Improving body image at scale among Brazilian adolescents: study protocol for the co-creation and randomised trial evaluation of a chatbot intervention

Background Body image concerns are prevalent among Brazilian adolescents and can lead to poor psychological and physical health. Yet, there is a scarcity of culturally-appropriate, evidence-based interventions that have been evaluated and made widely available. Chatbot technology (i.e., software that mimics written or spoken human speech) offers an innovative method to increase the scalability of mental health interventions for adolescents. The present protocol outlines the co-creation and evaluation of a body image chatbot for Brazilian adolescents via a partnership between academics, industry organisations and the United Nations Children’s Fund (UNICEF). Methods A two-armed fully remote randomised controlled trial will evaluate the chatbot’s effectiveness at improving body image and well-being. Adolescent girls and boys (N = 2800) aged 13–18 years recruited online will be randomly allocated (1:1) into either: 1) a body image chatbot or 2) an assessment-only control condition. Adolescents will engage with the chatbot over a 72-hour period on Facebook Messenger. Primary outcomes will assess the immediate and short-term impact of the chatbot on state- and trait-based body image, respectively. Secondary outcomes will include state- and trait-based affect, trait self-efficacy and treatment adherence. Discussion This research is the first to develop an evidence-informed body image chatbot for Brazilian adolescents, with the proposed efficacy trial aiming to provide support for accessible, scalable and cost-effective interventions that address disparities in body image prevalence and readily available resources. Trial registration number NCT04825184, registered 30th March 2021.

Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status

We examined sleep difficulties among adolescents in Germany and the association with physical activity (PA). Furthermore, we analyzed whether the association varied with the socioeconomic status (SES) among adolescent girls and boys in Germany. Using data from the German Health Interview Examination Survey for Children and Adolescents (KiGGS) study (Wave 2), 6599 adolescents aged 11 to 17 years were included in the analyses. We conducted sex-stratified logistic regression analyses. Dependent variables were unrecommended sleep duration (defined as a duration of sleep that does not meet the recommended duration), sleep-onset difficulties, trouble sleeping, and daytime sleepiness. Most adolescent girls and boys reported sleep difficulties. While no associations between PA and sleep difficulties were observed, a significant interaction between PA and SES was found for sleep duration in boys and daytime sleepiness in girls. Thus, adolescents with low SES had fewer sleep difficulties if they met the recommendation for PA, compared with those in other SES groups. In Germany, a large proportion of adolescents have sleep difficulties. We found that the experience of sleep difficulties varied according to PA, sex, and the family SES. Future sleep promotion programs should consider these differences.

Prevalence of and factors associated with insufficient physical activity among adolescents: evidence from a nationwide survey in Bangladesh

The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.

Sexual Abuse in Adolescent Girls and Boys with Mild Intellectually Disable

Introduction: The problems of girls and boys with mild intellectually disable (MID) increases with age gradually. Due to the emerging changes, puberty is a significant period for adolescents with MID. The aim of this study to investigate sexual abuse in girls and boys with mild intellectually disable in the puberty period. Methods: This research is a cross-sectional study. The statistical population consisted of all boys and girls with mild intellectual disabilities between the ages of 12 and 16 from exceptional public schools and their mothers in Yazd, Iran. 300 MID adolescents (150 girls and boys each) were selected by multi-stage sampling. To study sexual abuse, a self-designed questionnaire was used. The questionnaire comprised two sections. Kuder-Richardson coefficient obtained for boys and girls with MID turned out to be 0.80 and 0.84, respectively. Using frequency, percentage, and correlation coefficient (p<0.05). Data were analyzed with SPSS 24. Results: In this study, 2.67% (n = 4) of girls and 4% (n = 6) of boys with MID were abused. Also, their psychological and physical signs of sexual abuse were assessed (depression: girls,0.75% (n = 3), boys, 33.33% (n = 2), aggression: girls,0.75% (n = 3), boys, 66.66% (n = 4), avoiding certain adults, 0.50% (n = 2), boys, 33.33% (n = 2), sleep and eating disorder, 0.25% (n = 1), boys, 16.66% (n = 1) . Some of their parents pointed that their children had not received training in this area. There was a significant positive correlation coefficient between the mother's educational level and receiving training by schools and family with sexual abuse knowledge (p<0.05). Conclusion: The irrational reaction of families, the community, and the lack of adequate training lead to an increasein sexual abuse in such individuals. Hence, training these young individuals seems essential both before and during puberty.