Body confident coaching: a pilot randomized controlled trial evaluating the acceptability of a web-based body image intervention for coaches of adolescent girls

Figures & data

Table 1. Outline of the body confident coaching intervention.

Modules	Underpinning theories	Learning objectives	Learning experience
Module 1: Challenging gender stereotypes—explains the effect of gender stereotypes on girls’ participation in, and enjoyment, of sport	Gender essentialism (Allison, 2018; Greene, 2020): understand and identify how gender biases and stereotypes are perpetuated in sport; self-objectification theory (Fredrickson & Roberts, 1997): understand and identify how sexual objectification experiences accumulate over time and foster a self-objectifying attitude among girls in sport	Understand what gender stereotypes are and how they affect girls; identify gender stereotypes that are prevalent in sport; reflect on own explicit and implicit gender stereotypes and biases about girls in sport	Implicit bias association test, reflective log, quizzes, links to additional resources and scientific literature
Module 2: Introducing body image—introduces body image and why it matters in sport; discusses causes and consequences of having negative and positive body image	Tripartite influence model for body image (Keery et al., 2004): understand and identify how society (family, friends, media) create and perpetuate harmful body ideals about women in sport; self-objectification theory (Fredrickson & Roberts, 1997): understand and identify how sexual objectification experiences accumulate over time and foster a self-objectifying attitude among girls in sport	Understand what body image is and the potential consequences of having a negative or positive body image; identify different concerns athletes can have about their bodies; reflect on the influences that might be impacting athletes’ body image on and off the sports field	Case study, reflective log, quizzes, links to additional resources and scientific literature
Module 3: Tackling negative body image—teaches how to recognize specific body image concerns among athletes and how to tackle them; emphasizes risk-reduction (i.e., how to identify and address body image concerns) and prevention (i.e., how to prevent or minimize body image concerns)	Tripartite influence model for body image (Keery et al., 2004): understand and identify how society (family, friends, media) create and perpetuate harmful body ideals about women in sport; self-efficacy theory (Bandura, 1977): increase self-efficacy in addressing girls’ body image concerns in sport	Understand how to recognize negative body image practices in sport; identify how own actions can influence athletes’ body image concerns; develop strategies to prevent and reduce body image concerns among athletes	Case study, reflective log, quizzes, links to additional resources and scientific literature
Module 4: Promoting body confidence—teaches how to promote positive body image among athletes; takes a protective approach (i.e., how to promote body confidence)	Theory of embodiment and positive body image (Menzel & Levine, 2011; Piran, 2019): understand and identify how to promote body positive sport settings by focusing on what the body can do and experience, instead of what it looks like; self-determination theory (Deci & Ryan, 2012): understand and identify how to promote the three basic psychological needs (autonomy, competence, relatedness) among girls in sport; self-efficacy theory (Bandura, 1977): Increase self-efficacy in addressing girls’ body image concerns in sport	Understand what a positive body image environment looks like within sport; identify how own actions can promote body confidence among athletes; develop strategies to promote body confidence among athletes and sport environment	Checklist, reflective log, quizzes, links to additional resources and scientific literature
Module 5: Creating body confident communities—Teaches how to create positive body image environments that extend beyond sport; provides resources and knowledge about how to work with other key individuals (e.g., parents, teachers, other coaches)	Self-determination theory (Deci & Ryan, 2012): Understand and identify how to promote the three basic psychological needs (autonomy, competence, relatedness) among girls in sport	Understand how to broach body image conversations with parents, guardians, caregivers, teachers, and others; identify the roles of athletes, coaches, parents, teachers, and others in promoting positive body image environments; develop strategies to create positive body image communities that support athletes’ sport experience	Case study, reflective log, quizzes, links to additional resources and scientific literature, ‘key takeaways’ document containing a summary of the module content and a checklist for best practice

Figure 1. CONSORT flow diagram of participants’ progress through the study.

Table 2. Research outcomes and internal consistencies.

