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

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.