An educational programme for parents on the body image of preschool-aged boys

Introduction

Research has indicated that children are becoming aware of their body appearance and how they feel about this at 4 or 5 years of age (Kean, 2012; Smolak, 2011; Troncone et al., 2014). This suggests that the preschool years are an ideal time to promote a healthy attitude towards the body, food and exercise in order to prevent later body image issues and associated pathology such as eating disorders, depression and other health problems (Brausch and Gutierrez, 2009; Bun et al., 2012). As parents are the most important sociocultural influences for this age group, researchers have suggested that educational programmes involving parents are the first step towards preventing body dissatisfaction in children (McCabe et al., 2007).

In support of this proposition, studies have found that parents model attitudes and behaviours towards appearance, food and exercise and have a powerful impact on their children through their weight-related comments (e.g. Field et al., 2005; Phares et al., 2004). For example, Hendy et al. (2001) found that mothers’ verbal messages to be bigger were the most consistent predictor of body image among preschool boys and girls. Lowes and Tiggemann (2003) also found that 5- to 8-year-old boys and girls who desired a thinner body shape also believed their mother desired a thinner figure. Other research with preadolescent boys has suggested that pressure from parents to modify weight and muscles was one of the key predictors of engagement in body change strategies (Ricciardelli et al., 2006). Although research involving fathers is limited, studies indicate that they play a less influential role than mothers (Lowes and Tiggemann, 2003; McCabe and Ricciardelli, 2005). Nevertheless, the results of the above studies indicate that working with both mothers and fathers to reduce negative role modelling behaviours and detrimental verbal communication may, in turn, help prevent boys from feeling unduly concerned about looks.

In particular, parents communicate gendered ideas about the body, as preschool-aged boys express a desire for muscular and athletic physiques. McCabe et al. (2007) called for the development of educational programmes for parents after finding that boys as young as four were expressing some level of body dissatisfaction, particularly around muscles. After interviewing parents and teachers, the authors suggested that ‘fat talk’ as well as eating and exercise habits among parents were influencing the attitudes of preschool-aged children. They also suggested that children were receiving different messages about their looks from parents depending on their gender, such as the need to be big and strong for boys and thin for girls. Studies based on interviews with Australian boys aged 5–6 years support this suggestion. Birbeck and Drummond (2006) and Drummond (2010) found that the most important aspect of boys’ body image was their physical performance, followed by being strong. Physical ability was seen as a means by which boys could distinguish themselves from girls, while strength was viewed as a means of expressing masculinity. This is in contrast to girls, who typically focus on their ‘fat tummies’ (Jones, 2011). These gendered beliefs highlight the need for researchers to consider the different messages parents should be communicating to boys and girls when looking to effectively promote a healthy body image. This study also evaluated parents’ perceived knowledge of body image of preschool boys, including how they communicated positive body image messages to their son. The results of the above studies indicate that working with both mothers and fathers to improve their level of body satisfaction and appreciation may, in turn, help increase the likelihood that boys will feel comfortable with their appearance.

The study investigated whether an educational programme for parents focusing on the issues of a specific gender is beneficial. A randomised controlled trial of two workshops on body image (called ‘Body Talk’) was delivered to parents of boys aged 3–6 years. The workshops aimed to educate parents on how their attitudes and behaviours around food, exercise and appearance can be imitated and internalised by boys. The workshops also explored typical male body image concerns and strategies for communicating healthy attitudes towards the body to preschool-aged boys. We expected that compared to the control group, the parents in the intervention group would demonstrate the following:

Methods

Procedure

Approval to conduct the study was granted by the University Human Research Ethics Committee. Participants were recruited through flyers placed in preschools, kindergartens and early learning centres in Metropolitan Melbourne. A total of 218 centres were contacted, 34 agreed to participate and 16 centres recruited enough participants to run the workshops. Preschools and early learning centres willing to participate in the study were randomly allocated into either the control or intervention group. Of the centres that ran the workshops, eight were allocated to the intervention group and eight to the control group. The Body Talk workshops were run in a room within each centre and employed interactive group discussions and activities to explore the content. Table 1 outlines the topics covered in each workshop.

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Table 1.

Summary of the Body Talk workshops.

