Adapting a Cognitive Dissonance-based Eating Disorders Prevention Program for Teen Girls With Type 1 Diabetes

Paige Trojanowski

Advisor: Sarah Fischer Nowaczyk, Robyn Mehlenbeck

Committee Members: Christy Esposito-Smythers

Online Location, https://gmu.zoom.us/j/99218133993
April 28, 2021, 09:00 AM to 11:00 AM

Abstract:

Females with Type 1 Diabetes (T1D) experience higher rates of disordered eating and body image concerns, which are associated with severe diabetes-related medical complications. Eating disorder (ED) prevention programs for teen females with T1D, however, do not exist. The present dissertation describes two studies that begin to address this gap in prevention science. They aimed to adapt an existing, empirically supported cognitive dissonance-based ED prevention program--the Body Project--specifically for teen girls with T1D. In Study 1, young women, parents, and medical staff participated in focus groups and interviews centered on understanding factors that could influence body image development in the context of T1D and to gather suggestions on how to modify the Body Project to address T1D-specific factors that complicate body image development and healthy eating patterns in teens with T1D. Multiple themes were identified related to complicating factors: T1D stereotypes and misinformation, illness non-acceptance, demands of T1D and its management, patient-doctor relations, and family factors. Three themes related to protective factors also emerged: illness acceptance, validation and normalization of experiences, and family factors. From these factors, an adapted intervention was developed that centered on promoting illness acceptance by decreasing comparison to peers without T1D and encouraging self-affirmation, teaching effective communication to combat judgment-driven comments by others, and enhancing social support in addition to challenging sociocultural pressures to conform to body stereotypes as in the original program. Study 2 piloted the adapted, virtual prevention protocol in a sample of 35 teens and parents. Results demonstrated high acceptability and positive preliminary efficacy.