Associations between Exposure to Socio-Cultural Influences in Proximal Environments and Weight Concerns among Urban-Dwelling Women

Résumé Les préoccupations et comportements alimentaires entourant le poids sont omniprésentes chez les jeunes adolescentes et femmes qui habitent dans les cultures occidentales où les formes corporelles sont orientées vers un idéal ultra-mince. L’objectif de cette étude est d’examiner si une plus grande exposition aux endroits faisant la promotion de la minceur est associée à des préoccupations pour le poids plus élevées chez les femmes. Cette étude fait partie d’un projet intitulé ¨Social, cultural, and economic disparities and disordered eating: Understanding the contribution of neighbourhood and individual level factors¨ (Gauvin, Steiger, & Brodeur, 2009). Un échantillon de 1288 femmes âgées entre 20 et 40 ans et résidant à Montréal depuis au moins 12 mois ont répondu à un sondage téléphonique. Des régressions logistiques ont comparé les femmes se situant dans le quintile le plus élevé des préoccupations de poids avec les femmes dans les autres quintiles en fonction de leur exposition 15 jours ou plus dans des endroits faisant la promotion de la minceur. De plus, une analyse de sensibilité a vérifié si l’association demeurait significative à d’autres niveaux d’exposition. Les facteurs confondants ont été contrôlés statistiquement. Les résultats démontrent qu’une fréquentation d’au moins 15 jours par mois d’endroits faisant la promotion de la minceur est associée à des préoccupations plus élevées pour le poids. Aussi, fréquenter ces lieux entre 15 et 20 jours/mois est aussi associé à des préoccupations de poids élevées. Des interventions de santé publique pourraient viser la diminution des pressions socioculturelles vers la minceur.

Validation of the weight concerns scale applied to brazilian university students

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Weight concerns scale applied to college students: comparison between pencil-and-paper and online formats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Validation of the weight concerns scale applied to Brazilian university students

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Racial/ethnic differences on the body image perceptions and weight concerns of fourth grade girls

The purpose of this study was to determine the racial and ethnic differences on body image perceptions and weight concerns of fourth grade girls. A purposive sample of 182 fourth grade girls were eligible to participate, 166 were included in the data analysis. The Children's Eating Attitude Test (ChEAT) and a Dieting and Demographic Questionnaire (DDQ) were used to determine eating attitudes of fourth grade girls. A pictoral instrument that was modified from the original was used to assess body image. Anthropometric data was assessed and body mass index (BMI) values were used to classify subjects into percentiles. Results revealed that 56% of all fourth grade girls studied wanted to be thinner and 53% had tried to lose weight. Significantly more non-Hispanic white (NHW) girls reported wanting to be thinner than non-Hispanic black (NHB) and H girls (65.5% vs.32% and 47%, respectively, P=0.005) No significant racial/ethnic differences were revealed for the ChEAT scores. However, 19% of all subjects studied fell into the category indicative of anorexia nervosa. H girls who were less than the 85" %tile for BMI chose significantly smaller figures as their perceived body image (3.5±0.7) than both NHB and NHW girls (4.0±0.6 and 3.9±0.5, respectively, P<0.01). These findings demonstrated that weight concerns were prevalent among girls ages 9- 11 years. NHW and H girls may have more concerns about their body size and shape than their NHB counterparts. Implementing intervention programs at an early age may prevent eating disorders in adolescence and adulthood.

Encouragement of physical activity for weight loss may lead to negative psychological outcomes among girls

