An interventional study of Expand Your Horizon (EYH) and Creative Writing Control in Body Image, Body Image Dissatisfaction and Eating Disorders, sponsored by Universitat Autonoma de Barcelona. Not yet recruiting at 1 site in Spain. Open to participants aged 18 Years to 30 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-10-26.
Sponsored by Universitat Autonoma de Barcelona · Not applicable, Interventional, and Prevention
The goal of this clinical trial is to evaluate whether Expand Your Horizon (EYH), a brief writing intervention focused on body functionality, can improve body image in university students aged 18 to 30 years in Spain and Argentina.
The main questions it aims to answer are:
Does EYH improve body appreciation and appreciation of body functionality compared with an active control condition?
Are changes in body image flexibility, self-compassion, and mentalization potential mechanisms underlying improvements in body image?
Researchers will compare EYH with an active control program involving creative writing exercises to evaluate the effects of the intervention.
Participants will:
Complete online questionnaires before the intervention, immediately after it, and one month later.
Complete three writing exercises over approximately five days. Participants in the EYH group will write about their body's functions and their personal meaning, while those in the control group will complete creative writing exercises.
Answer questions about their experience of the intervention, including satisfaction and acceptability.
Have their written responses to the EYH exercises analyzed qualitatively to explore how they describe and understand their bodies and body functionality.
This study will adapt and evaluate the efficacy of Expand Your Horizon (EYH), a brief writing intervention designed to improve positive body image by encouraging individuals to appreciate their bodies for what they can do rather than focusing primarily on physical appearance. The study will be conducted with university students in Spain and Argentina and will examine the intervention's effects across these two cultural contexts.
The study will comprise two phases. The first phase will involve the linguistic and cultural adaptation of EYH into European Spanish and Argentine Spanish. The adaptation process will include translation, independent back-translation, review by the research and clinical teams, and assessment by an expert panel to ensure semantic and conceptual equivalence, clinical relevance, and cultural appropriateness. The adapted materials will be pilot tested with university students in each country. Feedback on clarity, comprehensibility, acceptability, and cultural appropriateness will be used to refine the final versions.
The second phase will be a two-arm, parallel-group randomized controlled trial. Approximately 200 university students will be recruited, with a target of 100 participants in Spain and 100 in Argentina. Within each country, participants will be randomly allocated in a 1:1 ratio to the EYH intervention or an active control condition consisting of creative writing exercises. Randomization will use block allocation stratified by gender. Both conditions will be delivered online through Qualtrics using comparable formats and schedules. Participants will not be informed which condition represents the intervention or control condition, and data analysts will remain blinded to group allocation during the primary analyses.
EYH consists of three structured reflective writing exercises focused on different domains of body functionality. Participants will reflect on their body's sensory experiences and physical capacities, internal processes and creative activities, and self-care and communication with others. For each exercise, participants will write about the functions their body performs and why these functions are personally meaningful. Participants will be instructed to write continuously for at least 15 minutes and then reread their responses without editing them.
The active control condition will consist of three fictional short-story writing exercises. Participants will select a character, setting, and plot for each exercise and write a story in detail. The control condition is designed to provide a comparable writing experience without the specific focus on body functionality. Participants assigned to the control group will be offered the opportunity to complete EYH after finishing the study assessments.
The intervention will be delivered over approximately five days. The first exercise will take place on Day 1, the second approximately two days later, and the third approximately two days after the second. Participants will complete online assessments at baseline, immediately after the intervention, and one month later. Automated email reminders will be used to support completion of the exercises and assessments.
In addition to evaluating intervention efficacy, the study will investigate potential psychological processes that may help explain changes following EYH. These exploratory analyses will examine body image flexibility, self-compassion, and mentalization as potential mechanisms of change. The study will also explore whether intervention effects differ according to gender and country.
Participants' adherence to the writing exercises and their satisfaction with the intervention will be assessed. Written responses to the EYH exercises will be analyzed qualitatively to explore how participants describe and make sense of their bodies and body functionality. This analysis will be conducted separately for Spain and Argentina and will consider both shared and context-specific themes. Open-ended feedback about participants' experiences of the intervention will also be collected to inform future refinements.
The study will be conducted in accordance with applicable ethical principles. Participation will be voluntary, and informed consent will be obtained before enrolment. Research data will be pseudonymized, with identifying contact information stored separately and deleted after data collection. Pseudonymized study data will be retained for five years after study completion, with access restricted to authorized members of the research team.
754 studies on the registry are indexed under Feeding and Eating Disorders; 161 are open to participants now.
This study's planned enrollment of 200 is above the median of 74 across 552 interventional studies indexed under Feeding and Eating Disorders.
Browse Feeding and Eating Disorders studies →Universitat Autonoma de Barcelona is the lead sponsor of 10 studies on the registry; 5 are open to participants now.
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Exclusion Criteria:
Participants will complete three structured reflective writing exercises focused on body functionality. The exercises address sensory experiences and physical capacities, internal bodily processes and creative activities, and self-care and communication with others. Participants will reflect on the functions their bodies perform and their personal meaning. Each exercise will involve writing continuously for at least 15 minutes. The intervention will be delivered online through Qualtrics over approximately five days.
Behavioral: Expand Your Horizon (EYH)
Participants will complete three creative writing exercises involving fictional short stories. For each exercise, participants will select a main character (other than themselves), a setting, and a plot, and write a detailed story. Different characters, settings, and plots will be used across the exercises. Participants will be instructed to write continuously for at least 15 minutes and not to worry about spelling, sentence structure, or grammar. The control program will be delivered online through Qualtrics over approximately five days. After completing all study assessments, participants will be offered the opportunity to complete the Expand Your Horizon (EYH) intervention.