Outcomes measures	Descriptions & internal consistencies	Time of assessment
Demographic information	Gender identity, age, ethnicity/racial origin, state, education, coaching experience (role, athletes, sports, competition level, coach tenure), previous training around the topic of body image and/or eating disorders.	Baseline (T1)
Efficacy outcomes
Self-efficacy in recognizing and addressing body image concerns (primary)	Coach Self-Efficacy for Body Image Scale (CSEBIS; Silva-Breen et al., 2022), comprising 27 items across four subscales: Knowledge (e.g., “I am confident in my ability to describe why body image is important in sport”), Recognition (e.g., “I am confident in my ability to recognize when an athlete feels bad about their body”), Engagement (e.g., “I am confident in my ability to normalize discussions around body image with my team”), Disengagement (e.g., “I am confident in my ability to refrain from talking about my body in front of my athletes”). Items are rated on an 11-point Likert scale (0 = No Confidence, 10 = Completely Confident), with higher scores reflecting greater self-efficacy. Internal consistency: α = .96.	Baseline (T1) and post- intervention (T2)
Fat phobia (secondary)	Modified Fat Phobia Scale (FPS; Bacon et al., 2001), comprising 14 adjective pairs (e.g., attractive, unattractive; fast, slow) as perceptions toward “obese” or “fat” people. An additional three pairs were added for the purposes of this research (i.e., athletic, not athletic; sporty, not sporty; unfit, fit [reversed]) for a total of 17 adjective pairs. The additional three pairs were combined with four other pairs (i.e., fast, slow; having endurance, having no endurance; active, inactive; weak, strong [reversed]) to create a sport-specific subscale of the FPS. Items are rated on a five-point scale, with higher scores reflecting greater levels of fat phobia. Internal consistency: α = .89.	Baseline (T1) and post- intervention (T2)
Gender essentialist beliefs (secondary)	Gender Essentialism Scale (GES; Skewes, 2018), comprising 25 items (e.g., “Differences between women and men’s personalities are in their DNA”). Items are rated on a five-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree), with higher scores reflecting greater levels of gender essentialist beliefs. Internal consistency: α = .89.	Baseline (T1) and post- intervention (T2)
Intervention acceptability^a	15 items assessed acceptability of the intervention. Factors included: affective attitude (e.g., “I liked the program”), burden (e.g., “Engaging with the program was too troublesome” [reversed]), ethicality (e.g., “It is important for other coaches to have access to this program”), self-efficacy (e.g., “I am confident that I will use the techniques I learned from the program in my coaching”), perceived effectiveness (e.g., “The program was successful in improving my knowledge about body image”). Items are rated on a five-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree), with higher scores reflecting greater acceptability. Four open-ended questions: “Are there any parts of the program that were not clear (e.g., meaning, relevance, terminology, etc.)?”, “Is there anything missing that you think should be included in this program?”, “Do you have feedback on the visual design of the modules?”, “Do you have any further feedback on this program?”.	Post- intervention (T2)
Intervention adherence^a	4 items assessed adherence to the intervention. Factors included: number of modules completed (digital), time to complete each module (self-report), time to complete entire intervention (self-report), engagement with additional resources (e.g., videos, additional reading, links, reflection exercises; self-report).	Post- intervention (T2)

^aIntervention group only.

Table 3. Study drop-out rates across time and intervention conditions.

	Total (N = 97)		Intervention (n = 52)		Control (n = 45)
	T1	T2	T1	T2	T1	T2
CSEBIS N (%)	0 (0%)	49 (51%)	0 (0%)	36 (69%)	0 (0%)	13 (29%)
FPS N (%)	0 (0%)	49 (51%)	0 (0%)	36 (69%)	0 (0%)	13 (29%)
GES N (%)	0 (0%)	49 (51%)	0 (0%)	36 (69%)	0 (0%)	13 (29%)
	Intervention only (n = 52)
Affective attitude N (%)	36 (69%)
Burden N (%)	36 (69%)
Ethicality N (%)	36 (69%)
Self-efficacy N (%)	48 (92%)
Perceived effectiveness N (%)	36 (69%)

Table 4. Characteristics of the baseline sample.

