Abstract| Volume 45, ISSUE 4, SUPPLEMENT , S4, July 2013

Adapting Online Body Image Education to Address Needs Unique to Low-income Adult Females


      To assess efficacy and appeal for incorporation of 2 lessons about body size initially designed for college students into About Eating, an online intervention.

      Target audience

      Low-income females.

      Theory, Prior Research, Rationale

      About Eating, based on the ecSatter model of eating competence, improves food resource management skills—one ecSatter tenet. Addressing body image strengthens model fidelity.


      SNAP-Ed participating agencies helped recruit from 3 geographically disparate Pennsylvania community settings. Respondents completed an online survey and a face-to-face cognitive interview while viewing lessons online; presentation order was alternated to reduce interview fatigue. Outcome measures included demographic information, verbalizations about graphics, design, navigation, pertinence, and 7-item lesson evaluation collected via online survey, interviews, and website survey respectively. Audio recordings were analyzed using Atlas.ti; data were analyzed with SPSS 19.0.


      Cognitive interviews were conducted with 24 low-income females, mostly white (75%) ranging from 21 to 48 y; 88% SNAP-Ed participants. Mean BMI was 32.8 ±7.5; 91% were either overweight or obese. Both lessons were denoted as “definitely interesting” (87% and 79% for each lesson) and “useful” (70% and 79%). Cognitive testing provided the rationale for lesson consolidation and modification. Suggestions were to add photos of diverse body sizes, and ages; show running/jogging examples; eliminate research terminology and drawing activity. Lesson merger into one, About My Size, was identified as a valid option.

      Conclusions and Implications

      Cognitive interviews supported incorporation of body image concepts, but with revisions to better reflect unique needs of low-income women. Adding these concepts to About Eating will better address intake regulation concepts and give broader appeal to low-income women.