Keohane, Emily ORCID: https://orcid.org/0000-0003-2511-180X (2026) Body Appreciation in Adolescents: A Multi-Study Approach to Understanding a Brief School-Based Program, Protective Factors, and Assessment in School Settings. PhD thesis, Victoria University.

Abstract

Body image concerns commonly emerge during early adolescence and are associated with poorer psychological wellbeing and reduced academic engagement. While prevention programs are widely implemented in schools, evidence for their effectiveness is mixed, and less is known about psychological factors that support body appreciation or how appearance concerns impact classroom participation. This thesis examined body appreciation in early adolescence through three complementary studies drawing on a shared adolescent dataset, with distinct research questions, analytic samples, and methodological approaches. Study 1 evaluated the effectiveness of Becoming Media Savvy, a single-session body image program developed by the Butterfly Foundation and delivered to Australian secondary school students. Using a randomised controlled design with 269 students aged 12 to 14 years, the study assessed body appreciation alongside self-esteem, media literacy, appearance-ideal internalisation, social comparison, and appearance-related conversations. Contrary to hypotheses, no significant program effects were observed on any outcome following correction for multiple comparisons. Body appreciation did not improve, media literacy declined across both groups, and self-esteem increased similarly in intervention and control participants, suggesting change over time that was independent of program exposure. No sex differences in program effects were observed. Findings highlight the need to reconsider the structure and duration of universal interventions for promoting body appreciation in early adolescence. Study 2 examined psychological predictors of body appreciation to identify potential alternative prevention targets. Hierarchical regression revealed sex differences in predictive pathways. For girls, self-esteem was the primary predictor of body appreciation, with resilience making a smaller but significant contribution. For boys, a multi-factor model emerged, with self-esteem, resilience, and positive affect each contributing uniquely. These findings suggest that interventions for girls should primarily strengthen self-esteem while also supporting resilience, whereas interventions for boys may need to target multiple psychological resources concurrently. Study 3 addressed limitations in existing measurement by developing and validating the Appearance-Related School Interference (ARSI) scale, assessing how appearance concerns disrupt classroom participation. Using split-sample methodology, exploratory and confirmatory factor analyses supported a unidimensional 7-item structure capturing interference in activities including classroom participation, presentations, group work, and physical education. The ARSI demonstrated strong reliability (α = 0.83–0.88) and good construct validity, with scores associated with lower body appreciation, lower psychosocial wellbeing, greater appearance-focused cognitions, and higher school anxiety. Correlational patterns differed by sex, suggesting distinct mechanisms through which appearance concerns affect academic engagement. Despite limitations including self-report measures, a single predominately Angelo-Australian cohort from higher SES metropolitan Melbourne schools, and cross-sectional design for Studies 2 and 3, these studies provide key insights into body appreciation during early adolescence. Brief, single-session programs are unlikely to produce meaningful improvements, highlighting the potential value of longer or more intensive programs. Self-esteem emerged as the central predictor for girls, with resilience also contributing, while boys’ body appreciation is influenced by multiple psychological resources, suggesting potential sex-specific prevention targets. The ARSI scale demonstrates that appearance concerns can disrupt classroom participation, emphasising the value of assessing practical outcomes alongside attitudes to guide developmentally appropriate, targeted prevention programs.

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