Workshop 1

Workshop 2

The different ways boys and girls think about their body between the ages of 3 and 6 years. For example, for boys, the importance of physical performance over looks. The areas of the body (e.g. muscles, height) that preschool-aged boys feel are most important for social acceptance and for their sense of masculine identity. What is body image and what does a positive and negative body image mean. Factors that influence the development of a boy’s body image. For example, body weight, bullying and family. How parents can influence the development of their son’s body image. This focused on role modelling and verbal comments. The potential effects a negative body image can have on boys later in life, for example, self-esteem issues and eating disorders. How parents can communicate positive messages about the body to their sons. This discussion focused on role modelling behaviours and attitudes, and ways of talking about food and exercise.

Defining self-esteem, and what it looks like when someone has a healthy level of self-esteem and a low level of self-esteem. How self-esteem and body image are inter-related. For example, our feelings towards our appearance and physical ability can impact our self-esteem. Discussion of two case studies using boys with low and high self-esteem. This explored the different factors that influence the development of self-esteem and demonstrated how self-esteem and body image can be inter-related. How parents can help encourage their sons to develop a healthy level of self-esteem. Focusing on parent and son relationships. Review of the strategies discussed in Workshop 1 on communicating positive messages about the body. Goal setting of one to three strategies from either workshop to implement within their own family and working through how parents would do this.

Participants in the intervention group attended two 2-hour workshops 1 week apart. At the beginning of the first workshop, participants were shown a plain language description of the study and consent form which they were invited to read and sign. Participants also completed the first questionnaire before the commencement of the workshop. At the end of the second and final workshop, participants completed this same questionnaire again, along with a qualitative feedback form. After 3 months, these participants completed an online version of the same survey.

Participants in the control group completed the online questionnaire three times over the course of 3½ month at equivalent times to the intervention group. They were then offered the Body Talk workshops. After attending the final workshop, participants in the control group completed a short qualitative feedback form.

Participants who attended the workshops received a child’s t-shirt and a fridge magnet with the slogan ‘Health before looks’. Participants in both the intervention and control groups also received a AUD30 gift card from a major department store upon completing the third (follow-up) questionnaire.

Results

Descriptive statistics

Descriptive statistics for the control and intervention groups on the Perceived Knowledge Scale and the Body Appreciation Scale are shown in Table 2.

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Table 2.

Descriptive statistics for participants in the intervention and control group.

	Time 1			Time 2			Time 3
	N	Mean	SD	N	Mean	SD	N	Mean	SD
Intervention group
Perceived knowledge	53	18.49	4.64	45	25.98	3.34	27	26.41	3.25
Body appreciation	54	40.59	11.00	45	46.76	8.79	27	43.11	9.38
Control group
Perceived knowledge	65	19.22	3.71	43	18.74	3.58	39	20.34	4.00
Body appreciation	64	33.55	8.59	42	35.67	9.29	37	37.32	9.77

SD: standard deviation.

Pearson’s product–moment correlations

Correlational analyses measured the association between the amount of change in perceived knowledge and the amount of change in body appreciation across each of the three measurement occasions (see Table 3).

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Table 3.

Correlates between Time 1, Time 2 and Time 3 perceived knowledge and body appreciation score (intervention group above the diagonal, control group below).

	T1 perceived knowledge	T1 body appreciation	T2 perceived knowledge	T2 body appreciation	T3 perceived knowledge	T3 body appreciation
T1 perceived knowledge	1	.36**	−.26	.34*	.06	.28*
T1 body appreciation	−.12	1	−.30*	.76**	.30*	.12
T2 perceived knowledge	.15	.13	1	.38*	.15	.53**
T2 body appreciation	.53**	.08	.23	1	.13	.08
T3 perceived knowledge	.32	.10	.47**	.18	1	.24
T3 body appreciation	.14	.54**	.28	.84**	.11	1

*

p < .05; **p < .01.

When comparing data for participants in the intervention group from before and after the workshops (Time 1 and Time 2), changes in perceived knowledge showed a positive relationship with changes in body appreciation, r = .38, p < .01. Lower levels of body appreciation at Time 1 were associated with higher levels of perceived knowledge at Time 2. There was no association between changes in these two variables between Time 2 (after the workshops) and Time 3 (at the 3-month follow-up) for the intervention group. However, when examining the responses of participants in the intervention group between Time 2 and Time 3, there was a significant positive correlation between their level of perceived knowledge at Time 2 and their level of body appreciation at Time 3.

For participants in the control group, there were no significant associations between change in the level of perceived knowledge and change body appreciation between Time 1 and Time 2 or between Time 2 and Time 3.