PURPOSE To examine correlates and consequences of parents' encouragement of girls' physical activity (PA) for weight loss (ENCLOSS). METHODS Data were collected for 181 girls, mothers and fathers when girls were 9, 11, and 13 years old. Mothers and fathers completed a self-report questionnaire of ENCLOSS (e.g., “I have talked to my daughter about how to exercise to lose weight”). Correlates of ENCLOSS that were assessed include girls' Body Mass Index (BMI) z-score and parents' modeling of and logistic support for PA. Dependent variables assessed at age 13 include girls' self-reported and objectively-measured PA, enjoyment of physical activity, and weight concerns. Associations between ENCLOSS, girls' BMI, and parent's support for PA were assessed using spearman rank correlations. To examine links between ENCLOSS and the outcome variables, scores for ENCLOSS were divided into tertiles at each age. Three groups were created including girls who were in the highest tertile at each age (high ENCLOSS), girls who were in the lowest tertile at each age (low ENCLOSS), and girls who varied in their tertile ranking (mid ENCLOSS). Group differences in the outcome variables were assessed using regression analysis (referent group: low ENCLOSS), controlling for girls' BMI and the outcome variable at age 9. RESULTS Girls' with higher BMI had mothers and fathers who reported higher ENCLOSS (r = .61-. 69, p<. 0001). Parents'reports of ENCLOSS were not associated with modeling of or logistic support for PA. Girls in the high ENCLOSS group reported significantly lower enjoyment of PA and higher weight concerns at age 13, independent of covariates. No differences in PA were noted. CONCLUSION Parents who encourage their daughters to be active for weight loss do not model PA or facilitate girls' PA. Persistent encouragement of PA for weight loss may lead to low enjoyment of PA and higher weight concerns among adolescent girls.

The contribution of psychosocial factors to socioeconomic differences in food purchasing

In developed countries the relationship between socioeconomic position (SEP) and health is unequivocal. Those who are socioeconomically disadvantaged are known to experience higher morbidity and mortality from a range of chronic diet-related conditions compared to those of higher SEP. Socioeconomic inequalities in diet are well established. Compared to their more advantaged counterparts, those of low SEP are consistently found to consume diets less consistent with dietary guidelines (i.e. higher in fat, salt and sugar and lower in fibre, fruit and vegetables). Although the reasons for dietary inequalities remain unclear, understanding how such differences arise is important for the development of strategies to reduce health inequalities. Both environmental (e.g. proximity of supermarkets, price, and availability of foods) and psychosocial (e.g. taste preference, nutrition knowledge) influences are proposed to account for inequalities in food choices. Although in the United States (US), United Kingdom (UK), and parts of Australia, environmental factors are associated with socioeconomic differences in food choices, these factors do not completely account for the observed inequalities. Internationally, this context has prompted calls for further exploration of the role of psychological and social factors in relation to inequalities in food choices. It is this task that forms the primary goal of this PhD research. In the small body of research examining the contribution of psychosocial factors to inequalities in food choices, studies have focussed on food cost concerns, nutrition knowledge or health concerns. These factors are generally found to be influential. However, since a range of psychosocial factors are known determinants of food choices in the general population, it is likely that a range of factors also contribute to inequalities in food choices. Identification of additional psychosocial factors of relevance to inequalities in food choices would provide new opportunities for health promotion, including the adaption of existing strategies. The methodological features of previous research have also hindered the advancement of knowledge in this area and a lack of qualitative studies has resulted in a dearth of descriptive information on this topic. This PhD investigation extends previous research by assessing a range of psychosocial factors in relation to inequalities in food choices using both quantitative and qualitative techniques. Secondary data analyses were undertaken using data