Measuring Medical Student Attitudes and Beliefs Regarding Patients Who Are Obese.

Dr. Ip is professor of biostatistical sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina. Ms. Marshall is a fourth-year medical student, University of California, San Francisco School of Medicine, San Francisco, California. Dr. Vitolins is professor of epidemiology and prevention medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Crandall is professor of family and community medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Mr. Davis is assistant professor of family and community medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Miller is associate professor of internal medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Ms. Kronner is project manager, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina. Ms. Vaden is education coordinator, Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Spangler is professor of family and community medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 3.47). 12/2012; DOI: 10.1097/ACM.0b013e31827c028d
Source: PubMed

ABSTRACT PURPOSE: Research shows obesity bias to undermine the patient-doctor relationship and lead to substandard care. The authors developed and tested an instrument to measure medical students' attitudes and beliefs about obese patients. METHOD: The authors conducted a literature search to identify validated measures of obesity bias. Because they identified no appropriate scale, they decided to design a novel survey instrument: the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale. An expert panel generated items which focus groups of third-year medical students then discussed. Next, experienced medical educators judged and weighted the remaining revised items. Then, second- and fourth-year medical students completed the scale alongside two previously validated measures of obesity bias, the Anti-Fat Attitudes Questionnaire (AFA) and Beliefs About Obese Persons Scale (BAOP). Third-year students completed the NEW Attitudes Scale before and after a simulated encounter with an obese standardized patient instructor. The authors tested the validity and reliability. RESULTS: The final instrument comprised 31 items. A sample of 201 judges rated the items. A sample of 111 second- and fourth-year medical students completed the survey (mean score 24.4, range -37 to 76 out of a possible -118 to 118; higher scores indicate more positive attitudes). Pearson correlations between the NEW Attitudes Scale and AFA and BAOP were, respectively, -0.47 and 0.23. Test-retest reliability was 0.89. Students scored 27% higher after completing the standardized patient-instructor encounter (P < .001). CONCLUSION: The NEW Attitudes Scale has good validity and reliability and may be used in future studies.

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    ABSTRACT: Background: A high prevalence of stigmatizing attitude among healthcare personnel towards obese people has been reported. Objective: To evaluate the beliefs, attitudes and phobias that Mexican medical and psychology students have towards obese people. Methods: A cross-sectional study was conducted with 528 students enrolled at the Autonomous University of Baja California in psychology and medical schools. Weight, height and waist circumference were evaluated. Beliefs about obesity were assessed with the BAOP scale, attitudes towards obese people by the ATOP scale and obesity phobias by the F-scale. Results: Participants achieved a mean F-scale score of 3.4. Only seven per cent showed neutral or positive attitudes towards obesity (<= 2.5). Less fat phobia was associated with beliefs that obesity was not a result of the person's self-control (p = 0.0001) and had better attitudes towards obese people (p = 0.0001). Men had higher risk of fat phobia (OR = 1.5). Conclusions: High prevalence of phobias and negative attitudes towards obesity was observed. Men had higher stigma.
    Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 08/2014; 30(1):37-41. DOI:10.3305/nh.2014.30.1.7512 · 1.25 Impact Factor
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    ABSTRACT: Question: Do physiotherapists demonstrate explicit and implicit weight stigma? Design: Cross-sectional survey with partial blinding of participants. Participants responded to the Anti-Fat Attitudes questionnaire and physiotherapy case studies with body mass index (BMI) manipulated (normal or overweight/obese). The Anti-Fat Attitudes questionnaire included 13 items scored on a Likert-type scale from 0 to 8. Any score greater than zero indicated explicit weight stigma. Implicit weight stigma was determined by comparing responses to case studies with people of different BMI categories (where responses were quantitative) and by thematic and count analysis for free-text responses. Participants: Australian physiotherapists (n = 265) recruited via industry networks. Results: The mean item score for the Anti-Fat Attitudes questionnaire was 3.2 (SD 1.1), which indicated explicit weight stigma. The Dislike (2.1, SD 1.2) subscale had a lower mean item score than the Fear (3.9, SD 1.8) and Willpower (4.9, SD 1.5) subscales. There was minimal indication from the case studies that people who are overweight receive different treatment from physiotherapists in clinical parameters such as length of treatment time (p = 0.73) or amount of hands-on treatment (p = 0.88). However, there were indications of implicit weight stigma in the way participants discussed weight in free-text responses about patient management. Conclusion: Physiotherapists demonstrate weight stigma. This finding is likely to affect the way they communicate with patients about their weight, which may negatively impact their patients. It is recommended that physiotherapists reflect on their own attitudes towards people who are overweight and whether weight stigma influences treatment focus. [Setchell J, Watson B, Jones L, Gard M, Briffa K (2014) Physiotherapists demonstrate weight stigma: a cross-sectional survey of Australian physiotherapists.Journal of Physiotherapy60:XXX-XXX.]
    Journal of physiotherapy 09/2014; DOI:10.1016/j.jphys.2014.06.020 · 2.89 Impact Factor
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    ABSTRACT: The aim of this study was to establish whether a 'teach-the-trainer' course leads to improvements in, firstly, the knowledge and attitude of clinical trainers and their trainees, and, secondly, the role model behaviour of the clinical trainers. A controlled intervention study was performed with GP trainers and GP trainees from four training institutes in the Netherlands. Clinical trainers in the two intervention institutes received two 3-h training sessions on weight management, focusing on knowledge and attitudes towards obesity, and on conveying the correct professional competency as a positive role model for trainees. This was measured using questionnaires on knowledge, attitude, and role model behaviour (the role model apperception tool; RoMAT). GP trainers showed an increase in knowledge and several characteristics could be identified as being related to positive role model behaviour. A small correlation was found between the trainer's score on the RoMAT and the attitude of the trainee. A teach-the-trainer course in which knowledge, attitudes, and role modelling are integrated proved to be a first step toward improving the knowledge of clinical trainers, but did not result in a measurably better professional outcome for the trainee, maybe due to a more objective level of assessment.