Sunday, April 28, 2024
4/28/2024
DESCRIPTION (provided by applicant): Background and Objective: 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. Obese persons are also subjected to weight bias, which leads to poor eating habits, refusal to diet, avoidance of exercise, and delays in cancer screenings. Weight bias is a negative attitude toward, belief about, or behavior against people who are overweight and obese. The prevalence of weight-based prejudice is 12 percent, which is comparable to race-based prejudice. Up to 69 percent of overweight and obese women report experiencing weight bias from health professionals. 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. The proposed study will be the first to evaluate 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: Estimate effect sizes of our intervention in improving beliefs, attitudes, and behaviors of health professionals toward obese persons in community primary care settings. 3: Explore potential impact of intervention on obese persons' perceptions of weight bias and receipt of preventive health behavior counseling in community primary care settings. Methods: Randomized controlled trial is used to pilot-test the intervention in 4 federall qualified community health centers (2 control, 2 intervention) serving high numbers of obese, poor, minority women. All practices receive education and resources on obesity management. Intervention practices also receive presentation of a 17-minute "Weight Bias in Health Care" video and online toolkit (guided by Attribution Theory, Empathy Induction, and Motivational Interviewing). Multi-methods data collection uses practice member surveys, patient exit interviews, and observations of field researcher at baseline, 3 and 12 months. Outcomes: Feasibility: acceptance rate (percent practice members receiving intervention and completing baseline surveys; satisfaction with intervention; percent patients completing interviews) 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' receipt of and satisfaction with health behavioral counseling, and perceptions of weight bias and practitioner's empathy. Significance: This innovative study will identify potential logistical barriers and allow for effect size calculaions 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.
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