Reducing the Stigma of Diabetes in Medical Education: A Contact-Based Educational Approach

Beverly, Elizabeth A.; Guseman, Emily Hill; Jensen, Laura; Fredricks, Todd R.

doi:10.2337/cd18-0020

Cited by 13 publications

(8 citation statements)

References 35 publications

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“…The current results suggest that interventions related to psychological health in the context of diabetes should consider, and possibly be tailored, to address weight stigma concerns unique to each diabetes type. Interventions and discussions to mitigate such stigma have been ongoing, citing the need for education and media to focus on correcting misconceptions about what causes diabetes and obesity, and how the two relate to each other [ 30 , 34 , 35 ]. Going forward, research on this disease should mobilize efforts towards stigma reduction, especially for subgroups where it may be most prevalent and most detrimental.…”

Section: Discussionmentioning

confidence: 99%

The influence of weight on psychosocial well-being in diabetes

2023

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Background Individuals with diabetes experience a wide variety of psychosocial responses to their illness due, in part, to the nature of type 1 and type 2 diabetes. Variation in patient weight may play a central role in these differences, yet its influence on psychosocial variation is largely unknown. The current study investigates the relationship between patients’ perceived weight status and aspects of psychosocial well-being among individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D). Methods Individuals who were diagnosed with type 1 or type 2 diabetes were assessed via an online survey from the Diabetes, Identity, Attributions, and Health Study. Participants were categorized into a lower v. higher weight status group based on their self-reported perceived weight. Analyses of covariance were conducted to assess differences in measures of disease onset blame, diabetes stigma, and identity concerns among diabetes type and perceived weight status. Covariates included in our models were gender, age, education, and time since diagnosis. Bonferroni correction was used for post-hoc tests to assess any significant interactions found in our models. Results Findings indicated that weight moderates multiple psychosocial outcomes pertinent to illness experience. Those with T2D and lower weight blamed themselves less for their disease onset, while those with higher weight felt blamed more for their disease onset by others, regardless of diabetes type. Individuals with T1D and higher weight were more frequently and more concerned about being mistaken for having the other disease type (i.e., T2D) compared to those with lower weight. Conclusions Weight is a key influence on the psychosocial outcomes for people with diabetes, but it operates differently in type 1 versus type 2 diabetes. By further examining the unique interaction between disease type and weight status we may be able to improve psychological well-being among affected individuals of all sizes.

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Section: Discussionmentioning

confidence: 99%

The influence of weight on psychosocial well-being in diabetes

2023

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“…Patient panels have been shown to reduce stigma toward patients with diverse medical conditions, including diabetes and OUD. 30 , 31 In the patient panel described by Dumenco et al, 31 students from all disciplines reported high rates of attitude change toward people with OUD after hearing from people with lived experience. The patient panel has become a critical component of our OUD education across the curriculum which always elevates people who use drugs as experts in their own health.…”

Section: Discussionmentioning

confidence: 99%

Integrating Persons With Lived Experience in Opioid Use Disorder Education: A Small Group Exercise and Patient Panel

Serota

Tookes

Tomita-Barber

et al. 2023

Journal of Medical Education and Curricular Development

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OBJECTIVES Based on increasing drug overdose deaths and a shortage of healthcare professionals trained in the management of opioid use disorder (OUD), it is imperative to improve health professional education in addiction medicine. This small group learning exercise and patient panel was designed to provide first year medical students with insights into the lives of people with OUD—through a lens of harm reduction—and to connect biomedical knowledge to the core values and professional themes of their doctoring courses. METHODS Facilitators were assigned to each small group of 8 students for the harm reduction-centered Long and Winding Road small group case exercise. This was followed by a patient panel of 2 to 3 persons with OUD. The small group was conducted with first-year medical students as a virtual training session due to the COVID-19 pandemic. Students completed pre- and post-session surveys about agreement with statements pertaining to the learning objectives. RESULTS The small group and patient panel were delivered over 8 sessions and attended by all first-year medical students (N = 201). Survey response rate was 67%. Post-session, there was significantly greater agreement with knowledge on all learning objectives compared to pre-session. Two relevant multiple-choice questions on the medical student final exam were answered correctly by 79% and 98% of students. CONCLUSION Centering on people with lived experience, we completed small groups and patient panels to introduce concepts of OUD and harm reduction to first year medical students. Pre- and post-session surveys showed short-term achievement of the learning objectives.

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“…Consent occurred online. As in previous studies conducted by the research team [ 26 – 30 ], participants clicked a radio button indicating “Yes, I consent to participate in this study. I may withdraw my participation at any time.“ Conversely, if participants declined to participate, they clicked a radio button indicating “I decline to participate.“ Both the online welcome screen for the survey and the informed consent document specified the voluntary nature of participation.…”

Section: Methodsmentioning

confidence: 99%

Measuring grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation osteopathic medical students

2023

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Background Medical school is a challenging time, with many medical students reporting symptoms of burnout, depression, anxiety, suicidal ideation, and psychological distress during pre-clinical and clinical years. First-generation college and first-generation medical students may be two groups of students at increased risk for the negative psychosocial effects of medical school. Importantly, grit, self-efficacy, and curiosity are protective factors against the negative psychosocial effects of medical school, whereas intolerance of uncertainty is a risk factor. Thus, research examining the associations among grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation medical students is needed. Methods We conducted a cross-sectional, descriptive study to assess medical students’ grit, self-efficacy, curiosity, and intolerance of uncertainty. We conducted independent samples t-tests and regression analyses using SPSS statistical software version 28.0. Results A total of 420 students participated in the study for a response rate of 51.5%. One-fifth of participants (21.2%, n = 89) identified as first-generation students, 38.6% (n = 162) participants reporting having a physician relative, and 16.2% (n = 68) reported having a physician parent. Grit, self-efficacy, and curiosity and exploration scores did not differ by first-generation college status, physician relative(s), or physician parent(s). However, total intolerance of uncertainty scores differed by physician relative(s) (t= -2.830, p = 0.005), but not by first-generation status, or physician parent(s). Further, subscale scores for prospective intolerance of uncertainty differed by physician relative(s) (t= -3.379, p = 0.001) and physician parent(s) (t= -2.077, p = 0.038), but not by first-generation college student status. In the hierarchical regression models, first-generation college student status and first-generation medical student status were not predictive of grit, self-efficacy, curiosity and exploration, or intolerance of uncertainty, although statistical trends were observed with students with physician relative(s) predicting lower intolerance of uncertainty scores (B= -2.171, t= -2138, p = 0.033) and lower prospective intolerance of uncertainty (B= -1.666, t= -2.689, p = 0.007). Conclusions These findings suggest that first-generation college students did not differ by grit, self-efficacy, curiosity, or intolerance of uncertainty. Similarly, first-generation medical students did not differ by grit, self-efficacy, or curiosity; however, first-generation medical students showed statistical trends in higher total intolerance of uncertainty and higher prospective intolerance of uncertainty. Additional research needs to confirm these findings in first-generation medical students.

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Reducing the Stigma of Diabetes in Medical Education: A Contact-Based Educational Approach

Cited by 13 publications

References 35 publications

The influence of weight on psychosocial well-being in diabetes

The influence of weight on psychosocial well-being in diabetes

Integrating Persons With Lived Experience in Opioid Use Disorder Education: A Small Group Exercise and Patient Panel

Measuring grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation osteopathic medical students

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