Author Identifier

Karen Lombardi

Date of Award


Document Type



Edith Cowan University

Degree Name

Doctor of Philosophy


School of Medical and Health Sciences

First Supervisor

Shelley Beatty

Second Supervisor

Amanda Devine

Third Supervisor

Leesa Costello

Fourth Supervisor

Ruth Wallace


Poor body image is a serious public health concern globally, and may lead to the development of poor mental and physical health, as well as eating disorders. Body image concerns were once believed to arise during puberty, though it is now reported children as young as three years of age present with such problems. Early intervention is therefore an important strategy to improve mental and physical health outcomes for very young children, and educators are an obvious conduit to build confidence, self-esteem and resilience of such children. In order for them to adequately fulfil this role, educators must first understand the problem and appreciate their significance in this area. While educators are well placed to influence the development of positive body image among children, research into their understanding of their role in body image development appeared to be limited. This project therefore aimed to design, implement and evaluate the impact of a professional development intervention for educators regarding the promotion of positive body image in preschool children.

This Healthway-funded study comprised a tri-phasic sequential-exploratory design. In the first phase of the study, qualitative data were collected from focus groups and telephone interviews. This formative research found educators understood the concept of body image, but were confused about its development and their role in positive body image promotion. They acknowledged their training regarding body image had been negligible and expressed interest in online professional development in this area. These findings informed the development of an online professional development intervention for educators (i.e. Phase Two).

In the third phase of the study, the intervention was implemented and its impact was evaluated. The intervention was delivered online as part of the existing Supporting Nutrition for Australian Childcare website. The impact of the intervention on knowledge, attitudes and behaviours of educators in relation to body image was measured using the pre-existing Body Appreciation Scale; adapted Child Feeding Practices Questionnaire; and Parenting Intentions Body Image and Eating Patterns in Childhood Questionnaire. In addition, educators’ perceptions of their role legitimacy and adequacy in terms of influencing body image development was assessed. Qualitative data were also collected and used to evaluate participants’ use and satisfaction with the intervention materials, and to determine intervention reach.

Post-intervention, quantitative results showed significant changes in participants’ role legitimacy scores and behaviour change scores. Positive changes in self-efficacy, knowledge of risk factors and understanding of the meaning of body image were also apparent. Additionally, role adequacy and legitimacy was found to be positively correlated with behaviour change, with results indicating respondents with higher role legitimacy and adequacy scores were more likely to implement positive eating practices in their early years service.

The findings of this research make an important contribution to the child health field because it is arguably the first study to explore the role of educators in the development of body image in very young children, and to develop and evaluate an intervention designed to upskill educators in this area.