obtained from two Brisbane-based studies, the Brisbane Food Study (N=1003, conducted in 2000), and the Sixty Families Study (N=60, conducted in 1998). Both studies involved main household food purchasers completing an interviewer-administered survey within their own home. Data pertaining to food-purchasing, and psychosocial, socioeconomic and demographic characteristics were collected in each study. The mutual goals of both the qualitative and quantitative phases of this investigation were to assess socioeconomic differences in food purchasing and to identify psychosocial factors relevant to any observed differences. The quantitative methods then additionally considered whether the associations examined differed according to the socioeconomic indicator used (i.e. income or education). The qualitative analyses made a unique contribution to this project by generating detailed descriptions of socioeconomic differences in psychosocial factors. Those with lower levels of income and education were found to make food purchasing choices less consistent with dietary guidelines compared to those of high SEP. The psychosocial factors identified as relevant to food-purchasing inequalities were: taste preferences, health concerns, health beliefs, nutrition knowledge, nutrition concerns, weight concerns, nutrition label use, and several other values and beliefs unique to particular socioeconomic groups. Factors more tenuously or inconsistently related to socioeconomic differences in food purchasing were cost concerns, and perceived adequacy of the family diet. Evidence was displayed in both the quantitative and qualitative analyses to suggest that psychosocial factors contribute to inequalities in food purchasing in a collective manner. The quantitative analyses revealed that considerable overlap in the socioeconomic variation in food purchasing was accounted for by key psychosocial factors of importance, including taste preference, nutrition concerns, nutrition knowledge, and health concerns. Consistent with these findings, the qualitative transcripts demonstrated the interplay between such influential psychosocial factors in determining food-purchasing choices. The qualitative analyses found socioeconomic differences in the prioritisation of psychosocial factors in relation to food choices. This is suggestive of complex cultural factors that distinguish advantaged and disadvantaged groups and result in socioeconomically distinct schemas related to health and food choices. Compared to those of high SEP, those of lower SEP were less likely to indicate that health concerns, nutrition concerns, or food labels influenced food choices, and exhibited lower levels of nutrition knowledge. In the absence of health or nutrition-related concerns, taste preferences tended to dominate the food purchasing choices of those of low SEP. Overall, while cost concerns did not appear to be a main determinant of socioeconomic differences in food purchasing, this factor had a dominant influence on the food choices of some of the most disadvantaged respondents included in this research. The findings of this study have several implications for health promotion. The integrated operation of psychosocial factors on food purchasing inequalities indicates that multiple psychosocial factors may be appropriate to target in health promotion. It also seems possible that the inter-relatedness of psychosocial factors would allow health promotion targeting a single psychosocial factor to have a flow-on affect in terms of altering other influential psychosocial factors. This research also suggests that current mass marketing approaches to health promotion may not be effective across all socioeconomic groups due to differences in the priorities and main factors of influence in food purchasing decisions across groups. In addition to the practical recommendations for health promotion, this investigation, through the critique of previous research, and through the substantive study findings, has highlighted important methodological considerations for future research. Of particular note are the recommendations pertaining to the selection of socioeconomic indicators, measurement of relevant constructs, consideration of confounders, and development of an analytical approach. Addressing inequalities in health has been noted as a main objective by many health authorities and governments internationally. It is envisaged that the substantive and methodological findings of this thesis will make a useful contribution towards this important goal.