	Total sample	Intervention	Control
	(N = 97)	(n = 52)	(n = 45)
Gender N (%)
Women	68 (70.10%)	37 (71.15%)	31 (68.89%)
Men	25 (25.77%)	15 (28.85%)	10 (22.23%)
Non-binary	2 (2.06%)	–	2 (4.45%)
Prefer not to say	1 (1.03%)	–	1 (2.23%)
Prefer to self-describe	1 (1.03%)	–	1 (2.23%)
Age in years M (SD)	36.62 (10.43)	36.67 (10.78)	36.56 (10.12)
Ethnicity N (%)
Asian	2 (2.06%)	1 (1.92%)	1 (1.92%)
Black or African American	6 (6.18%)	2 (3.84%)	4 (7.69%)
Hispanic, Latino/a, Spanish origin	4 (4.12%)	3 (5.77%)	1 (1.92%)
Native American or Alaska Native	2 (2.06%)	1 (1.92%)	1 (1.92%)
Native Hawaiian or Other Pacific Islander	1 (1.03%)	1 (1.92%)	–
White	75 (77.32%)	40 (76.92%)	35 (67.31%)
Multiracial or Biracial	3 (3.09%)	3 (5.77%)	–
Prefer not to say	2 (2.06%)	–	2 (3.84%)
Prefer to self-describe	2 (2.06%)	1 (1.92%)	1 (1.92%)
Region N (%)
Midwest	38 (39.18%)
Northeast	15 (15.46%)
South	17 (17.53%)
West	27 (27.84%)
Sport N (%)
Acrobatics and tumbling	2 (2.06%)
Athletic training	2 (2.06%)
Baseball	2 (2.06%)
Basketball	13 (13.40%)
Badminton	1 (1.03%)
Bobsleigh	1 (1.03%)
Bowling	1 (1.03%)
Cheer	1 (1.03%)
Climbing/wall climbing	3 (3.09%)
Cricket	1 (1.03%)
Cross country	13 (13.40%)
Crew/rowing	5 (5.15%)
Curling	1 (1.03%)
Cycling	1 (1.03%)
Fencing	1 (1.03%)
Field hockey	1 (1.03%)
Figure skating	1 (1.03%)
Football	1 (1.03%)
Golf	2 (2.06%)
Gymnastics	1 (1.03%)
Ice hockey	3 (3.09%)
Judo	2 (2.06%)
Karate	2 (2.06%)
Lacrosse	3 (3.09%)
Martial arts	1 (1.03%)
Nordic skiing	6 (6.18%)
Rock climbing	3 (3.09%)
Rugby	2 (2.06%)
Soccer	18 (18.55%)
Softball	7 (7.22%)
Strength and conditioning	3 (3.09%)
Swimming	7 (7.22%)
Taekwondo	1 (1.03%)
Tennis	1 (1.03%)
Track and field	17 (17.52%)
Ultimate	2 (2.06%)
Volleyball	10 (10.31%)
Water polo	1 (1.030%)
Wrestling	1 (1.030%)
Another sport	4 (4.12%)
Education N (%)
High school graduate, diploma or equivalent	1 (1.03%)	1 (1.92%)	–
Some college credit, no degree	4 (4.12%)	3 (5.77%)	1 (2.23%)
Trade/technical/vocational training	1 (1.03%)	1 (1.92%)	–
Associate degree	1 (1.03%)	1 (1.92%)	–
Bachelor’s degree	47 (48.45%)	24 (46.15%)	23 (51.12%)
Master’s degree	38 (39.17%)	19 (36.54%)	19 (42.23%)
Professional degree	4 (4.12%)	3 (5.77%)	1 (2.23%)
Doctorate degree	1 (1.03%)	–	1 (2.23%)
Role N (%)
Head coach	66 (68.04%)	34 (65.38%)	32 (71.12%)
Associate head coach	8 (8.25%)	4 (7.69%)	4 (8.89%)
Assistant coach	16 (16.50%)	11 (21.15%)	5 (11.12%)
Volunteer	1 (1.03%)	1 (1.92%)	–
Other	6 (6.18%)	2 (3.84%)	4 (8.89%)
Coaching pupils N (%)
Young women	20 (20.62%)	9 (17.31%)	11 (24.45%)
Young men	13 (13.40%)	6 (11.54%)	7 (15.56%)
Adolescent girls	97 (100%)	52 (100%)	45 (100%)
Adolescent boys	45 (46.39%)	23 (44.23%)	22 (48.89%)
Competition level N (%)
Club	50 (51.55%)	29 (55.77%)	21 (46.67%)
College/university	9 (9.28%)	5 (9.61%)	4 (8.89%)
High school/secondary school	62 (63.92%)	31 (59.61%)	31 (68.89%)
International	1 (1.03%)	–	1 (2.23%)
Junior/community college	2 (2.06%)	–	2 (4.45%)
Middle/intermediate school/junior high	22 (22.68%)	12 (23.07%)	10 (22.23%)
National/Olympic	1 (1.03%)	–	1 (2.23%)
Recreational/in-house/community leagues	16 (16.50%)	6 (11.54%)	10 (22.23%)
Other	3 (3.09%)	1 (1.92%)	2 (4.45%)
Current role length in years M (SD)	5.53 (5.30)	5.43 (4.52)	5.65 (6.12)
Coaching length in years M (SD)	11.38 (8.01)	10.94 (6.22)	11.89 (9.74)
Has received body image training N (%)
Yes	21 (21.65%)	6 (11.54%)	15 (33.34%)
No	70 (72.17%)	44 (84.61%)	26 (57.78%)
Not sure	6 (6.19%)	2 (3.85%)	4 (8.89%)

