Weight Bias Reduction Intervention with Nursing Students Using Simulation: The BRAVE Study - PROJECT SUMMARY/ABSTRACT Longstanding evidence documents the detrimental effects of provider biases on poor patient outcomes. Weight bias among nurses is an understudied concept that causes increased morbidity and mortality in populations living with obesity. Specifically, studies show that nurses with weight bias: 1) assume patients' symptoms are related to obesity and do not further probe underlying causes, 2) are more reluctant to perform preventative health screenings (such as pelvic examinations, cancer screenings, and mammograms), 3) spend less time engaging with patients during visits, all of which causes patients to withdraw from the provider, potentially resulting in difficulty remembering or adhering to provider advice and avoiding future preventative care visits. Given the increasing rates of obesity in the United States, efforts are direly needed to improve the care provided by nurses who work with this demographic to thwart preventable health consequences (e.g., diabetes, heart disease). Our pilot work showed favorable improvements in nursing students' attitudes and beliefs toward individuals with obesity following a Weight Bias Reduction (WBR) intervention when implemented into their clinical course. Gaps remain, however, in: 1) whether WBR interventions can translate into behavior change in clinical practice and make notable reductions in the weight bias patients are experiencing, and 2) whether these changes are sustained over time. To fill these gaps, the proposed BRAVE (Building Respect and Acceptance through Valuing Everybody, WBR intervention) will build on our previous research to include education on communication skills and empathic competence, as well as utilize simulation with standardized participants living with obesity. The study design is a cluster-randomized controlled trial comparing BRAVE to SOL (Standard Obesity Lecture) in reducing weight bias among nursing students (n = 368) and will include follow-up measures to determine the intervention's sustained effects one year later. Additionally, the broader impacts of this BRAVE intervention can enhance long-term health outcomes with the potential for improved patient satisfaction while navigating the healthcare system. This may have significant cost savings in our financially overwhelmed healthcare system. Implementing this project will also strengthen nursing curricula with a pioneering WBR program as an optimal way of providing healthcare for patients living with obesity. The project will leverage a robust research team, create a pipeline of nursing students who will be integrated throughout the entire research project, and will build on the existing simulation infrastructure at Villanova University to provide transformative and innovative educational simulations for improved clinical care and subsequent health outcomes. The National Institute of Nursing Research’s mission is to promote and enhance the health of individuals directly, and this research aligns directly with this goal by seeking to improve the healthcare experience for persons living with obesity through a BRAVE intervention.
