mothers. However, its original 3-session format may be unfeasible for mothers alongside other commitments. Thus, we tested the impact of a single 15-minute Expand Your Horizon session on state body appreciation and functionality appreciation. Mothers (N = 143) of 0-10-year-olds were randomly allocated to either the intervention group, or an active control group. State body appreciation and functionality appreciation were assessed pre- and post-intervention. Trait self-compassion was tested as a potential moderator. Participants who completed Expand Your Horizon reported greater state body appreciation and functionality appreciation post-intervention than those in the control group. Self-compassion moderated the intervention's effect on state functionality appreciation, with effects strongest for those with lower levels of self-compassion. Overall, findings support the intervention's suitability for mothers, particularly those with low self-compassion. Practical implications include possibly tailoring Expand Your Horizon and similar interventions to benefit all mothers. Future research directions include longitudinal and qualitative designs, and extension to other specific populations.

Pilot feasibility and acceptability trial of BE REAL's BodyKind: A universal school-based body image intervention for adolescents.

Body dissatisfaction is prevalent among adolescents and a primary risk factor for eating disorders, yet there are few body image interventions for older adolescents that support development of positive body image. Therefore, we assessed the feasibility, acceptability and preliminary effectiveness of BodyKind, a four-lesson, mixed gender, teacher-led, school-based curriculum for older adolescents, that combines principles of self-compassion, compassion for others, cognitive dissonance, and social activism to address contemporary adolescent body image concerns (i.e., appearance bias, comparisons on social media) and strengthen positive body image development. The sample contained 147 adolescents, predominantly racial/ethnic minorities (>95%), 54.8% male, 41.5% female and 4.1% gender-minority students aged 15-18 years (M=16.24, SD=.96) from a low-income, inner-city high school in the Midwestern US. Two teachers received training and delivered the curriculum to students. This single arm, mixed methods trial assessed student and teacher acceptability, teacher fidelity and student intervention outcomes. Despite reasonable teacher fidelity, recruitment/attendance rates, post-intervention data loss (35% attrition) limited evaluations of program effectiveness and study feasibility. Important learnings regarding study feasibility will inform optimisation for future school-based trials. Findings demonstrate high acceptability of BodyKind among teachers and adolescents in a lower socioeconomic school setting, and further randomized controlled effectiveness trials are required.

Appearance and performance factors associated with muscle building supplement use and favourable attitudes towards anabolic steroids in adolescent boys.

Introduction: The demand for appearance and performance enhancing substances, including muscle building supplements and anabolic androgenic steroids, is increasing in Australia. However, little is known about the associations between appearance and performance-based factors and appearance and performance enhancing substances (APES), particularly among adolescent boys. This study sought to examine (a) the prevalence of muscle building supplement use in a sample of adolescent boys and (b) how both performance and appearance factors relate to muscle building supplement use and favourable attitudes towards anabolic androgenic steroids in this sample. Method: N = 488 adolescent boys aged 13-16 (Mage = 14.59) from nine Australian schools completed measures of supplement use, favourable attitudes towards using steroids, muscle dissatisfaction, body fat dissatisfaction, mesomorphic ideal internalisation, weight training, and sports participation. Hierarchical logistic regressions were used to examine cross-sectional correlates of muscle building supplement use and favourable attitudes towards using anabolic androgenic steroids. Results: In the past three months, 12.7% of the sample had used muscle building supplements. Both appearance and performance-related factors - mesomorphic ideal internalisation and weight training - were related to muscle building supplement use. Only one appearance-related factor - body dissatisfaction - was related to favourable attitudes towards anabolic androgenic steroids. Discussion: The findings from this study are important as they may help to guide intervention strategies regarding appearance and performance enhancing substance use by Australian adolescent boys, with the ultimate goal of ensuring this population's safety.

Body image profiles combining body shame, body appreciation and body mass index differentiate dietary restraint and exercise amount in women.

