Mental Health Wellness 1NCT04135729
Mental Health in Fitness Instructors
An observational study of Mental Health Wellness 1 and Depression, Anxiety, run by Norwegian School of Sport Sciences at 1 site in Norway.
Trial summary
The aim of this project is to improve the evidence-base regarding lifestyle and mental health symptoms among fitness instructors. A national cohort of fitness instructors will be invited to participate in this study by responding to an online questionnaire. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Mental Health Wellness 1, Depression, Anxiety, Eating Disorders
- How many people
- 304 participants
- Where
- 1 siteNorway
- Study dates
- 1 Nov 2019to 30 May 2020
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: All operating fitness instructors working at fitness facilities/gym's in Norway during autumn 2019 are recruited by information in social media, by information given directly to CEO/administration of facilities listed by the cooperative in Norway, Virke Trening, and by information given directly to gym facilities identified by other means in Norway.
Who may be able to join
- Operating as a fitness instructor (personal trainer or group instructor) during autumn 2019
- Age above 18 years
- Living and operating in Norway
- Understanding and communicating with Norwegian language
Who cannot join
- Not engaged as a fitness instructor at recruitment time (autumn 2019)
- Age below 18 years of age
- Not living and/or operating in Norway
- Only speaking/communicating in foreign language (i.e. not Norwegian language)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Body Image and Mental Health Symptoms in Personal Trainers and Group Instructors
The aim of this project is to improve the evidence-base regarding lifestyle and mental health symptoms among fitness instructors. A national cohort of fitness instructors will be invited to participate in this study by responding to an online questionnaire. The questionnaire will consist of items regarding exercise, nutrition, eating disorders, the menstrual cycle, depression, anxiety, body dissatisfaction and satisfaction, drive for muscularity and leanness, and experiences of sexual harassment. Findings from this study will provide an evidence-base for initiatives to improve/optimize mental health among fitness instructors, and also in the process of developing fitness centres to a core partner in public health and health promotion work.
Read the detailed description
Previous research has shown that prevalence of self-reported eating disorders vary from 5-40% among group fitness instructors. Most of these studies were conducted more than 10 years ago, hence the potential impact of social media on the fitness instructors' body image and mental health symptoms has therefore not been taken into account. Recent studies reveal that social media is a significant contributor for perceived body image and for eating and exercise-related disturbances. A more recent Norwegian study from 2015 found a prevalence of self-reported eating disorders of 4.8% and 4.3% among female and male group fitness instructors, respectively. However, major limitations with this previous study was the low sample size (n=107), few men included, not being national representative (i.e. only recruiting from a smaller geographical area), and the lack of instruments assessing body awareness of muscularity and leanness instead of thinness.
The fitness industry has great potential as a public health collaborator, and to improve physical activity level and public health status. However, this potential can be flawed by instructors complying with a culture idealizing unhealthy attitudes, motivation and behaviour with regards to nutrition, exercise and body image. This is a culture also potentially being underlined by the new exercise concepts and titles brought forward by the fitness industry, emphasizing body ideals and appearance, and body weight control. An additional concern to the mental health of fitness instructors, are the increase in reports of sexual harassment.
The high prevalence of perceived negative body image and disordered eating among fitness instructors, reports of sexual harassment, and the focus on appearance and control of body shape in the fitness industry, causes concern for the mental health of the employees (i.e. fitness instructors). Hence, this cohort study aims to map the prevalence of mental health symptoms in a national cohort of fitness instructors.
- Conditions
- Mental Health Wellness 1, Depression, Anxiety, Eating Disorders, Eating Behavior, Body Image, Sexual Harassment
- Keywords
- Mental health, Eating disorders, Depression, Anxiety, Body dissatisfaction, Body image, Thinness, Leanness, Muscularity, Compulsive exercise, Eating behavior, Dieting, Exercise, Sexual harassment
- Medical subject headings
- Depression, Anxiety Disorders, Feeding and Eating Disorders, Feeding Behavior, Sexual Harassment, Body Weight Changes, Weight Loss, Weight Gain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Personal trainer (PT) | Cross-sectional study on mental health symptoms in personal trainers | |
| Group instructors (GI) | Cross-sectional study on mental health symptoms in group instructors | |
| Combined instructors (PT + GI) | Cross-sectional study on mental health symptoms in personal trainers |
What is being measured
The primary outcome is the main question the study is designed to answer.
Body image
Body image in fitness instructors (personal trainers and group instructors) by Body Appreciation Scale-2 (BAS-2). The scale comprises 10 items rated on a 5-point scale, ranging from 1 (Never) to 5 (Always), with higher total scoring indicating more positive body appreciation.
Measured: Autumn 2019
Eating disorders
Prevalence of eating disorders in fitness instructors (personal trainers and group instructors) by Eating disorders Examination questionnaire (EDE-q). The questionnaire has 6 items with open scorings reporting frequency of symptoms, and 22 items scored on a likert scale from 0-6 (no days - all days). The questionnaire has a total score and four subscales, with higher scorings (ranging from 0-6) indicative of higher severity.
