The application's broad long-term objective is to decrease racial disparities in cancer outcomes. The higher prevalence of obesity in minority women may be a contributing factor to cancer disparities, since obese persons have higher incidence and mortality from several cancers but lower rates of cancer screenings. One reason obese women delay preventive screenings is to avoid weight bias in health care settings. Weight bias is a negative attitude toward, belief about, or behavior against people who are overweight and obese, and it leads to negative emotional, physical health, social, and economic consequences. Sources of weight bias in health care settings include negative clinician and staff attitudes, embarrassing weighing procedures, lack of appropriately sized medical equipment, and an unwelcoming office environment. Since minority women have higher prevalence of obesity, they are disproportionately subjected to weight bias. The proposed study will be the first to test the efficacy of an intervention to reduce weight bias in community health care settings.
Specific Aims : 1: Evaluate the feasibility of an educational intervention in decreasing weight bias in community primary care settings. 2: Determine potential efficacy of intervention in improving beliefs, attitudes, and behaviors of health professionals toward obese persons in community primary care settings. 3: Evaluate potential impact of intervention on obese persons'perceptions of weight bias in community primary care settings and their intentions for preventive health behaviors. Methods: Pre- post-test design is used to pilot-test the intervention in 4 federally qualified community health centers serving high numbers of obese, poor, minority persons. The 1 hour practice level educational intervention, guided by Attribution Theory, Empathy Induction, and Motivational Interviewing, consists of a 17-minute "Weight Bias in Health Care" video and discussion of an online toolkit and other resources on obesity management. Multi- methods data collection using surveys of practice members and patients, and observations of field researcher are conducted at baseline, 3 and 12 months. Outcomes: Feasibility: acceptance rate (percent practice members receiving intervention and completing baseline surveys, percent patients completing surveys) and retention rates ( percent practice members completing follow-up surveys). Primary treatment outcomes: beliefs, attitudes, and behaviors of health professionals toward obese patients;Secondary treatment outcomes: obese patients'perceptions of weight bias and their practitioner's empathy, and patients'self-reported intentions for weight loss and cancer screenings. Significance: This innovative study will identify potential logistical barriers and allow for effect size calculations and statistical power analyses for a future larger scale randomized controlled trial. Improving health professionals'behaviors toward obese persons may have great potential impact in improving health care delivery for a high number of underserved minority women with obesity who are at risk for cancer disparities.
These feasibility studies will pilot-test an educational intervention to decrease weight bias among health professionals in community health care settings. Minority women are disproportionately subjected to weight bias, which increases poor eating habits, refusal to diet, avoidance of exercise, and delays in cancer screenings. Improving health professionals'behaviors toward obese persons may have great potential impact in improving health care delivery for a high number of underserved minority women with obesity who are at risk for cancer disparities. .