The purpose of this study is to evaluate whether a digital intervention can improve body image and psychological well-being among adolescent boys who attend fitness clubs. Fitness club environments and social media often promote appearance ideals related to muscularity and leanness, which may contribute to body appearance pressure, body dissatisfaction, and psychological distress among boys.
In this cluster-randomized controlled trial, approximately 260 boys aged 15 to 18 years will be recruited from fitness clubs in Oslo, Norway. Participants from fitness clubs assigned to the intervention group will receive access to a 12-week website-based program consisting of four interactive modules focusing on body image, psychological well-being, critical social media literacy, and attitudes toward food and sports supplements. Participants in the control group will continue their usual activities.
The study will examine whether the intervention reduces internalization of appearance ideals and body appearance pressure and improves body appreciation, health-related quality of life, psychological well-being, social media-related behaviors, and attitudes toward food and sports supplements. Outcomes will be assessed at baseline, immediately after the intervention, and at a 6-month follow-up.
Cisgender boy
Aged 15 to 18 years
Current member of a fitness club
Attends the fitness club at least once per week
Does not meet one or more of the inclusion criteria
Not able to provide informed consent
Previously enrolled in the study
Parallel
Website
Other interventionParticipants assigned to the intervention arm will receive access to the Strong Minds website, a 12-week digital intervention designed to promote positive body image and psychological well-being among adolescent male fitness club members. The intervention consists of four interactive modules released every three weeks and addresses body image, psychological well-being, critical social media literacy, and attitudes toward food and sports supplements. Modules include brief narrative-based content, quizzes, personalized feedback, and reflection exercises. Total engagement time is approximately 75 minutes across the 12-week intervention period.
Internalization
Internalization of appearance ideals (Sociocultural Attitudes Towards Appearance Questionnaire-4 \[SATAQ-4\]). This outcome assesses the extent to which participants adopt societal appearance ideals related to muscularity, leanness, and low body fat as personal standards for evaluating their own appearance. Internalization is measured using the relevant SATAQ-4 subscales. Items are rated on a 5-point Likert scale ranging from 1 (definitely disagree) to 5 (definitely agree), with higher scores indicating greater internalization of societal appearance ideals. The outcome will be assessed at baseline, post-intervention (12 weeks), and 6-month follow-up.
Body appearance pressure
Body appearance pressure measured using the Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised (SATAQ-4R). Scores range from 1 to 5, with higher scores indicating greater perceived appearance-related pressure from media and sociocultural influences.
Body appreciation
The extent to which participants respect, accept, and value their bodies and maintain a positive body image despite societal appearance pressures.
Social Media use
Self-reported social media use, including platform(s) used, frequency of use per day, time spent on social media (hours/day), exposure to appearance-related content, appearance comparison, selfie posting, and motivations for use.
General health-related quality of life.
Self-reported health-related quality of life measured using the KIDSCREEN-10 questionnaire. Higher scores indicate better quality of life and well-being.
Psychological distress
Psychological distress assessed using the Hopkins Symptom Checklist-10 (HSCL-10). The HSCL-10 is a self-report measure of symptoms of anxiety and depression. The total score is calculated as the mean of the 10 items, with response options ranging from 1 (not at all) to 4 (extremely). Scores range from 1 to 4, with higher scores indicating greater psychological distress and a worse outcome.
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