Promoting positive body image in children through theatre: An evaluation of Cinderella: the AWESOME Truth

Highlights

• Attending Cinderella: the AWESOME Truth improved state body appreciation in children.

• Effects were consistent across child gender.

• Attending Cinderella improved children’s self-image.

• Children’s enjoyment of the production was near universally high.

Abstract

Cinderella: the AWESOME Truth is a children’s theatrical production developed with the aim of promoting positive body image and improved self-image. As part of the production’s initial run at the Polka Theatre in London, United Kingdom, we conducted an evaluation of the show’s efficacy at improving state positive body image and self-image. Using a single-arm design, we recruited 54 girls and 45 boys between the ages of 5 and 9 years attending a performance of Cinderella with their parents/caregivers, and asked them to complete an adapted measure of state body appreciation at pre- and post-attendance. Participants were also asked to complete open-ended questions about their own uniqueness and awesomeness – two central themes of the production – at both time-points, and their enjoyment of the show at post-attendance. Results indicated that attending the performance improved state body appreciation, self-perceived uniqueness, and self-perceived awesomeness, with small-to-moderate effects. These results were consistent across girls and boys, and enjoyment of the performance was near universally high. Despite limitations – including the lack of a control group and the constrained assessment period – these results suggest that tailored children’s theatre may be a viable method of promoting positive body image in young age groups.

Introduction

Although adolescence is widely recognised as an important developmental period for experiencing and negotiating body image concerns (Maes et al., 2021, Markey, 2010, Wertheim and Paxton, 2011), it is also clear that body image develops in childhood (Grogan, 2021; León et al., 2021). For instance, research suggests that, by age five, children have begun to internalise societal standards of appearance (Damiano et al., 2015) and that body dissatisfaction begins to manifest in both girls and boys from age six onwards (Nichols et al., 2018; Schuck et al., 2018; Tatangelo et al., 2016). In turn, body and appearance dissatisfaction is reliably associated with a multitude of detrimental health and psychological outcomes, including symptoms of depression, low self-esteem, symptoms of disordered eating, and decreased physical activity (Bornioli et al., 2019, Neumark-Sztainer et al., 2006, Paxton et al., 2006). As such, childhood is increasingly recognised as a critical period in shaping body image, with experiences of body and appearance dissatisfaction carried into adolescence and emerging adulthood (Bufferd et al., 2022, Frisén et al., 2015).

Despite the weight of this evidence, however, it should not be assumed that childhood experiences of body image are uniform (i.e., that all children experience similar developmental trajectories in relation to their body images) and irrevocably detrimental (Ricciardelli et al., 2018). Indeed, emerging research has suggested that the period between childhood and early adolescence offers important opportunities not only to overcome experiences of negative body image, but also to develop positive body image (Holmqvist Gattario and Frisén, 2019, Poulter and Treharne, 2021). Positive body image here broadly refers to “an overarching love and respect for the body” (Tylka, 2018, p. 9) that is distinct from, and not merely the absence of, negative body image. Further, positive body image is a multidimensional construct (Tylka, 2018), with some research suggesting that body appreciation (i.e., accepting and respecting the body, while rejecting unrealistic appearance ideals; Tylka & Wood-Barcalow, 2015) and functionality appreciation (i.e., appreciation for what one’s body can do and is capable of doing; Alleva et al., 2017) are central facets of the overall construct (Swami et al., 2020). Experiences of body appreciation and functionality appreciation begin developing early in life (e.g., Frisén & Holmqvist, 2010; Holmqvist & Frisén, 2012) and, as in adults, are associated with improved body-related and emotional well-being in younger age groups (e.g., Halliwell et al., 2017; Sahlan et al., 2022).

