title: An effectiveness trial of a new enhanced dissonance eating disorder prevention program among female college students.
abstract: OBJECTIVE
  Efficacy trials indicate that a dissonance-based prevention program in which female high school and college students with body image concerns critique the thin-ideal reduced risk factors, eating disorder symptoms, and future eating disorder onset, but weaker effects emerged from an effectiveness trial wherein high school clinicians recruited students and delivered the program under real-world conditions. The present effectiveness trial tested whether a new enhanced dissonance version of this program produced larger effects when college clinicians recruited students and delivered the intervention using improved procedures to select, train, and supervise clinicians.
  
  
  METHODS
  Young women recruited from seven universities across the US (N = 408, M age = 21.6, SD = 5.64) were randomized to the dissonance intervention or an educational brochure control condition.
  
  
  RESULTS
  Dissonance participants showed significantly greater decreases in risk factors (thin-ideal internalization, body dissatisfaction, dieting, negative affect) and eating disorder symptoms versus controls at posttest and 1-year follow-up, resulting in medium average effect size (d = .60). Dissonance participants also reported significant improvements in psychosocial functioning, but not reduced health care utilization or unhealthy weight gain.
  
  
  CONCLUSIONS
  This novel multisite effectiveness trial with college clinicians found that the enhanced dissonance version of this program and the improved facilitator selection/training procedures produced average effects that were 83% larger than effects observed in the high school effectiveness trial.
authors.affiliation: Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA. Electronic address: stice@psy.utexas.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Stice
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Butryn
authors.forename: Paul
authors.initials: P
authors.lastname: Rohde
authors.forename: Heather
authors.initials: H
authors.lastname: Shaw
authors.forename: C Nathan
authors.initials: CN
authors.lastname: Marti
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology; D003073:Cognitive Dissonance; D005247:Feeding Behavior / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D010174:Pamphlets; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D055815:Young Adult
keywords: Body dissatisfaction; Dissonance; Eating disorder; Effectiveness trial; Prevention