Behavioral: Creative Writing Control
Expand Your Horizon (EYH) is a brief online writing intervention designed to improve body image by promoting appreciation of body functionality. Participants complete three structured reflective writing exercises focusing on sensory experiences and physical capacities; internal bodily processes and creative activities; and self-care and communication with others. In each exercise, participants reflect on the functions their bodies perform and their personal meaning. Participants write continuously for at least 15 minutes per exercise. The intervention is delivered through Qualtrics over approximately five days.
Participants will complete three creative writing exercises involving fictional short stories. For each exercise, participants will select a main character (other than themselves), a setting, and a plot, and write a detailed story. Different characters, settings, and plots will be used across the exercises. Participants will be instructed to write continuously for at least 15 minutes and not to worry about spelling, sentence structure, or grammar. The control program will be delivered online through Qualtrics over approximately five days. After completing all study assessments, participants will be offered the opportunity to complete the Expand Your Horizon (EYH) intervention.
Functionality Appreciation (Functionality Appreciation Scale (FAS))
Functionality appreciation will be assessed using the 7-item Functionality Appreciation Scale (FAS), which measures appreciation of the body for what it can do and is capable of doing. Items are rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree). The mean item score ranges from 1 to 5, with higher scores indicating greater appreciation of body functionality.
Time frame: Baseline (day 1), immediately post-intervention (day 7), and 1-month follow-up.
Body Appreciation (Body Appreciation Scale-2 (BAS-2))
Body appreciation will be assessed using the 10-item Body Appreciation Scale-2 (BAS-2), which measures body acceptance, respect for and care of one's body, and protection from unrealistic beauty standards. Items are rated on a 5-point scale from 1 (never) to 5 (always). The mean item score ranges from 1 to 5, with higher scores indicating greater body appreciation.
Time frame: Baseline (day 1), immediately post-intervention (day 7), and 1-month follow-up.
Body Image Flexibility (Body Image Acceptance and Action Questionnaire-5 (BI-AAQ-5))
Body image flexibility will be assessed using the 5-item Body Image Acceptance and Action Questionnaire-5 (BI-AAQ-5). Items are rated on a 7-point scale from 1 (never true) to 7 (always true). Items are reverse-coded and averaged to yield a mean score ranging from 1 to 7, with higher scores indicating greater body image flexibility.
Time frame: Baseline (day 1), immediately post-intervention (day 7), and 1-month follow-up.
Self-Compassion (Self-Compassion Scale-Short Form (SCS-SF))
Self-compassion will be assessed using the 12-item Self-Compassion Scale-Short Form (SCS-SF). Items are rated on a 5-point scale from 1 (almost never) to 5 (almost always). The mean item score ranges from 1 to 5, with higher scores indicating greater self-compassion.
Time frame: Baseline (day 1), immediately post-intervention (day 7), and 1-month follow-up.
Eating Disorder Symptoms (Eating Disorder Examination Questionnaire (EDE-Q-7))
Eating disorder symptoms will be assessed using the 7-item Eating Disorder Examination Questionnaire (EDE-Q-7), which measures core aspects of eating disorder psychopathology, including dietary restraint, overvaluation of shape and weight, and body dissatisfaction. Items are rated on a 7-point scale from 0 (no days/not at all) to 6 (every day/markedly). Items are averaged to yield a total score, with higher scores indicating greater eating disorder symptomatology.
Time frame: Baseline (day 1), immediately post-intervention (day 7), and 1-month follow-up.
Mentalization (Reflective Functioning Questionnaire (RFQ-8))
Mentalization will be assessed using the 8-item Reflective Functioning Questionnaire (RFQ-8). Items are rated on a 7-point Likert scale from 1 (strongly disagree) to 7 (strongly agree). Items are reverse-coded and averaged to yield a total score, with higher scores indicating greater mentalizing capacity. The Spanish version has demonstrated good psychometric properties and supports a unidimensional structure and the use of a single overall score (Cronbach's α = 0.76).
Time frame: Baseline (day 1), immediately post-intervention (day 7), and 1-month follow-up.
Intervention Adherence
Adherence to the writing program will be assessed using automated Qualtrics platform usage data. Adherence will be measured by the number of writing exercises completed (range: 0-3) and the proportion of participants completing all three exercises. Time spent on each exercise will also be recorded.
Time frame: Immediately post-intervention (day 7)
Participant Satisfaction with EYH
Satisfaction with the EYH intervention will be assessed among participants in the intervention group at post-intervention using four adapted items from the Client Satisfaction Questionnaire (CSQ-8). Items assess satisfaction with the program, perceived quality, willingness to repeat the program, and willingness to recommend it to others. Items are rated on a 4-point scale. Participants will also answer three open-ended questions about perceived benefits and whether the program changed how they think about or relate to their bodies.
Time frame: Immediately post-intervention (day 7)
Qualitative Themes in EYH Writing Responses
Written responses to the three EYH exercises will be analyzed qualitatively to explore how participants describe and make sense of their bodies and body functionality. The analysis will examine themes in participants' accounts and consider shared and context-specific patterns across Spain and Argentina.
Time frame: Intervention day 1, intervention day 2, intervention day 3
Plan to share: No — Individual participant data will not be shared with other researchers. Study data will be pseudonymized, and identifying contact information will be stored separately and deleted after data collection. Pseudonymized data will be retained for five years after study completion, with access restricted to authorized members of the research team.
Start is estimated for Dec 2026; primary completion for May 2027, 5 months later.
Of 305 non-industry interventional studies with no phase under Feeding and Eating Disorders, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 46. This study's planned 5 months is below that.
Counting every sponsor, half of 311 studies reached it within 25 months; a quarter within 12 and three quarters within 45.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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Universitat Autonoma de Barcelona