This project aimed to establish whether meaningful body image profiles (BIPs) could be identified across measures of body shame, body appreciation, and body mass index (BMI), and whether these profiles could differentiate key health behaviours. Data came from 1200 adult women who responded to an online body image survey. Latent profile analysis was used to identify BIPs based on relative levels of body shame, body appreciation and BMI. Differences in dietary restraint and weekly exercise amount were investigated according to BIP membership. Latent profile analysis revealed four unique BIPs; 1. Appreciative BIP (AP-BIP); 2. Medium Shame BIP (MS-BIP); 3. High Shame BIP (HS-BIP) and 4. Average BIP (AV-BIP). Dietary restraint and exercise amount differed significantly according to BIP in most comparisons. Women in the High Shame BIP exhibited the highest dietary restraint and lowest exercise. Women in the Appreciative BIP exhibited the lowest dietary restraint and highest exercise. Body shame and body appreciation intersect with BMI to form unique profiles (BIPs) that differentiate dietary restraint and exercise. Using BIPs to tailor interventions designed to promote healthful diet and exercise should be considered in public health initiatives.

Independent pragmatic replication of the Dove Confident Me body image program in an Australian Girls Independent Secondary School.

Following calls for the independent replication of universal body image programs under diverse conditions, this research aimed to investigate whether the universal co-educational prevention program developed for audiences in the United Kingdom (Dove Confident Me, DCM), was an acceptable and effective intervention when delivered by teachers to adolescent girls attending a single-sex Australian school. Comprising two studies, Study 1, evaluated DCM among Grade 8 students (N = 198) at a single-sex private school, and compared the results with students (N = 208) s from a matched comparison group. No improvements were observed on outcome measures between the comparison and intervention girls over the three time points. Study 2 involved minor modifications to the aesthetics and content of the program, as well as the logistics of delivery. Delivered by teachers to Grade 8 students (N = 242 intervention and N = 354 comparison), there were significant improvements in acceptability of the modified DCM program, yet no interaction effects observed on outcome measures. While the program did no harm, it is possible that there are adjustments to the methods utilized and content of programs that are trialed in efforts to prevent body image concerns and eating disorders in the school setting.

Zooming in: The relationship between appearance concerns and perceived performance whilst videoconferencing among Australian adults.

Videoconferencing for work/study purposes has increased rapidly due to the COVID-19 global pandemic. Given this practice often involves viewing one's own video image, higher appearance concerns whilst videoconferencing may be linked to poorer performance whereby individuals may not feel they are able to engage or have control during a work/study meeting. The present study cross-sectionally examined whether both facial appearance concerns and fear of negative evaluation during videoconferencing for work/study purposes were directly and indirectly related to performance control and engagement, through self-focused attention and appearance distraction. Adult participants (N = 534, Mage = 26.32, SD = 11.08; 78% female) completed an online survey during the COVID-19 pandemic in Australia. Path analysis revealed direct and indirect effects, suggesting that heightened appearance self-consciousness was associated with greater self- and appearance-focused attention. In turn, this was related to impaired performance during videoconferencing. Multigroup analyses demonstrated that the magnitude of the proposed correlational effects were comparable across men and women. Given the ongoing reliance on videoconferencing, these findings have important theoretical and practical implications.

Goodform: A cluster randomised controlled trial of a school-based program to prevent body dissatisfaction and muscle building supplement use among adolescent boys.

Although body dissatisfaction is common among adolescent boys, few intervention programs specifically developed for boys have been shown to be effective for reducing body dissatisfaction. Our study aim was to evaluate Goodform, a 4-session, teacher delivered intervention program specifically developed for boys to reduce body dissatisfaction and muscle building supplement use. The Goodform program was based on cognitive dissonance, social learning theory, and a social norms approach, and drew from two existing body image intervention programs that have shown promise among males: The Body Project- More than Muscles, and the Athletes Training and Learning to Avoid Steroids Program (ATLAS). A sample of 488 boys in grades 9 and 10 (Mage = 14.81, SDage = 0.51) at nine secondary schools in Australia were randomly assigned to Goodform (n = 244) or control (n = 244) at the school level. Self-reported body image, supplement use, anabolic androgenic steroid (AAS) use, and attitudes around using AAS and muscle building supplements were measured at baseline, post-intervention, and eight-week follow-up. Analyses with multi-level, mixed-effect regression models revealed no changes over time attributable to the intervention. Our results have implications for researchers in the body image and eating disorder prevention fields. Lessons learned in this study can inform future school-based efforts for reducing muscle building supplement use.

