Plain English Summary
Background and study aims
This study explored ways of preventing eating disorders and tackling body dissatisfaction in young people. Although several school programmes of this sort already exist in the UK, none has been rigorously evaluated to determine whether it is actually helpful for young people. Our aim was to see whether students that receive a school intervention called Me, You & Us showed improvements in body esteem, eating habits, the extent to which they buy in to a media ideal of thinness, interactions with friends, mood and self-esteem, compared to their peers in a control group. We were also interested in how much students liked these lessons and whether school staff were able to deliver the lessons from a manual which we gave them.
Who can participate?
All students in years 8 and 9 of participating schools were be eligible to take part in this study. Students did not take part if they did not have written consent from a parent or carer, or if they were deemed by school staff to have insufficient English language abilities to understand consent procedures and to complete the study questionnaires.
What does the study involve?
Classes in participants schools were randomly allocated to receive either the Me, You & Us intervention or to continue having their usual curriculum. The Me, You & Us programme involved six 50 minute lessons and was be delivered by participants usual school teachers.
All students were asked to complete a series of questionnaires at three times: before the lessons started, after the lessons finished and three months later. These questionnaires focused on eating habits, body satisfaction, friendships, mood and self-esteem. They took no longer than 45 minutes to complete and were administered by school staff during the normal school day.
What are the possible benefits and risks of participating?
Participants were offered a £10 shopping voucher on completion of the questionnaires as a gesture of appreciation of the time spent taking part. In addition, the school received £10 per student taking part in recognition of the time and effort required to run the study.
There were no risks of physical harm from taking part in this study. There was a small chance that students may find answering questions about eating or body satisfaction to be upsetting. However, students were reminded that they did not have to answer any questions that they did not want to and their teacher was be present at all times to provide support if it was needed.
Where is the study run from?
The study was run from the Section of Eating Disorders, Institute of Psychiatry, Kings College London.
When is the study starting and how long is it expected to run for?
The study started in June 2011 and ran for approximately 15 months. Each participants involvement in the study lasted four - five months: one and a half months receiving the lessons followed by a period of three months before the final questionnaires.
Who is funding the study?
The study has been funded by the National Institute for Health Research (NIHR).
Who is the main contact?
Ms Helen Sharpe, Helen.firstname.lastname@example.org (PhD Candidate)
Prof Ulrike Schmidt, Ulrike.email@example.com (Supervisor)
Me, You & Us: A programme for preventing eating disorders in UK secondary schools - a cluster randomised controlled trial
Students receiving the intervention will show significant improvements in body esteem, internalisation, peer support, appearance conversations, depressive symptoms, self-esteem and eating pathology compared to students in the control group at post-intervention and at a three month follow up.
1. Students will find the material in the intervention acceptable, in that they will report enjoying the lessons and perceive them as useful.
2. It will be feasible to train usual secondary school teachers to deliver an eating disorder prevention programme from a manual and student workbook with high fidelity.
Approval provided by Kings College London Research Ethnics Committee, Psychiatry, Nursing & Midwifery Research Ethics Subcommittee (REF PNM 10 11-96) on 03 May 2011
Single centre cluster randomised controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Eating disorders / body dissatisfaction
Participants in classes allocated to the intervention arm received six 50 minute sessions outlined in the Me, You & Us manual, focusing on media literacy, peer interactions, boosting mood and self-esteem. The sessions were delivered as part of the usual school day by teachers in participating schools. Teachers received a two hour training session on the material prior to delivery. Specific content of the sessions can be obtained from the contact details listed below.
Participants in classes allocated to the control arm received no intervention (curriculum as usual). Lessons provided will be those usually given by school staff.
Primary outcome measures
Participant self-reported body esteem, assessed by the 23-item Body Esteem Scale for Adolescents and Adults. Questionnaires were administered at baseline, post-intervention and three-month follow-up.
Secondary outcome measures
1. Participant self-reported questionnaires assessing:
1.1. Eating pathology (Eating Disorders Diagnostic Scale, 22 items)
1.2. Thin-ideal internalization (Sociocultural Attitudes Towards Appearance Scale Internalization, 9 items)
1.3. Appearance conversations with friends (Appearance Conversations with Friends Scale, 5 items)
1.4. Peer support (Multidimensional Scale of Perceived Social Support Friends, 4 items)
1.5. Depressive symptoms (Depression, Anxiety and Stress Scale, 21 items)
1.6. Self-esteem (1 item).
All questionnaires were administered at baseline, post-intervention and three-month follow-up.
2. In addition participants provided feedback on the acceptability of the intervention at post-intervention with two self-report items assessing how much students liked the lessons and how helpful they found the lessons.
3. Feasibility of the mode of delivery was assessed through observations of two intervention lessons in each participating school, which were rated based on the number of activities outlined in the manual that were completed in the session.
Overall trial start date
Overall trial end date
Participant inclusion criteria
School inclusion criteria: UK based secondary school with students in years 8 and/or 9
Participant inclusion criteria: student (male or female) in year 8 or 9 in participating secondary school
Target number of participants
Participant exclusion criteria
Participant exclusion criteria:
1. Lack of parental/carer consent
2. Insufficient English language ability to understand assent procedures or complete questionnaire measures
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Section of Eating Disorders
King's College London (UK)
Research and Graduate School Support
King's College London
Waterloo Bridge Wing
Franklin Wilkins Building
150 Stamford Street
National Institute for Health Research (NIHR) (UK) - Programme Grants for Applied Research scheme (RP-PG-0606-1043)
Funding Body Type
Funding Body Subtype
NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Kings College London (UK)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting
2013 results in: http://www.ncbi.nlm.nih.gov/pubmed/24115345
Sharpe H, Schober I, Treasure J, Schmidt U, Feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders: cluster randomised controlled trial., Br J Psychiatry, 2013, 203, 6, 428-435, doi: 10.1192/bjp.bp.113.128199.