Changes in Healthcare Professionals' Practice Behaviors Through an Educational Intervention Targeting Weight Bias

Amanda Velazquez; Karen J Coleman; Robert F Kushner; Joseph F Nadglowski; Patricia M Nece; Jing Zhang; A Janet Tomiyama

doi:10.1007/s11606-024-09212-9

Changes in Healthcare Professionals' Practice Behaviors Through an Educational Intervention Targeting Weight Bias

J Gen Intern Med. 2024 Dec 18. doi: 10.1007/s11606-024-09212-9. Online ahead of print.

Authors

Amanda Velazquez¹, Karen J Coleman^{2

3}, Robert F Kushner⁴, Joseph F Nadglowski⁵, Patricia M Nece⁵, Jing Zhang², A Janet Tomiyama⁶

Affiliations

¹ Center for Weight Management and Metabolic Health, Jim and Eleanor Randall Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA. amanda.velazquez@cshs.org.
² Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
³ Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
⁴ Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁵ Obesity Action Coalition, Tampa, FL, USA.
⁶ Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.

PMID: 39695062
DOI: 10.1007/s11606-024-09212-9

Abstract

Objective: Weight bias is pervasive in healthcare and leads to worse patient outcomes. A uniquely designed 4-h continuing medical education (CME) intervention was assessed for changing healthcare professionals' (HCPs') weight biases and clinical practice behaviors.

Design: The intervention used a (1) pre/post design examining CME attendees' self-reported weight bias at baseline, after, and 4- and 12-month follow-up, and (2) post/post design examining obesity practice behaviors 12 months after intervention in attendees and non-attendees.

Setting: Single medical center service area within Kaiser Permanente Southern California.

Participants: All HCPs (n = 472) from the target service area were eligible to attend. Analyses were done with 218 HCPs who attended and 89 who did not.

Methods and analysis: The intervention contained theory-based elements of changing attributions of responsibility of obesity, increasing empathy, creating self-awareness of weight bias, and creating a bias-free culture. For pre/post analyses, the primary outcome was self-reported weight bias. For comparative analyses of CME attendees and non-attendees, the outcomes were electronic medical record-confirmed rates of obesity diagnosis and referrals to evidence-based obesity treatments in the 12 months following the CME intervention.

Results: Self-reported negative obesity stereotypes were significantly reduced compared to baseline while self-reported empathy and confidence in caring for patients with obesity were significantly increased immediately post intervention and were maintained at 4- and 12-month follow-up. After adjusting for years in practice, race/ethnicity, gender, profession type, practice type, and panel size, HCPs who attended the CME intervention had significantly increased odds (range 60-212%) of diagnosis and obesity-related referrals in the 12 months following the CME intervention when compared to HCPs who did not attend.

Conclusion and relevance: This intervention has promise to be a scalable program that goes beyond impacting HCP's self-reported weight bias and also changes HCPs' clinical practice behaviors related to obesity treatment.

Keywords: continuing medical education; intervention; obesity; weight bias; weight stigma.

Abstract

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