Measured: Autumn 2019
Secondary outcomes (9)
Depression
Symptoms of depression in fitness instructors (personal trainers and group instructors) by Beck Depression Inventory (BDI-1a). It consists of 21 items scored on a 4-point Likert scale ranging from 0 (not at all) to 3 (extreme). Total score range is 0-63, and a cutoff score of ≥21 is recommended for use to detect a clinically significant episode of major depression.
Measured: Autumn 2019
Mental health symptoms
Symptoms of mental health symptoms in fitness instructors (personal trainers and group instructors) by Symptom Check List (SCL-10). The 10-item questionnaire measures symptoms of anxiety and depression with a likert scale ranging from 0-4 (not at all - very much), with higher scoring meaning higher clinical severity.
Measured: Autumn 2019
Drive for leanness
Symptoms of drive for leanness in fitness instructors (personal trainers and group instructors) by Drive for Leanness scale. It constitutes 6 questions scored by a 6 point scale ranging from never (1) to always (6) with a possible total score 0-36, and in which higher score is indicative of greater investment in leanness.
Measured: Autumn 2019
Drive for muscularity
Symptoms of drive for muscularity in fitness instructors (personal trainers and group instructors) by Drive for Muscularity Scale. It constitutes seven questions scored on a 6 points scale ranging from (1) always to (6) never, uses a reversed coding in analysis, and has a total score of 15-90 (high score means higher DM).
Measured: Autumn 2019
Compulsive Exercise
Symptoms of compulsive exercise in fitness instructors (personal trainers and group instructors) by Compulsive exercise test (CET). CET is a 24-item instrument scored on a 5-point Likert scale (0 = never true, 5 = always true), and evaluated with five different subscale mean scores (avoidance and rule driven behaviour, weight control exercise, mood improvement, lack of exercise enjoyment, and exercise rigidity), and a global score summing the means of subscales (score range 0-30).
Measured: Autumn 2019
Drive for thinness
Symptoms of drive for thinness in fitness instructors (personal trainers and group instructors) by Drive for Thinness subscale (DT) of Eating Disorder Inventory (EDI-3). The subscales constitutes 7 of the totally 91 questions in the EDI-3, and is scored on a likert scale from 0-4, with higher scoring meaning higher clinical severity, and a suggested clinical cutoff of 14.
Measured: Autumn 2019
Sexual harassment
Experience of sexual harassment in professional work by fitness instructors (personal trainers and group instructors). This is screened by questions on experiences of harassment of different character (comments, characteristic bodily movements, or physical touch or abuse), and scored on a scale by alternatives; never, yes-by collegues, yes-by clients, yes-by leaders.
Measured: Autumn 2019
Sociocultural Attitudes Towards Appearance Questionnaire
Sociocultural Attitudes Towards Appearance in fitness instructors (personal trainers and group instructors). The questionnaire has subscales that assess internalization (general, athlete), pressures, and information, and is scored from 1-5 (def. disagree - def. agree), with higher scorings indicating higher clinical severity.
Measured: Autumn 2019
Eating behavior
Symptoms of eating behavior in fitness instructors (personal trainers and group instructors) by Three Factor Eating Questionnaire (TFE-q 21). TFE-q measures symptoms of cognitive restrictive eating (RE, 6 items), emotional eating (EE, 6 items), and uncontrolled eating (UE, 9 items). It constitutes 20 questions rating agreements to different assertions by score of 1-4, and one question rating agreement by 1-8 points. The total subscale scores may be presented as raw scores, or as transformed scores (scale 0-100), and higher scorings means higher clinical severity.
Measured: Autumn 2019
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Oct 2019
- Study start1 Nov 2019
- Primary completion30 Apr 2020
- Study completion30 May 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mental Health Wellness 1Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 304 participants (actual)
Sponsor and investigators
- Lead sponsor
- Norwegian School of Sport Sciences
- Sponsor type
- University, hospital or other
- Collaborators
- Ostfold University College, University College of Southeast Norway
- Responsible party
- Principal investigator, Professor Jorunn Sundgot-Borgen, Norwegian School of Sport Sciences
- Investigators
- Jorunn Sundgot-Borgen, PhD, Principal investigator, Norwegian School of Sport Sciences
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04135729
- Sponsor's protocol ID
- 19/00742
- Other IDs
- 28855
- Status last verified
- Jun 2020
- First submitted
- 20 Oct 2019
- Last updated
- 12 Jun 2020
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Data is held within the group of scientists, but sharing may be evaluated on request.
