Highlights To date there have been no examinations of moderators of outcome in universal eating disorder prevention trials This study investigated if depression moderated outcome of Media Smart, a school-based program previously found to reduce risk factors over a 2.5-year follow-up Baseline depression moderated program outcome for shape and weight concern, media internalization, body dissatisfaction, ineffectiveness and perceived pressure. Participants with high depression experienced significant immediate benefit from Media Smart at postporgram, while those with low depression experienced a prevention effect over the 2.5-year follow-up. The goal of universal eating disorder prevention programs should be to halt risk factor growth over time and Media Smart did this for the important variable of shape and weight concern.
*Highlights (for review)Depression as a moderator 2 Abstract Objective: To investigate if baseline depression moderated response to Media Smart, an 8-lesson school-based program previously found to achieve a long-term risk reduction effect in young adolescents. Method: 540 Grade 8 students (M age = 13.62 years, SD = .37) from 4 schools participated with 11 classes receiving the Media Smart program (126 girls; 107 boys) and 13 comparison classes receiving their normal lessons (147 girls; 160 boys). Shape and weight concern, media internalization, body dissatisfaction, dieting, ineffectiveness, and perceived pressure were the outcome variables. Results: Moderation was indicated by significant interaction effects for group (Media Smart; Control) X moderator (high depression; low depression) X time (post-program; 6-month follow-up; 2.5-year follow-up), with baseline entered as a covariate. Such effects were found for shape and weight concern, media internalization, body dissatisfaction, ineffectiveness and perceived pressure. Posthoc testing found high depression Media Smart participants scored significantly lower than their control counterparts at post-program on shape and weight concern, media internalization and dieting, whereas low depression Media Smart participants scored significantly lower on shape and weight concern at 2.5-year followup. Discussion: Media Smart achieved a reduction in eating disorder risk factors for high-depression participants and a reduced rate of growth in risk factor scores for low-depression participants.