Social comparison and body image in non or infrequent exercisers and exercisers

Body image refers to an individual's internal representation ofhis/her outer self (Cash, 1994; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). It is a multidimensional construct which includes an individual's attitudes towards hislher own physical characteristics (Bane & McAuley, 1998; Cash, 1994; Cash, 2004; Davison & McCabe, 2005; Muth & Cash, 1997; Sabiston, Crocker, & Munroe-Chandler, 2005). Social comparison is the process of thinking about the self in relation to others in order to determine if one's opinions and abilities are adequate and to assess one's social status (Festinger, 1954; Wood, 1996). Research investigating the role of social comparisons on body image has provided some information on the types and nature of the comparisons that are made. The act of making social comparisons may have a negative impact on body image (van den Berg et ai., 2007). Although exercise may improve body image, the impact of social comparisons in exercise settings may be less positive, and there may be differences in the social comparison tendencies between non or infrequent exercisers and exercisers. The present study examined the nature of social comparisons that female collegeaged non or infrequent exercisers and exercisers made with respect to their bodies, and the relationship of these social comparisons to body image attitudes. Specifically, the frequency and direction of comparisons on specific tal-gets and body dimensions were examined in both non or infrequent exercisers and exercisers. Finally, the relationship between body-image attitudes and the frequency and direction with which body-related social comparisons were made for non or infrequent exercisers and exercisers were examined. One hundred and fifty-two participants completed the study (n = 70 non or ill infrequent exercisers; n = 82 exercisers). Participants completed measures of social physique anxiety (SPA), body dissatisfaction, body esteem, body image cognitions, leisure time physical activity, and social comparisons. Results suggested that both groups (non or infrequent exercisers and exercisers) generally made social comparisons and most frequently made comparisons with same-sex friends, and least frequently with same-sex parents. Also, both groups made more appearance-related comparisons than non-appearance-related comparisons. Further, both groups made more negative comparisons with almost all targets. However, non or infrequent exercisers generally made more negative comparisons on all body dimensions, while exercisers made negative comparisons only on weight and body shape dimensions. MANOV As were conducted to examine if any differences on social comparisons between the two groups existed. Results of the MANOVAs indicated that frequency of comparisons with targets, the frequency of comparisons on body dimensions, and direction of comparisons with targets did not differ based on exercise status. However, the direction of comparison of specific body dimensions revealed a significant (F (7, 144) = 3.26,p < .05; 1]2 = .132) difference based on exercise status. Follow-up ANOVAs showed significant differences on five variables: physical attractiveness (F (1, 150) = 6.33,p < .05; 1]2 = .041); fitness (F(l, 150) = 11.89,p < .05; 1]2 = .073); co-ordination (F(I, 150) = 5.61,p < .05; 1]2 = .036); strength (F(I, dO) = 12.83,p < .05; 1]2 = .079); muscle mass or tone (F(l, 150) = 17.34,p < .05; 1]2 = 1.04), with exercisers making more positive comparisons than non or infrequent exercisers. The results from the regression analyses for non or infrequent exercisers showed appearance orientation was a significant predictor of the frequency of social comparisons N (B = .429, SEB = .154, /3 = .312,p < .01). Also, trait body image measures accounted for significant variance in the direction of social comparisons (F(9, 57) = 13.43,p < .001, R2adj = .68). Specifically, SPA (B = -.583, SEB = .186, /3 = -.446,p < .01) and body esteem-weight concerns (B = .522, SEB = .207, /3 = .432,p < .01) were significant predictors of the direction of comparisons. For exercisers, regressions revealed that specific trait measures of body image significantly predicted the frequency of comparisons (F(9, 71) = 8.67,p < .001, R2adj = .463). Specifically, SPA (B = .508, SEB = .147, /3 = .497,p < .01) and appearance orientation (B = .457, SEB = .134, /3 = .335,p < .01) were significant predictors of the frequency of social comparisons. Lastly, for exercisers, the results for the regression of body image measures on the direction of social comparisons were also significant (F(9, 70) = 14.65,p < .001, R2adj = .609) with body dissatisfaction (B = .368, SEB = .143, /3 = .362,p < .05), appearan.ce orientation (B = .256, SEB = .123, /3 = .175,p < .05), and fitness orientation (B = .423, SEB = .194, /3 = .266,p < .05) significant predictors of the direction of social comparison. The results indicated that young women made frequent social comparisons regardless of exercise status. However, exercisers m,a de more positive comparisons on all the body dimensions than non or infrequent exercisers. Also, certain trait body image measures may be good predictors of one's body comp~son tendencies. However, the measures which predict comparison tendencies may be different for non or infrequent exercisers and exercisers. Future research should examine the effects of social comparisons in different populations (i.e., males, the obese, older adults, etc.). Implications for practice and research were discussed.

Exploring Body-Related Experiences among Individuals with Spinal Cord Injury

Using modified constructivist grounded theory, the purpose of the present study was to explore body-related experiences, specifically body image, in people with spinal cord injury. A total of nine participants (five women, four men) who had a broad range of body image experiences (from very negative to very positive) were interviewed. Most participants explained experiencing a fluctuating body image that varied from day-to-day. Negative body image experiences were represented by appearance, weight concerns, and function with all body image experiences encompassed by self-presentational concerns and tactics (an unanticipated finding). Positive body image was represented by acceptance, appreciation and gratitude of the body. Interestingly, negative body image experiences were not found to be represented by the opposite of positive body image experiences as they were each distinct. These findings have direct implications for medical professionals in hospital and rehabilitation settings to understand the importance of body image after spinal cord injury.

Validação das escalas de preocupação com o peso corporal e de estresse percebido

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Validação de um instrumento de preocupação com a forma corporal aplicado a estudantes universitárias

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)