Feasibility and Preliminary Outcomes of a School-Based Intervention to Promote Body Image in Rural Adolescents: The Hoosier Sport Re-Social Pilot Study

Background Adolescents in rural communities face unique barriers to physical and mental well-being, including limited recreational resources and high exposure to social media, which can negatively affect body image. Hoosier Sport Re-Social is a school-based program designed to improve body image, enhance social media literacy, and increase physical activity among rural middle school students. This pilot study evaluated the program’s feasibility and explored preliminary behavioral and psychosocial outcomes. Methods A 4-week intervention was delivered during health and physical education classes to students in grades 6–8 at a rural Midwestern middle school. The program integrated sport skill development, body confidence lessons, and social media literacy activities. Feasibility was assessed through the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure, along with attendance and retention rates. Outcomes included daily physical activity (accelerometry), social media usage (phone-recorded screen time), social media literacy, body satisfaction, body appreciation, and basic psychological needs satisfaction. Paired-sample t-tests examined pre- to post-intervention changes, and linear mixed-effects models explored behavioral predictors of body image change, adjusting for age and gender. Results Thirty-two students (53% female; mean age 12.7 years) participated. Median feasibility scores exceeded the a priori success threshold for both adolescents and implementers. Attendance averaged 93% for participants and 99% for implementers. From pre- to post-intervention, daily physical activity increased (p = .002) and social media use decreased (p = .008). Body dissatisfaction decreased (p = .002; large effect size), and body appreciation increased (p = .011; moderate-to-large effect size), with greater improvements observed in participants who increased physical activity (interaction p = .022). Social media literacy scores significantly improved (p < .001), while social media addiction and basic psychological needs satisfaction showed no significant change. Conclusions The Hoosier Sport Re-Social program was feasible, well-received, and associated with positive changes in physical activity, social media use, and body image among rural adolescents. Findings support further evaluation with larger, more diverse samples and longer follow-up to assess sustainability and scalability. Trial registration: Retrospectively registered at ClinicalTrials.gov (NCT06556719; registration date: February 3, 2025).