Weight bias reduction among first‐year medical students: A quasi‐randomized, controlled trial

Abstract

Summary Implicit and explicit weight bias is prevalent among healthcare professionals and results in negative outcomes, including weak physician‐patient rapport, low patient trust in physicians, and avoidance of healthcare. This study aimed to decrease weight bias in medical students via a one‐session, curriculum‐based intervention founded on the elaboration likelihood model (ELM). First‐year medical students (N = 101) were quasi‐randomly assigned to a group‐based experimental or education‐based control intervention. Data collected included measures of implicit and explicit weight bias and empathy (pre‐intervention and up to 2 days post‐intervention), and thoughts regarding weight bias (collected at the end of the intervention). Social desirability was identified as an important covariate. After controlling for social desirability, the intervention group showed no greater reduction in multi‐item explicit bias rating scales or a computerized implicit bias task than the control group. Both groups showed less discomfort when near individuals with obesity (p < 0.01). The intervention group wrote a greater number of statements about weight bias and obesity (p < 0.05) and a greater number of statements about the harms of weight bias (p < 0.001) than the control group on a thought‐listing task. Results highlight use of the ELM and the importance of controlling for social desirability in weight bias interventions. A thought‐listing task captured unique intervention effects, highlighting potential gaps in the assessment of weight bias.

Interventions for reducing weight bias in healthcare providers: An interprofessional systematic review and meta‐analysis

“…The first author carefully scanned each title for studies of interest and ultimately reviewed 36 abstracts. Of these 36 articles, 16 were then selected for full article review 9,17,18,33–43 . Two articles 46,47 were removed after a full article review because there was no intervention, leaving 14 articles included in this systematic review.…”

“…Methodological characteristics are represented in Table 2. Most studies ( n = 11) 9,17,18,34–37,39,40,41,42 used a pre‐test, post‐test quasi‐experimental design, with five studies including additional data collection time points at 1 month, 17,40,43 4 months 37 and yearly for 4 years 36 …”

“…Curricular‐based interventions are the most common, as these studies aimed to influence students. The majority ( n = 8) offered a one‐time educational intervention 17,34,35,37–39,40,42 with various components including lecture, discussion, videos and simulation. Oliver et al 41 included an initial teaching segment followed by five reflective journaling opportunities throughout a 14‐week semester.…”

“…Videos highlighting the experiences of recipients of weight bias and the consequences of weight bias were also used to evoke empathy. “Stigma—The Human Cost of Obesity,” 35 video clips from the TV show “House” depicting weight bias in health care 37 and trigger films 40 were key components of empathy‐evoking interventions.…”

ESI Clinical Practice Guidelines for the Evaluation and Management of Obesity In India

“…[ 144 ] Personal biases, both explicit and implicit, have been noted in physicians which can affect the delivery of care. [ 145 146 ] Physicians have reported that their busy schedules may not allow enough time to spend on the care of obesity. [ 147 ] Primary and secondary care facilities may not have dieticians, educators and psychologists with expertise regarding management of obesity.…”