Note. The two randomized group showed comparable age (t = -.05, df = 95, p = .95), role length in years (t = .19, df = 95, p = .84), and coaching length in years (t = .58, df = 95, p = .56).

Table 5. Outcome means by group and time points.

		Total sample		Intervention		Waitlist control
	Score range	T1 (N = 97)	T2 (N = 48)	T1 (N = 52)	T2 (N = 16)	T1 (N = 45)	T2 (N = 32)	t-Test comparing groups at baseline
CSEBIS M (SD)	0–10	7.11 (1.45)	7.74 (1.27)	7.16 (1.35)	8.26 (1.02)	7.06 (1.57)	7.47 (1.32)	t = −.32, df = 95, p = .75
CSEBIS knowledge	0–10	7.37 (1.66)	8.08 (1.27)	7.46 (1.60)	8.66 (1.04)	7.27 (1.74)	7.80 (1.30)	t = −.55, df = 95, p = .58
CSEBIS recognition	0–10	6.67(1.74)	7.30 (1.26)	6.73 (1.77)	7.87 (1.17)	6.62 (1.72)	7.01 (1.23)	t = −.34, df = 95, p = .74
CSEBIS engagement	0–10	6.16 (1.96)	7.13 (1.75)	6.00 (1.95)	7.51 (1.51)	6.35 (1.97)	6.95 (1.85)	t = .88, df = 95, p = .38
CSEBIS disengagement	0–10	8.31 (1.41)	8.43 (1.29)	8.53 (1.22)	9.00 (0.75)	8.06 (1.60)	8.15 (1.42)	t = −1.65, df = 95, p = .10
FPS M (SD)	1–5	3.19 (0.54)	3.06 (0.55)	3.15 (0.54)	2.70 (0.63)	3.23 (0.53)	3.24 (0.40)	t = .70, df = 95, p = .48
FPS sport	1–5	3.19 (0.71)	3.08 (0.69)	3.15 (0.68)	2.62 (0.79)	3.24 (0.75)	3.30 (0.52)	t = .60, df = 95, p = .55
GES M (SD)	1–5	2.64 (0.57)	2.60 (0.57)	2.50 (0.49)	2.34 (0.46)	2.81 (0.60)	2.73 (0.59)	t = 2.86, df = 95, p = .005
Affective attitude M (SD)	1–5				4.31 (0.61)
Burden M (SD)	1–5				4.58 (0.64)
Ethicality M (SD)	1–5				4.70 (0.46)
Self-efficacy M (SD)	1–5				4.25 (0.42)
Perceived effectiveness M (SD)	1–5				4.34 (0.72)

Figure 2. Quantitative findings relating to intervention acceptability.

Figure 3. Results of preliminary efficacy analyses.

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Data availability statement

The data that support the findings of this study are available from the corresponding author, JS, upon reasonable request.