"Can you see me?" Videoconferencing and eating disorder risk during COVID-19: Anxiety, impairment, and mediators.

OBJECTIVE: The use of videoconferencing has increased during the pandemic, creating prolonged exposure to self-image. This research aimed to investigate whether eating disorder (ED) risk was associated with videoconferencing performance for work or study and to explore whether the use of safety behaviors and self-focused attention mediated the relationship between ED risk and perceived control over performance anxiety, impaired engagement, or avoidance of videoconferencing for work or study. METHOD: In 2020, an online survey was distributed within Australia to those aged over 18 years via academic and social networks, measuring: use of videoconferencing for work/study, demographics, ED risk, safety behaviors for appearance concerns, self-focused attention, perceived control over performance anxiety, perceived engagement impairment, and avoidance of videoconferencing. A total of 640 participants (77.3% female, Mage  = 26.2 years) returned complete data and were included in analyses. RESULTS: 245 participants (38.7%) were considered at-risk for EDs (SCOFF > 2). Those at-risk reported significantly more safety behaviors, self-focused attention, impaired engagement, and avoidance, plus lower perceived control over performance anxiety than those not at-risk. Multiple mediation models found the effects of ED risk on control over performance anxiety, impaired engagement, and avoidance were partially mediated by safety behaviors and self-focused attention. DISCUSSION: Our cross-sectional findings suggest videoconferencing for work/study-related purposes is associated with performance anxiety, impaired engagement, and avoidance among individuals at-risk for EDs. Poorer videoconferencing outcomes appear more strongly related to social anxiety variables than ED status. Clinicians and educators may need to provide extra support for those using videoconferencing. PUBLIC SIGNIFICANCE: Because videoconferencing often involves seeing your own image (via self-view) we wondered whether the appearance concerns experienced by those with eating disorders (EDs) might interfere with the ability to focus on or to contribute to work/study videoconferencing meetings. We found that although those with EDs experience more impairments in their videoconferencing engagement/contribution, these were linked just as strongly to social anxiety as they were to appearance concerns.

The Needs of School Professionals for Eating Disorder Prevention in Australian Schools: A Mixed-Methods Survey.

(1) Background: School professionals such as teachers and counsellors are uniquely positioned to facilitate discussion around disordered eating and body image; however, little is known about the needs of school professionals with respect to eating disorder prevention. This study aimed to explore the needs and perceptions of Australian school professionals regarding eating disorder prevention. (2) Methods: School professionals were recruited to a mixed-methods online cross-sectional survey. The survey assessed demographics and perceived needs and attitudes to eating disorder prevention. (3) Results: Most participants (92%) were willing to participate in eating disorder prevention; however, only 61% reported good knowledge and 41% reported feeling confident in implementing eating disorder prevention. Those who had received training in eating disorders (24%) reported higher confidence (p = 0.02) and knowledge (p = 0.04). Only 66% of respondents reported that all teachers should be involved in eating disorder prevention while barriers including workload, knowledge, and resources were commonly highlighted. Fewer respondents working in primary school settings reported the need for prevention approaches (p = 0.046). (4) Conclusions: Despite a willingness to be involved in the prevention of eating disorders, there are inconsistencies in attitudes regarding the role of school professionals in eating disorder prevention. The findings of this study reinforce that understanding professional roles, school settings, and personal attitudes is critical in the development of more efficacious school professional training and prevention interventions.