Study at a glance
From the registry record, last updated by the sponsor on 12 Jun 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Body Image and Mental Health Symptoms in Personal Trainers and Group Instructors
- ClinicalTrials.gov ID
- NCT04135729
- Acronym / sponsor ID
- 19/00742
- Conditions
- Mental Health Wellness 1, Depression, Anxiety, Eating Disorders, Eating Behavior, Body Image, Sexual Harassment
- Keywords
- Mental health, Eating disorders, Depression, Anxiety, Body dissatisfaction, Body image, Thinness, Leanness
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 304 participants (actual)
- Lead sponsor
- Norwegian School of Sport SciencesUniversity, hospital or other
- Collaborators
- Ostfold University College, University College of Southeast Norway
- Study start
- 1 Nov 2019 (actual)
- Primary completion
- 30 Apr 2020 (actual)
- Study completion
- 30 May 2020 (actual)
- First posted
- 23 Oct 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this project is to improve the evidence-base regarding lifestyle and mental health symptoms among fitness instructors. A national cohort of fitness instructors will be invited to participate in this study by responding to an online questionnaire. The questionnaire will consist of items regarding exercise, nutrition, eating disorders, the menstrual cycle, depression, anxiety, body dissatisfaction and satisfaction, drive for muscularity and leanness, and experiences of sexual harassment. Findings from this study will provide an evidence-base for initiatives to improve/optimize mental health among fitness instructors, and also in the process of developing fitness centres to a core partner in public health and health promotion work.
Detailed description
Previous research has shown that prevalence of self-reported eating disorders vary from 5-40% among group fitness instructors. Most of these studies were conducted more than 10 years ago, hence the potential impact of social media on the fitness instructors' body image and mental health symptoms has therefore not been taken into account. Recent studies reveal that social media is a significant contributor for perceived body image and for eating and exercise-related disturbances. A more recent Norwegian study from 2015 found a prevalence of self-reported eating disorders of 4.8% and 4.3% among female and male group fitness instructors, respectively. However, major limitations with this previous study was the low sample size (n=107), few men included, not being national representative (i.e. only recruiting from a smaller geographical area), and the lack of instruments assessing body awareness of muscularity and leanness instead of thinness.
The fitness industry has great potential as a public health collaborator, and to improve physical activity level and public health status. However, this potential can be flawed by instructors complying with a culture idealizing unhealthy attitudes, motivation and behaviour with regards to nutrition, exercise and body image. This is a culture also potentially being underlined by the new exercise concepts and titles brought forward by the fitness industry, emphasizing body ideals and appearance, and body weight control. An additional concern to the mental health of fitness instructors, are the increase in reports of sexual harassment.
The high prevalence of perceived negative body image and disordered eating among fitness instructors, reports of sexual harassment, and the focus on appearance and control of body shape in the fitness industry, causes concern for the mental health of the employees (i.e. fitness instructors). Hence, this cohort study aims to map the prevalence of mental health symptoms in a national cohort of fitness instructors.
Study design
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Personal trainer (PT) | – | –Cross-sectional study on mental health symptoms in personal trainers |
| Group instructors (GI) | – | –Cross-sectional study on mental health symptoms in group instructors |
| Combined instructors (PT + GI) | – | –Cross-sectional study on mental health symptoms in personal trainers |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- All operating fitness instructors working at fitness facilities/gym's in Norway during autumn 2019 are recruited by information in social media, by information given directly to CEO/administration of facilities listed by the cooperative in Norway, Virke Trening, and by information given directly to gym facilities identified by other means in Norway.
Key inclusion criteria (4 listed)
- Operating as a fitness instructor (personal trainer or group instructor) during autumn 2019
- Age above 18 years
- Living and operating in Norway
- Understanding and communicating with Norwegian language
Key exclusion criteria (4 listed)
- Not engaged as a fitness instructor at recruitment time (autumn 2019)
- Age below 18 years of age
- Not living and/or operating in Norway
- Only speaking/communicating in foreign language (i.e. not Norwegian language)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Body image
Time frame: Autumn 2019
Body image in fitness instructors (personal trainers and group instructors) by Body Appreciation Scale-2 (BAS-2). The scale comprises 10 items rated on a 5-point scale, ranging from 1 (Never) to 5 (Always), with higher total scoring indicating more positive body appreciation.
Eating disorders
Time frame: Autumn 2019
Prevalence of eating disorders in fitness instructors (personal trainers and group instructors) by Eating disorders Examination questionnaire (EDE-q). The questionnaire has 6 items with open scorings reporting frequency of symptoms, and 22 items scored on a likert scale from 0-6 (no days - all days). The questionnaire has a total score and four subscales, with higher scorings (ranging from 0-6) indicative of higher severity.
9 secondary outcomes
Depression
Time frame: Autumn 2019
Mental health symptoms
Time frame: Autumn 2019
Drive for leanness
Time frame: Autumn 2019
Drive for muscularity
Time frame: Autumn 2019
Compulsive Exercise
Time frame: Autumn 2019
Drive for thinness
Time frame: Autumn 2019
Sexual harassment
Time frame: Autumn 2019
Sociocultural Attitudes Towards Appearance Questionnaire
Time frame: Autumn 2019
Eating behavior
Time frame: Autumn 2019
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jun 2020.
- Individual participant dataSharing planned: No. Data is held within the group of scientists, but sharing may be evaluated on request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jorunn Sundgot-Borgen, PhD principal investigator
Norwegian School of Sport Sciences
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Mental Health Wellness 1 and Depression, Anxiety, run by Norwegian School of Sport Sciences at 1 site in Norway.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 12 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Body image (time frame: Autumn 2019). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jun 2020.