Associate Clinical Professor of Pediatrics UCLA Los Angeles, California, United States
Background: Pediatric patients with obesity face weight bias and stigma from their community, families, media, and healthcare providers. Many physicians hold implicit and explicit biases against patients with overweight. Healthcare related weight stigma negatively affects patients’ quality of life and can have several deleterious effects on their health. Objective: 1. Develop aweight bias curriculum forpediatric residentsusing theTransformative Learning Theory conceptual framework,with sessions fulfilling the elements of thedisorientingexperience, critical reflection, acquiring skills, and role modeling new behavior. 2. Measure pre/post changes from the weight bias curriculum on pediatric residents’ implicit and explicit weight bias scores using theWeight Bias Implicit Association Tests (IAT)and theFat Attitudes AssessmentToolkit(FAAT).
Design/Methods: The curriculum contained six didactic, role play, or reflection activities. Effectiveness of the curriculumwasmeasured using Kirkpatrick’s Evaluation Framework. Learners’ reaction to the curriculumwascollectedanonymouslyonline immediately after the rotationas well as through a post rotation discussion.To assess change in knowledge and behavior around weight bias,implicitand explicit bias was measuredat baselinebefore the curriculum and immediately aftercompletion ofthe curriculum two weeks later. Results: Eleven second year pediatric residents enrolled in the UCLA Public Health Ambulatory Basics and Beyond (PHABB) track completed all elements of the curriculum over two weeks in December 2022. Residents completed an online anonymous evaluation asking them how much they agreed that the material taught was informative, engaging, and delivered effectively on a 5 point Likert scale (Strongly Agree, Agree, Uncertain, Disagree, Strongly Disagree). Residents (n=11) reported an average score of 4.5 out of a total of 5 for the six elements of the weight bias curriculum. Pre-curriculum Weight Bias IAT showed the presence of significant implicit anti-fat bias (n=12, Mean d-score-0.51, p-value = 0.0003) while post-curriculum IAT did not show significant evidence of implicit anti-fat bias (n=10, Mean d-score –0.28, p-value = 0.08). Explicit weight bias (FAAT) scales showed a trend towards lower explicit bias scores on the critical health, general complexity, and responsibility scales.
Conclusion(s): A weight bias curriculum for pediatric residents is well received by the learners and may decrease implicit weight bias scores and reduce explicit bias.