Informing mHealth and Web-Based Eating Disorder Interventions: Combining Lived Experience Perspectives With Design Thinking Approaches.

BACKGROUND: App-based interventions designed to prevent and treat eating disorders have considerable potential to overcome known barriers to treatment seeking. Existing apps have shown efficacy in terms of symptom reduction; however, uptake and retention issues are common. To ensure that apps meet the needs and preferences of those for whom they were designed, it is critical to understand the lived experience of potential users and involve them in the process of design, development, and delivery. However, few app-based interventions are pretested on and co-designed with end users before randomized controlled trials. OBJECTIVE: To address the issue, this study used a highly novel design thinking approach to provide the context and a lived experience perspective of the end user, thus allowing for a deeper level of understanding. METHODS: In total, 7 young women (mean age 25.83, SD 5.34, range 21-33 years) who self-identified as having a history of body image issues or eating disorders were recruited. Participants were interviewed about their lived experience of body image and eating disorders and reported their needs and preferences for app-based eating disorder interventions. Traditional (thematic analysis) and novel (empathy mapping; visually depicting and empathizing with the user's personal experience) analyses were performed, providing a lived experience perspective of eating disorders and identifying the needs and preferences of this population in relation to app-based interventions for eating disorders. Key challenges and opportunities for app-based eating disorder interventions were also identified. RESULTS: Findings highlighted the importance of understanding and identifying problematic eating disorder symptoms for the user, helpful practices for recovery that identify personal values and goals, the role of social support in facilitating hope, and aspects of usability to promote continued engagement and recovery. CONCLUSIONS: Practical guidance and recommendations are described for those developing app-based eating disorder interventions. These findings have the potential to inform practices to enhance participant uptake and retention in the context of app-based interventions for this population.

'There's Just Something Really Peaceful About It': a Qualitative Exploration of Mothers with Young Children and Engagement in Group-Based Physical Activity Programs.

BACKGROUND: Many mothers with young children often do not achieve recommendations of at least 150-min moderate-to-vigorous physical activity (MVPA) each week. Previous qualitative work has generally focused on getting inactive mothers with young children to be active, so the characteristics of women who are active during early postpartum period are not well understood. This research set out to capture the characteristics of mothers with young children who engage in MVPA and how these women manage barriers and harness enablers to sustain in engagement in physical activity (PA) over an extended period. METHOD: Thirty-two participants ranging in age from 27 to 42 years (35.2 ± 4.8), with age of their youngest child ranging from 6 weeks old to 5 years, participated in semi-structured interviews. RESULTS: Inductive thematic analysis revealed three overarching themes and fourteen sub-themes relating to the characteristics of active mothers with young children and the engagement and maintenance factors that recruit and sustain these women in group-based physical activity programs. Specifically, mothers with young children relish a welcoming and supportive environment that accommodates babies and young children, is affordable and convenient, focuses on building strength and functionality, and is non-judgmental. CONCLUSION: These findings advance knowledge by providing considerations and recommendations that support intervention and program designers to be able to develop group-based physical activity programs for mothers with young children.

Critical measurement issues in the assessment of social media influence on body image.

Progress towards understanding how social media impacts body image hinges on the use of appropriate measurement tools and methodologies. This review provides an overview of common (qualitative, self-report survey, lab-based experiments) and emerging (momentary assessment, computational) methodological approaches to the exploration of the impact of social media on body image. The potential of these methodologies is detailed, with examples illustrating current use as well as opportunities for expansion. A key theme from our review is that each methodology has provided insights for the body image research field, yet is insufficient in isolation to fully capture the nuance and complexity of social media experiences. Thus, in consideration of gaps in methodology, we emphasise the need for big picture thinking that leverages and combines the strengths of each of these methodologies to yield a more comprehensive, nuanced, and robust picture of the positive and negative impacts of social media.

Mumbod? A comparison of body image and dietary restraint among women with younger, older, and no children.

