Perceived stress, coping and eating behaviours in Maltese adolescents: Developing an effective online intervention
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Prevalence rates of overweight and obesity in Maltese adolescents are amongst the highest in the world. Stress-induced eating and dysfunctional coping skills have been linked to overeating and obesity. This study was undertaken in two phases. Phase 1 examined the relationship between perceived stress, coping and eating behaviours in Maltese adolescents and devised a model to guide the development of an effective Internet-based intervention. Based on the findings, Phase 2 developed ACES – a novel online intervention for the reduction of perceived stress and emotional eating in Maltese adolescents – and assessed its feasibility. In Phase 1, cross-sectional data were gathered from 79 Maltese adolescents using an online questionnaire with 6 self-report measures examining perceived stress, coping responses, eating behaviours, self-efficacy, physical exercise and social support. Findings suggested that emotional eating behaviours can be decreased by reducing perceived stress and dysfunctional coping strategies (self-controlling and escape-avoidance) and increasing self-efficacy and functional coping strategies (seeking social support and planful problem solving). In Phase 2, ACES was developed and a feasibility study, with a one-group pretest-posttest design, carried out to assess the functionality, usability, perceived utility and acceptability of ACES and to test the design of a definitive randomized controlled trial. Forty-six out of 125 participants completed ACES. Findings suggested that ACES is feasible and well-received by participants. Preliminary effectiveness results provide additional support for the Phase 1 findings concerning the variables that need to be taken into account to decrease emotional eating behaviours. This study has made significant contributions to the literature and offered insights into specific functional and dysfunctional coping strategies impacting perceived stress and eating behaviours. It has produced an online intervention, which is a feasible avenue for the reduction of perceived stress and emotional eating, that could be built upon by practitioners and researchers, with potential implications for obesity prevention.
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