World first study shows new program improves self-esteem for girls

A world-first study has shown a group-based targeted intervention improves self-esteem in teenage girls. Published in the American Journal of Health Promotion, the collaborative Monash University and Monash Health study is the first randomised trial to demonstrate that a group-based intervention improves protective health factors among girls at risk of developing negative mental, physical, and social health outcomes.

Research shows low self-esteem and body dissatisfaction in girls is related to disordered eating, obesity, depression, anxiety and other mental illnesses.

Professor Helen Truby, Head of the Department of Nutrition and Dietetics at Monash University and Laura Tirlea from Monash Health led the study evaluating an intervention known as 'Girls on the Go!' (GoG), a ten week program designed to improve self-esteem, body image and confidence.

"This is the first large trial of a gender-specific community-based program that has shown to effectively increase self-esteem," Professor Truby said.

"GoG is a novel intervention targeting girls with a range of issues with eating such as overweight or underweight and in both primary and secondary schools."

Delivered by health professionals outside the school environment from a community health venue to preadolescent and adolescent girls, the GoG program uses an empowerment model that involves interactive and experiential learning approaches.

"Using a stepped-wedge randomised controlled trial, we tested the effectiveness of the GoG program on the outcomes of self-esteem, impairment induced by eating disorders, body satisfaction, self-efficacy, and dieting behaviours," said co-author Professor Terence Haines, Director, Allied Health Research Unit at Monash Health and Monash University.

"The GoG intervention had a positive impact on participants' self-esteem, self-efficacy (including mental and physical health), and dieting behaviours."

The GoG intervention was provided to schools in the culturally diverse City of Greater Dandenong, an area of high social disadvantage. In small group sessions, health professionals motivated and supported GoG participants to change their attitudes and behaviours, and embrace change for better health outcomes.

"Over the ten week period, interactive activities and discussions took place around goal setting, body image, self-esteem, personal safety and assertiveness, health eating and healthy minds, involvement in physical activities that are fun, trust, confidence, and making community connections," Ms Tirlea said.

"Our findings are important, particularly given our study sample included a high proportion of girls from culturally and linguistically diverse backgrounds and was set in a community with lower socioeconomic status."

"These groups can be difficult to recruit into research programs and are often underrepresented in research of this nature.

"Previous meta-analyses have found that similar health promotion interventions have had only a small, short-term effect whereas the gains in GoG participants were retained after six months and up to nine months of follow up."

Significantly, this evaluation provides an evidence base for the effectiveness of the GoG program at a time when preventive approaches are timely and desperately needed.

"Focussing on self-esteem as a general protective factor is a safe approach and leads to overall health and well-being in at-risk preadolescent and adolescent girls," Ms Tirlea said.