Operation Self-esteem: a cluster-randomized study of school-based eating disorder prevention delivered by patient advocates

Mental health providers face serious challenges identifying risks and providing effective and accessible help for young people with eating disorders. The present study conducted a preliminary evaluation of Operation Self-esteem (OS), a manualized school-based intervention program for promoting eating disorder related mental health in adolescents, delivered by a patient advocacy group for eating disorders. A cluster-randomized design was used to study OS or controls with no OS in eight high schools (girls: OS N = 104, controls N = 120; boys: OS N = 60, controls N = 60; total N = 344). Three months post-intervention OS participants scored significantly lower than controls on Internalization of Media Ideals and had a greater propensity to turn to teachers and school health services when encountering mental health problems. However, there were no significant differences on other key measures (e.g. Self-esteem, Body Dissatisfaction, and General help-seeking behavior). The study suggests that collaboration between researchers and patient advocacy groups in the development and implementation of interventions is highly important for addressing today's mental health challenges. OS shows promise as a low-cost, implementation focused intervention to reduce internalization of media ideals and promote help-seeking behavior, but more research is needed to further optimize intervention.