The role of weight bias and role-modeling in medical students’ patient-centered communication with higher weight standardized patients

Phelan, Seán; Puhl, Rebecca M.; Burgess, Diana J.; Natt, Neena; Mundi, Manpreet S.; Miller, Nathaniel E.; Saha, Somnath; Harden, Kristin; Ryn, Michelle van

doi:10.1016/j.pec.2021.01.003

Cited by 25 publications

(24 citation statements)

References 52 publications

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“… 54 , 55 Although inferences of causality cannot be made due to the cross-sectional nature of the current study, research has shown that individuals' beliefs and attitudes are in turn able to predict their behaviour, 56 , 57 meaning that students' exhibited weight bias may negatively impact the well-being of people living with overweight or obesity. The presence and strength of both explicit and implicit bias among samples of public health, 58 physical therapy, 59 marriage and family therapy 37 and medical students 31 , 48 were comparable to the current sample, indicating that Australian health care students' exhibited weight bias was similar to that of health care students in other countries. Robinson et al 38 sample of Australian health care students (11 disciplines) at an individual university scored slightly higher (albeit moderately higher on the Fear of Fat subscale) on the AFA, indicating that the current sample exhibited lower negative attitudes towards people living with overweight or obesity.…”

Section: Discussionsupporting

confidence: 49%

“…The provision of care to people living with overweight or obesity in students’ future practice may be compromised, as preliminary evidence demonstrates the presence of both explicit and implicit weight bias among health care students. 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 …”

Section: Introductionmentioning

confidence: 99%

“…Medical students who perceived that negative attitudes toward people living with overweight or obesity were the norm in medical school were associated with objectionable patient-related behaviours including low levels of respectfulness, responsiveness, interactivity, and attentiveness. 31 In a sample of 4732 medical students, students with a lower (vs. higher) Body Mass Index (BMI) were found to hold higher levels of both explicit and implicit weight bias. 32 Similarly, implicit weight bias has been reported amongst nursing and psychology students.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have included students across limited health care disciplines at large individual universities, often within the United States. 31 , 34 , 40 In Australia, studies investigating weight bias among health care students are scarce. Furthermore, some studies have found factors such as student BMI, level of study and witnessing the enactment of weight bias by role models may be associated with students' weight bias; however, the lack of consistency of results across studies and methodologies renders it difficult to establish whether these factors apply to health care students across all disciplines.…”

Section: Introductionmentioning

confidence: 99%

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Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Jayawickrama¹,

O’Connor²,

Flint³

et al. 2023

eClinicalMedicine

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Section: Discussionsupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Jayawickrama¹,

O’Connor²,

Flint³

et al. 2023

eClinicalMedicine

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“…As 40% of the population in the United States is obese, MUCC website graphics do not capture the diversity present in the general population [ 32 ]. Prior research has demonstrated that obese/overweight individuals experience stigma related to their weight which may lead to decreased care utilization [ 33 , 34 ]. MUCCs may be creating further barriers to care utilization for overweight/obese patients by employing marketing practices that exclude models with diverse body types.…”

Section: Discussionmentioning

confidence: 99%

Characterizing the lack of diversity in musculoskeletal urgent care website content

Dlott

Metcalfe

Bahel

et al. 2023

BMC Health Serv Res

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Background Musculoskeletal urgent care centers (MUCCs) are becoming an alternative to emergency departments for non-emergent orthopedic injuries as they can provide direct access to orthopedic specialty care. However, they tend to be located in more affluent geographies and are less likely to accept Medicaid insurance than general urgent care centers. MUCCs utilize websites to drive patients to their centers, and the content may influence patients’ consumer behaviors and perceptions of the quality and accessibility of the MUCCs. Given that some MUCCs target insured patient populations, we evaluated the racial, gender, and body type diversity of website content for MUCCs. Methods Our group conducted an online search to create a list of MUCCs in the United States. For each MUCC, we analyzed the content featured prominently on the website (above the fold). For each website, we analyzed the race, gender, and body type of the featured model(s). MUCCs were classified according to their affiliation (i.e. academic versus private) and region (i.e. Northeast versus South). We performed chi-squared and univariate logistic regression to investigate trends in MUCC website content. Results We found that 14% (32/235) of website graphics featured individuals from multiple racial groups, 57% (135/235) of graphics featured women, and 2% (5/235) of graphics featured overweight or obese individuals. Multiracial presence in website graphics was associated with the presence of women on the websites and Medicaid acceptance. Conclusion MUCC website content has the potential to impact patients’ perceptions of medical providers and the medical care they receive. Most MUCC websites lack diversity based on race and body type. The lack of diversity in website content at MUCCs may introduce further disparities in access to orthopedic care.

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Does dissection influence weight bias among doctor of physical therapy students?

Rompolski,

Pascoe

2024

Anatomical Sciences Ed

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Anatomy with human dissection may help to develop respect for the human body and professionalism; however, dissection may worsen students' attitudes about body weight and adiposity. The purpose of this study was to measure weight bias among Doctor of Physical Therapy (DPT) students enrolled in gross anatomy and determine if, and how the experience of dissection impacts weight bias. Ninety‐seven DPT students (70 University of Colorado [CU], 27 Moravian University [MU]) were invited to complete a survey during the first and final weeks of their anatomy course. The survey included demographic items, two measures of weight bias—the Modified Weight Bias Internalized Scale (M‐WBIS) and the Attitudes Towards Obese Persons (ATOP) Scale—and open‐ended questions for the students who participated in dissection (CU students) that explored attitudes about body weight and adiposity. At baseline, there were no significant differences (p > 0.202) in ATOP, M‐WBIS, or BMI between the two universities. The mean scores on both the ATOP and M‐WBIS indicated a moderate degree of both internalized and externalized weight bias. There were no significant changes in ATOP (p = 0.566) or M‐WBIS scores (p = 0.428). BMI had a low correlation with initial M‐WBIS scores (⍴ = 0.294, p = 0.038) and a high correlation with change scores in CU students (⍴ = 0.530, p = 0.011). Future studies should utilize the same measures of weight bias in other healthcare trainees to facilitate comparison and incorporate larger populations of DPT students.

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The role of weight bias and role-modeling in medical students’ patient-centered communication with higher weight standardized patients

Cited by 25 publications

References 52 publications

Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Characterizing the lack of diversity in musculoskeletal urgent care website content

Does dissection influence weight bias among doctor of physical therapy students?

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