Discussion

The findings show that participants who attended the Body Talk workshops felt more knowledgeable about their influence on their son’s body image as well as ways to communicate healthy messages about the body, food and physical activity to their sons. This finding was sustained at the 3-month follow-up. Participants also reported greater levels of body appreciation than control participants both immediately after the final workshop and 3 months later. Changes in body appreciation and perceived knowledge shared a positive relationship among intervention participants after attending the final workshop. Interestingly, those with lower levels of body appreciation at Time 1 showed high knowledge after completing the workshops.

The current findings support McCabe et al.’s (2007) suggestion that parent education programmes are important for helping parents learn how to communicate positive body image strategies to children. McCabe et al. noticed that body image concerns were emerging from 4-year-old boys who expressed concern about the size of their muscles. In contrast, girls voiced concern about their weight. The authors suggested that ‘fat talk’ as well as eating and exercise habits among parents were shaping the thoughts and attitudes of preschool-aged children. They recommended parent education programmes to prevent negative childhood attitudes from evolving into body image problems and disordered eating behaviour. This study did not measure the impact of the parent education workshops on boys; however, the findings show that educational programmes are beneficial for parents. This may, in turn, benefit children. Future research needs to explore the impact of these parent education programmes on children’s body image.

Our findings indicate that the educational workshops increased parents’ perceived understanding and awareness of a boy’s developing body image. Parents reported a greater understanding of the importance of role modelling and communicating positive attitudes about the body, which included gender-specific features such as muscles, weight, height and physical performance. This indicates that parents were able to absorb information in line with previous research which found that physical performance (e.g. running fast, kicking a ball) was the most important physical trait to a 5- or 6-year-old boy’s masculine identity (Birbeck and Drummond, 2006; Drummond, 2010). In these studies, strength was also highly valued by preschool-aged boys and viewed as a way to express their masculinity. Parents in the intervention group of this study reported feeling better equipped to role model and communicate healthy messages about these aspects of the body than parents in the control group. Future studies could consider trialling a similar programme focused on the specific body image concerns of girls.

As well as a greater sense of perceived knowledge, parents in the intervention group felt greater levels of acceptance and respect for their own body on completion of the workshops. This change was sustained at the 3-month follow-up. Previous research (e.g. Hendy et al., 2001; Hutchinson and Calland, 2011) has strongly suggested that parents are the most influential factor in a child’s developing body image. It is worth noting that the improvements in the parents’ body image occurred without directly addressing or discussing the body image of parents in the workshops. Both workshops focused on how parents communicate messages about the body, food and exercise to their sons.

Among participants in the intervention group, change in the level of body appreciation across both workshops shared a moderate positive relationship with change in perceived knowledge. This may be due to participants gaining a greater understanding of the role they play in their son’s body image and subsequently becoming motivated to reflect upon and make positive changes to their thoughts, feelings and attitudes regarding their own body. Alternatively, or perhaps concurrently, exploring techniques that parents can use to communicate healthy attitudes about the body to their sons may have prompted parents to not only communicate these attitudes to their sons but also internalise them as their own. It is noteworthy that empowering parents by helping them feel more informed and aware of body image issues in children may benefit their attitude towards their own body. This proposal is supported by the finding that changes in perceived knowledge at Time 2 were associated with an increased level of body appreciation at Time 3. It is possible that gaining knowledge at Time 2 was associated with increased body image 3 months later.

The current findings should be interpreted with caution, as the sample size was smaller than recommended for multilevel model analysis. This form of analysis was chosen to account for the non-independence between observations. Other forms of analyses do not account for this or the levels nested within repeated measures data. In addition, most of the parents in this study were mothers. Studies with fathers are needed to assess the impact of educational programmes on their body image and related behaviours.

The findings of this study show that parent education workshops on body image of preschool-aged boys are beneficial for parents and worth pursing in future research. Results demonstrated that parents in the intervention group, when compared to those in the control group, improved their perceived knowledge about how they may influence their son’s body image and increased their level of positive feelings towards their own body. These findings were significant immediately after completing the final workshop and at the 3-month follow-up. The findings also showed that increasing parents’ awareness of their role in their son’s body image is associated with greater levels of body appreciation, possibly through increased motivation to role model positive attitudes for their sons. Although future studies are needed to investigate whether improving the body image of parents is associated with an improved body image among their sons, this study indicates that educational workshops with parents might be the first step towards helping parents role model a healthy body image for future generations.