Unsurprisingly, scholars have called for the development and prioritisation of interventions aimed at promoting positive body image in childhood (Bray et al., 2018, Daniels and Roberts, 2018). School-based body image interventions have been touted as particularly useful, given that they can target a large number of children and can be embedded within existing curricula (Yager, 2019). A number of such school-based interventions now exist in the United Kingdom (UK) and Scandinavia, with evaluations showing that they are effective at promoting healthier body esteem, body satisfaction, and embodiment in children (e.g., Bird et al., 2013; Damiano et al., 2018; Halliwell et al., 2016; Sundgot-Borgen et al., 2020). Importantly, however, the focus of these interventions has typically been on reducing negative body image (e.g., avoiding appearance conversations and body comparisons), rather than promoting positive body image per se. Moreover, their uptake in the UK at least has been limited (Diedrichs et al., 2016) and, despite guidance being developed to assist the teaching of body image to children and adolescents in schools (Personal, Social, and Health Education Association, 2018), the framework is not currently embedded within compulsory teaching curricula and training for teachers remains limited (Bray et al., 2018).

Other interventionist programmes – such as Confident Body, Confident Child (Hart et al., 2016) – are family-focused, offering parenting resources and strategies aimed at promoting healthy eating and positive body image in young children (for a review, see Carbonneau et al., 2021). Evaluations of such programmes have shown that they are effective at reducing body dissatisfaction in children (Hill et al., 2020), though evaluations focused on indices of positive body image specifically are currently lacking. Other standalone interventions with a more explicit focus on the promotion of positive body image include a brief yoga intervention (Halliwell et al., 2018), an educational board game (Guest et al., 2021), a brief animated film (Matheson et al., 2020), and the use of children’s picture books designed to promote positive body image (Dohnt & Tiggemann, 2008; see also Itzoe & Frasso, 2021). However, evaluations of these interventions have suggested that they may not produce improvements in positive body image beyond that obtained by control groups (Guest et al., 2021, Halliwell et al., 2018, Matheson et al., 2020) or that any improvement is limited to the immediate term (Dohnt & Tiggemann, 2008).

Given these mixed results, it may be useful to consider other interventionist methods for promoting positive body image in children. One such method may involve arts-based practices, such as theatre (i.e., “live performances” that involve music, dance, voice, acting, and singing; Staricoff et al., 2001). While engagement with the creative arts in general has been widely shown to improve psychological health and well-being across all age groups (for a review, see Fancourt & Finn, 2019), theatre may offer hitherto unexplored opportunities to engage children in relation to their body image. For instance, existing research has shown that attendance at theatrical performances is effective at promoting psychological well-being, social engagement, belonging, and flow (Meeks et al., 2018). For children, in particular, watching tailored theatrical performances can provide profound educational, emotional, and expressive benefits (Furman, 2000, Maguire and Schuitema, 2012, Reason, 2010, Rosenberg and Epstein, 1990), while also serving as a medium for effective teaching, instruction, and information transmission (Eluyefa, 2017). That is, children’s theatre is able to stimulate the imagination of children and provide them with new skills and creativity to face, understand, and challenge the world around them (Eluyefa, 2017; Gardner, 2013).

To date, however, we are not aware of evaluations of any children’s theatrical productions aimed at promoting positive body image and self-image. One production that was developed and produced with these aims in mind is Cinderella: the AWESOME Truth (Punshon et al., 2021). Specifically, this production was developed with the aim of (among other things) raising awareness about body shaming and its deleterious effects, managing appearance expectations and anxieties, highlighting the ways in which social media can negatively affect body image, and promoting body and functionality appreciation. As part of the production’s initial run at the Polka Theatre in London (UK) between November 2021 and January 2022, we conducted an evaluation of the effectiveness of Cinderella at promoting positive body image in children. More specifically, we examined the effectiveness of the production in delivering immediate changes in body appreciation (i.e., state changes in an index of positive body image) and recognition of one’s uniqueness and awesomeness. We hypothesised that attending and watching Cinderella would result in improved state body appreciation, as well as greater feelings of uniqueness and awesomeness. Further, we expected these effects to be consistent across girls and boys.