Table 1.

Outline of the media literacy intervention

	Objectives	Materials & Activities
Session 1: (40 minutes)	a) to provide elective cosmetic surgery statistics in Iran and the world, b) to explain and discuss body ideals and provide a history of the standards of beauty among Iranian women, c) to explain dangers of elective cosmetic surgery procedures and economic motivations of plastic surgeons and d) to explain women’s beliefs about cosmetic surgery and their expectations of such procedures	-Slides showing the prevalence of cosmetic surgery in Iran and the world -Video about females who had elective cosmetic surgery with complications such as facial nerve injury, unfavorable scar formation, skin loss, etc and group discussion -Slides showing the changes in the standards of beauty among Iranian women -individual brainstorming regarding beliefs and expectations and negative and positive experiences regarding elective cosmetic surgery.
Session 2: (60 minutes)	a) to explain the influence of the media in creating false and unrealistic expectations about elective cosmetic surgery and dissatisfaction about one’s physical appearance, b) to explain persuasive marketing and misleading advertising (e.g. unrealistic beauty images) of media, c) to inform about the techniques used by the media (e.g. airbrushing and computer graphics) to create ideal body images and models (the media’s manipulation of images), and d) to introduce cognitive strategies (critical analysis and expression skills) for challenging the messages they receive from the mass media and resisting the advertising pressure for cosmetic surgery practice.	-Slides of misleading advertising in various media -Small group work: habits of inquiry, analyze, evaluate, and use media messages -Small group work: selection of advertisements about cosmetic surgery (what are they trying to tell? are they realistic?) -An instructional booklet about the mentioned objectives.
Session 3: (60 minutes)	a) to review introduced cognitive strategies in session 2, b) to provide statistics about the prevalence of body dissatisfaction and body dysmorphic disorder in cosmetic surgery candidates, c) to explain the process by which the media leads to disturbances in body image, self-esteem and body satisfaction, d) to explain body comparison and its negative consequences, and e) training thought stopping and relaxation methods to extinguish distress about appearance (Rosen, Reiter, & Orosan, 1995).	-Small groups: what can we do to feel positive about our body? -Small groups: ask the participants to identify and then discuss functional aspects of their bodies and positive qualities that are not associated with appearance -Showing short ‘Evolution’ video produced by Dove in avoiding body comparison with media images (Richardson & Paxton, 2010). -An instructional pamphlet about the method of thought stopping practice -An audio CD of Progressive Muscular Relaxation.
Session 4: (50 minutes)	a) to review strategies introduced in session 3, b) to provide information about the role of self-esteem in preventing elective cosmetic surgery, and c) to introduce strategies focused on enhancing self-esteem.	-Slides regarding six strategies introduced by WHO for increasing general self-esteem (including: 1) take a Self-Esteem Inventory, 2) set realistic expectations, 3) set aside perfection and grab a hold of accomplishments and mistakes, 4) explore yourself 5) be willing to adjust your own self-image, and 6) stop comparing yourself to others) (Groho, 2014).