Pregnancy and the postpartum period are times of significant body, and body image changes for women. Adult women (N = 885) aged 21 to 47 years old completed an online questionnaire. Mothers of young children (0-5 years) had significantly lower levels of body shame, self-objectification, and dietary restraint than women without children, and women with school-aged (6-10 years) children had significantly lower self objectification than women without children, once we controlled for age. BMI predicted body shame more than motherhood status. This research has implications for the development of appropriate body image interventions for adult women.

Practice-based evidence: Perspectives of effective characteristics of Australian group-based physical activity programs for postpartum women.

ISSUE ADDRESSED: Many postpartum women often do not achieve recommendations of at least 150 minutes moderate-to-vigorous physical activity (MVPA) each week. Previous qualitative work has focused on postpartum women's barriers and challenges to being active, with recent research starting to explore the characteristics of PA programs and women who are active during the postpartum period. Yet, little research has focused on the characteristics of key stakeholders and community organisations that support women to sustain their PA engagement during the postpartum period. METHODS: This research generates practice-based evidence to provide essential insights for effective implementation, strategies and actions of community group-based PA programs that recruit and retain postpartum women to ensure future interventions are scalable and sustainable. Ten participants (90% female), ranging in age from 34 to 40 years, were recruited from nine community organisations/businesses. The ten participants engaged in semi-structured interviews for an average length of 31 minutes. RESULTS: Inductive thematic analysis revealed four overarching themes (i) effective practitioners have a history of, and passion for women's health and PA; (ii) low-cost, connected approaches attract postpartum women into community group-based PA programs; (iii) inclusive, flexible, varied, and holistic approaches sustain postpartum women's participation; and (iv) utilise connections to overcome barriers to community group-based PA programs. These four themes were informed by twelve sub-themes relating to the background of stakeholders and practitioners and the approaches that they use to attract and sustain postpartum women in community group-based PA programs. CONCLUSIONS: Practice-based findings should inform future practices and the development of future real-world group-based PA interventions for postpartum women. SO WHAT?: Specifically, interventions will need to be designed and implemented by practitioners who have a history of, and passion for women's health and PA, be low-cost, connected approaches, that are inclusive, flexible, varied, and holistic that prioritise physical, emotional, and social wellbeing.

Identifying barriers and facilitators to implementing mindfulness-based programmes into schools: A mixed methods study.

Mindfulness-based initiatives have been shown to improve psychological wellbeing and increase academic engagement in school settings. The current study explored barriers and facilitators to the implementation of mindfulness-based (MB) programmes in schools. Ninety-five teachers completed an online survey, and six principals were interviewed, with questions for both informed by the Theoretical Domains Framework (TDF). Quantitative data was analysed via descriptive statistics and independent sample t tests. Qualitative interview data were analysed via thematic analysis. Teachers reported facilitators to successful MB programme implementation as self-efficacy and motivation, knowledge about MB programmes, acceptance of responsibility to deliver MB programmes and belief of negative consequences if MB programmes are not delivered. Principals reported organisational-level facilitators as having a school-wide positive education framework relevant to the school context, taking a long-term approach, school leaders supporting the initiatives and understanding the evidence behind MB programmes and empowering staff to engage in mindfulness. Individual-level facilitators included staff buy-in and commitment to practice and understanding mindfulness. Barriers included time, resources/money, staff buy-in and competing strategic priorities within the school. These findings are important for consideration by policymakers determining the way forward for more widespread implementation of MB programmes in Australia.

The Body Confident Mums challenge: a feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook.

BACKGROUND: Motherhood is a time of intense physical, psychological, and identity transformation, and body dissatisfaction may emerge through the process of pregnancy, birth, and adaptation to parenting. We present a feasibility trial of the Body Confident Mums Challenge, a program developed by adapting existing, effective interventions that focus on self-compassion and appreciation of body functionality to be specific to mothers. METHODS: The program was delivered using the social learning function in a closed Facebook group. Qualitative evaluation of evidence of change was conducted by gathering individual written reflections posted during the challenge (n = 120). Feasibility and acceptability was determined using a feedback survey (n = 22). RESULTS: Participant's reflective posts indicated that they were embracing self-compassion, and de-prioritising body image concerns during the challenge. Feedback indicated that the program was mostly feasible and acceptable for mothers, with recommendations from some participants relating to slowing the pace of content delivery and reducing the time commitment of the Challenge. CONCLUSIONS: The social media environment may therefore be a useful setting in which to implement brief intervention programs to improve body image and wellbeing.

