Abstract
Background: The obesity pandemic is resulting in
premature mortality and increased morbidity and
healthcare costs. Prevention is a global health
priority but effective management for established
obesity is also important. It is known that clinicians
often have anti-fat attitudes and assumed
that this adversely affects care (Puhl et al 2009).
However there is a paucity of research linking
anti-fat attitudes to clinical behaviour.
Aims: to assess the attitudes of multidisciplinary
clinicians to obese individuals and identify
variables influencing decision-making.
Methods: Online vignettes were generated via a
Factorial Survey Design method to assess clinical
decision making and were combined with the
obesity Implicit Association Test (IAT) to assess
subconscious anti-fat bias. Data were collected
anonymously from a voluntary convenience sample
during 2011-2012 in a virtual research lab managed
by Project Implicit®. Multiple gatekeepers in 2
health trusts and 2 universities emailed invitations
to registered nurses and students, medical doctors
and students, dieticians and students. Participants
used a hyperlink to self-administer eight randomly
generated unique vignettes with integrated
patient photographs, a demographic questionnaire
and the IAT. Vignette responses (n = 3,416)
were analysed using Multivariate Regression and
the questionnaires by descriptive statistics. The
IAT score was calculated from the standardised
differences in mean response times on 2 key IAT
conditions (Greenwald et al 2003).
Results: 427 clinicians participated, 79% being
female. Disciplines represented were nurses
(38%), student nurses (14%), doctors (19%),
medical students (20%), dieticians (7%) and
dietetic students (2%). Preliminary vignette
analysis identified patient and clinician variables
influencing motivation to treat, likelihood of
addressing weight, and time with the patient
The mean IAT score was 0.6854 (95% confidence
Intervals 0.6399-0.7309) indicating a strong
anti-fat bias.
Discussion and Conclusion: Our study suggests
there may be both patient and clinician variables
that impact on effective treatment interventions
for clinical management of obese patients.
premature mortality and increased morbidity and
healthcare costs. Prevention is a global health
priority but effective management for established
obesity is also important. It is known that clinicians
often have anti-fat attitudes and assumed
that this adversely affects care (Puhl et al 2009).
However there is a paucity of research linking
anti-fat attitudes to clinical behaviour.
Aims: to assess the attitudes of multidisciplinary
clinicians to obese individuals and identify
variables influencing decision-making.
Methods: Online vignettes were generated via a
Factorial Survey Design method to assess clinical
decision making and were combined with the
obesity Implicit Association Test (IAT) to assess
subconscious anti-fat bias. Data were collected
anonymously from a voluntary convenience sample
during 2011-2012 in a virtual research lab managed
by Project Implicit®. Multiple gatekeepers in 2
health trusts and 2 universities emailed invitations
to registered nurses and students, medical doctors
and students, dieticians and students. Participants
used a hyperlink to self-administer eight randomly
generated unique vignettes with integrated
patient photographs, a demographic questionnaire
and the IAT. Vignette responses (n = 3,416)
were analysed using Multivariate Regression and
the questionnaires by descriptive statistics. The
IAT score was calculated from the standardised
differences in mean response times on 2 key IAT
conditions (Greenwald et al 2003).
Results: 427 clinicians participated, 79% being
female. Disciplines represented were nurses
(38%), student nurses (14%), doctors (19%),
medical students (20%), dieticians (7%) and
dietetic students (2%). Preliminary vignette
analysis identified patient and clinician variables
influencing motivation to treat, likelihood of
addressing weight, and time with the patient
The mean IAT score was 0.6854 (95% confidence
Intervals 0.6399-0.7309) indicating a strong
anti-fat bias.
Discussion and Conclusion: Our study suggests
there may be both patient and clinician variables
that impact on effective treatment interventions
for clinical management of obese patients.
Original language | English |
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Pages | 16-16 |
Number of pages | 1 |
Publication status | Published - 2013 |
Event | Royal College of Nursing International Research Conference - Belfast, United Kingdom Duration: 20 Mar 2013 → … |
Conference
Conference | Royal College of Nursing International Research Conference |
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Country/Territory | United Kingdom |
City | Belfast |
Period | 20/03/2013 → … |