A pre–post study of self-esteem, self-concept and body image among adolescents in the context of a co-created community intervention on screen use

INTRODUCTION: Excessive screen use negatively affects adolescents' self-esteem, self-concept, and body image, largely due to social comparison on digital platforms. Educational interventions are often less effective without community involvement, highlighting the importance of an ecological and participatory approach. This study aimed to assess the changes observed following the implementation of a community co-created intervention programme on screen use, self-esteem, self-concept, and positive body image among adolescents from a rural area in Catalonia. METHODS: The study was conducted in Bellpuig, a rural municipality in Catalonia, Spain, involving adolescents aged twelve to sixteen years enrolled at `Lo Pla d'Urgell´ institute. This was a quasi-experimental single-group study with pre and post intervention measurements. The intervention program was co-created with adolescents, families, teachers, healthcare professionals, and local community stakeholders through a participatory design process, and comprised educational and participatory activities focused on fostering digital balance and promoting self-esteem, self-concept, and positive body image. Data were collected using validated self-report measures before and after the intervention. Pre-post changes were assessed using two-sided Wilcoxon signed-rank tests. Differences in individual pre-post change scores between girls and boys were assessed using two-sided Mann-Whitney U tests. Rank-biserial correlations with 95% confidence intervals were reported as effect-size estimates. RESULTS: The intervention led to a moderate improvement in positive body image, self-esteem, and self-concept among adolescents. No notable differences were found in the impact of the intervention between sex participants. However, baseline differences in self-esteem and body image were observed, with higher initial values among boys. CONCLUSION: These findings suggest that a community co-created intervention program can be an effective strategy to improvement positive body image and self-esteem among adolescents. Future research should explore long-term effects and adaptation to diverse populations. PUBLIC CONTRIBUTION: This study underscores the value of community co-created interventions to support adolescent well-being, especially in rural areas with limited mental health resources. The findings offer useful guidance for health professionals, educators, and policymakers to design and evaluate programs that foster healthy self-perception and digital habits, while also raising community awareness.