Mothers' experiences of the relationship between body image and exercise, 0-5 years postpartum: A qualitative study.

The relationship between body image and exercise in early motherhood is an important yet understudied determinant of mother and infant wellbeing. To address this, we report on a qualitative study of early mothers' lived experiences of the relationship between body image and exercise in the first five years post-birth. Twenty-one mothers (0-5 years postpartum) completed individual, semi-structured online/phone interviews (M interview time =47.25 min), to elicit narratives about peripartum body image and its relationship with exercise. Thematic analysis was conducted according to the Braun and Clarke framework. Three key themes, and several subthemes, were identified: 1.body image in early motherhood is diverse, dynamic and individual, 2.postpartum exercise forms part of early motherhood adjustment, and 3.body image and exercise form an important, intricate relationship in early motherhood. Women's narratives indicated three body image/exercise patterns, each characterised by different behaviours and motivations. Mothers who reported exercising, or avoiding exercising, for reasons related to body dissatisfaction appeared at greatest risk of negative outcomes from body-related distress and maladaptive exercise patterns. Conversely, mothers reporting higher body appreciation described more adaptive exercise behaviours. This research provides important information for the development of interventions to support positive body image and healthful exercise in early motherhood.

Do we cause harm? Understanding the impact of research with young children about their body image.

Although research into the early development of body image and eating behaviors is essential, concerns have been raised about whether their assessment might precipitate body or eating concerns in children. We aimed to identify how parents perceived their young children (under 9 years) had been impacted from involvement in the longitudinal Children's Body Image Development Study (CBIDS) that assessed body image and eating behaviors. Participants were 218 parents (99 % mothers) who completed an online questionnaire assessing whether and why their child discontinued participation in CBIDS, and the perceived impact of participation on children's body image, weight attitudes, language about bodies, internalisation of appearance ideals, peer appearance conversations, dietary restraint, muscle building activities, and physical activity. Impact and reasons for cessation of participation were assessed retrospectively. Almost all parents were positive or neutral about their child's involvement, 0.5%-3.2% of parents perceived a negative impact in an area, and 0.9 % of parents moderately agreed that they regretted participating in CBIDS. Themes for positive and negative aspects of CBIDS involvement were explored using thematic analysis. Although research is essential to guide development of prevention strategies, this study highlights the need to implement safeguards to ensure a positive experience for all children.

Muscle building supplement use in Australian adolescent boys: relationships with body image, weight lifting, and sports engagement.

BACKGROUND: The extent and implications of muscle building protein supplement use among adolescents is relatively unknown. This study aimed to describe the prevalence of protein powder, creatine, and anabolic steroid use in a sample of 14-16 year-old boys in Australia, and the predictors of actual use, and intentions to use protein powder. METHODS: Data were obtained from questionnaires with Australian adolescent boys aged 14-16 years from one independent boy's school in Melbourne (N = 237). Hierarchical linear and logistic regressions were used to determine the predictors of intentions, and actual use of protein powder. RESULTS: 49.8% of boys reported current use of, and 62% intended to use protein powder; 8.4% used creatine, and 4.2% used anabolic steroids. Higher levels of drive for muscularity, participation in weight training, and playing a greater number of sports were significant predictors of higher current use and intentions to use protein powder, but age, BMI, body esteem, and ethnicity were not. CONCLUSIONS: Prevalence of muscle building supplement use was relatively high among this adolescent population. This research has implications for intervention and prevention programs to educate young boys about muscle building supplements to reduce negative physical and psychological health effects of their use.