About this trial
The goal of this three-arm randomized controlled trial is to evaluate the acceptability and efficacy of two podcast-based interventions -- a podcast with an accompanying journal and the same podcast without a journal -- which aim to improve body confidence among millennial-aged women (29-44 years of age) in the United Kingdom.
A total of 1800 women in the UK (29-44 years), who are podcast listeners, will be recruited by a research agency. Participants will be randomised to one of three groups: body confidence podcast episode with journal; body confidence podcast episode alone; a non-body confidence-related podcast episode from the same series as the intervention podcast.
The research aims are to determine the following:
1. Are the two versions of the intervention (i.e., podcast with and without a journal) effective in improving appearance esteem (primary outcome), internalisation of appearance ideals, self-objectification, and weight esteem among UK-based women (i) 1 day post-intervention and (ii) 1 week post-intervention, compared to a control podcast? 2. Are the two interventions (i.e., podcast with and without a journal) effective in generating immediate change in state body satisfaction and state mood, compared to a control podcast? 3. Are the two versions of the intervention acceptable to women?
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Be fluent in English
Identify as a woman between 29 and 44 years
Be based in the UK
Has a personal device to complete the study
Disqualifiers
Never listens to podcasts
Has listened to part or all of the How To Fail podcast episode featuring Pamela Anderson
Trial design
Parallel
Treatments tested in this trial
Body confidence podcast episode and supplementary exercises in a journal
BehavioralThe 52-minute long podcast episode is hosted on the How to Fail podcast featuring a conversation between its host, Elizabeth Day, and the guest, actor and activist, Pamela Anderson ("It wasn't about being pretty, it was about being brave"). The podcast episode is accompanied by supplementary exercises in a journal to reinforce the body confidence messages shared during the episode. The 8-page journal ("Beauty on Your Own Terms") consists of two primary activities. The first activity ("A vision for your future") involves 3 questions, a 3-minute visualisation exercise, and a prompt for written reflection all intended to facilitate "accepting your body as it is, rejecting societal and media pressures that define beauty narrowly, and defining beauty on your own terms." The second activity ("Beauty-on-your-own-terms challenge") involves 4 exercises intended to help women reflect on what they can "change about your routine and habits to start defining beauty on your own terms".
Body confidence podcast episode
BehavioralThe podcast episode is hosted on the How to Fail podcast featuring a conversation between its host, Elizabeth Day, and the guest, actor and activist, Pamela Anderson ("It wasn't about being pretty, it was about being brave").
Non-body image-related podcast episode
BehavioralA podcast episode from the same podcast series as the intervention, How to Fail, which contains no body image content and is matched on length and guest similarities. The episode features host Elizabeth Day in conversation with actor and activist Cynthia Nixon ("Being brave is feeling scared and doing it anyway"), which is 47 minutes in length.
Treatment groups
Trial outcomes
Primary outcomes
Change in appearance esteem as measured by the Appearance subscale of the Body Esteem Scale for Adolescents and Adults (BESAA)
The Appearance subscale of the BESAA (Mendelson et al., 2001) contains 10 items, which assess self-evaluations of one's overall appearance using a scale of 1 (never) to 5 (always). Six items are reverse scored and scores for each item are averaged with higher scores indicating higher appearance esteem.
Secondary outcomes
Change in internalisation of appearance ideals as measured by the Internalisation of appearance ideals subscale of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3)
An adapted five-item version of the SATAQ-3 subscale (Thompson et al., 2004; Mahon et al., 2025) assesses the extent to which appearance ideals are internalised. Participants respond to each of the five statements from 1 (Definitely disagree) to 5 (Definitely agree). Item scores are averaged with higher scores indicating greater internalisation of appearance ideals.
Change in self-objectification as measured by the Likert version of the Self-Objectification Questionnaire (LSOQ)
The LSOQ (Wollast et al., 2021) is comprised of 10 items describing different body attributes; five items constitute the appearance subscale and five items constitute the competence subscale. Participants indicate how important each of the items are in relation to how they feel about their body using a scale from 1 (low importance) to 11 (high importance). The items for each subscale are averaged. A higher appearance subscale score in comparison to the competence subscale score indicate greater self-objectification.
Change in weight esteem as measured by the Weight subscale of the BESAA
The Weight subscale of the BESAA (Mendelson et al., 2001) consists of eight items, which assess self-evaluations of one's weight using a scale of 1 (never) to 5 (always). Three items are reverse scored and scores for each item are averaged with higher scores indicating higher weight esteem.
Change in state body satisfaction as measured by a one-item visual analogue scale
A visual analogue scale (VAS) (Heinberg \& Thompson, 1995) will assess participants' state body satisfaction using a single item (i.e, "How satisfied do you feel about your appearance, right now?"). Participants will indicate their mood on a 101-point VAS (0 = completely dissatisfied - 100 = completely satisfied) with higher scores indicating greater body satisfaction.
Other outcomes
Total acceptability of the intervention
All participants will answer the same five acceptability questions. Participants in Arm A (podcast and journal) will answer an additional two questions related to the journal. The five questions relate to their enjoyment in listening to the podcast; relatability of the podcast content; likeability of the podcast host; likeability of the podcast guest; and likelihood of recommending the podcast. The two additional questions for Arm A participants relate to their enjoyment in completing the journal and the likelihood of recommending the journal. Responses for all acceptability questions are on a scale from 1 (not at all) to 5 (very much).
Total engagement in the intervention
Participants will be asked five multiple-choice manipulation checks to gauge their level of podcast engagement. Each manipulation check asks a simple question based on content shared in the podcast and provides five possible responses: one response is correct, three responses are incorrect, one response is "I don't know". Responses will be categorised as follows for each arm: * 0-1 correct=low pod engagement; * 2-3 correct=medium pod engagement; * 4-5 correct=high pod engagement. Journal engagement will be determined by the amount of time spent engaging with the journal based on time stamps: * 0-60 secs=no journal engagement; * 1-4 mins=low journal engagement; * 5-8 mins=medium journal engagement; * 9 mins+=high journal engagement. Total engagement for Arm A (podcast + journal) will be as follows: * high pod engagement + high journal engagement=high engagement; * low pod engagement + low journal engagement=low engagement; * any other combination=medium engagement.
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