1. Beale Rural-Urban Continuum Code
Obesity Bias in Medical Students Within an Appalachian University Britni Ross, M.A., Penny Koontz, Psy.D., April Fugett, Ph.D.
Results
Introduction
Figure 1
It is possible that the sample size is too small and lacks sufficient power to allow for an accurate portrayal of students’ attitudes in either comparison.
Providing brief training and interventions to medical students will serve to increase participants’ awareness of obesity stigma and may encourage increased sensitivity when treating obese patients.
Research suggests there is a pervasive, culturally accepted negative stereotype of obese people, and health care providers are not immune to this bias (Sabin, Maddalena, & Nosek, 2012).
In a recent study, medical residents reported feeling incompetent to treat obesity, negative feelings regarding the physical appearance of obese patients, and that most obese patients would not be able to lose weight (Davis, Shishodia, Taqui, Dumfeh, & Wylie-Rosett, 2007).
Post-graduate students enrolled in health discipline programs view patients as lacking motivation, difficult to treat, and non-compliant with medical treatment, and tend to attribute more behavioral causes to obesity (Puhl, Luedicke, & Grilo, 2013).
Dietetics and medical students reported a decrease in negative attitudes toward obese patients and an increase in awareness of genetic and environmental influences after watching anti-stigma films (Poustchi, Saks, Piasecki, Hahn, & Ferrante, 2013; and Swift et al., 2013).
Please see Table 1 for a breakdown of participant demographic information.
A paired samples t-test was conducted to determine whether there was a significant difference in participants’ pre and post-treatment explicit obesity attitudes. Preliminary data indicate there was not a significant difference in pre-treatment and post-treatment scores; t (18) = -.32, p > .05, two-tailed. (See Figure 1).
A simple linear regression was conducted to assess the ability of a participant’s Body Mass Index (BMI) to predict post-treatment explicit obesity attitudes scores on the adapted Foster scale. Preliminary results indicated that participants’ BMI did not significantly predict their explicit attitudes toward obese individuals, R2 = .20, F (1, 13) = 3.18, p >.05.
Limitations
Some limitations of the current study include the small sample size. The researchers have encountered significant difficulty in recruiting participants at the medical school.
The study hopes to expand to the nursing school and psychology departments at Marshall University to obtain additional participants.
Also, missing variables in both demographics and participant pre and post-test responses may have reduced our ability to detect significance in the outcomes.
Discussion
Once additional data is collected, this information will be analyzed to determine if rural participants have differing negative obesity attitudes than their urban counterparts. Research on obesity attitudes of rural residents is lacking, and it is predicted that being from a rural area will serve to soften one’s attitudes, due to high prevalence of obesity in rural areas.
There was not a significant difference in the pre-treatment and post-treatment scores in this preliminary sample. It is possible that the brief video intervention was ineffective in reducing negative explicit obesity attitudes, however, this would be contrary to findings of past studies (Poustchi, Saks, Piasecki, Hahn, & Ferrante, 2013; and Swift et al., 2013).
Additionally, participant BMI was not a predictor of explicit obesity attitudes in this sample. This finding is also contradictory to past research that found that a higher BMI tends to soften participants’ views of obese patients (Brown et al., 2007). It should be noted that some participants did not record their BMI on the demographics sheet. These missing variables could account for the lack of significance in the results.
Table 1
Methods
Participants:
Second year medical students from a university School of Medicine in Huntington, W.V. (n = 19)
Measures:
An adapted version of the Foster et al. (2003) survey, Primary Care Physicians’ Attitudes about Obesity and Its Treatment, examined two domains of medical students’ attitudes about obesity: causes of obesity & attitudes towards treatment.
Demographic information included: age, gender, racial/ethnic group, BMI, & participant resident status based on the Beale 2013 rural/urban continuum codes.
Procedures:
Medical students were assessed on their explicit anti-obesity attitudes, watched a video presentation on reducing weight bias in health care, and retook the attitude measure.
Results from the pre- and post- measures were analyzed to determine whether the targeted intervention was effective in decreasing negative attitudes towards obese patients and whether participant BMI or resident status predicted their explicit attitudes.
Beale Rural-Urban Continuum Code
Frequency
Metro of 1 million or more 1
Metro less than 250,000 4
20,000 or more, physically adjacent to a metro area
20,000 or more, not physically adjacent to a metro area 3
2,500 to 19,999, physically adjacent to a metro area 2
2,500 to 19,999, not physically adjacent to a metro area
Less than 2,500, physically adjacent to a metro area
Less than 2,500, not physically adjacent to a metro area
References
For a list of references or to contact the authors, please
Britni Ross
Marshall University Psychology Dept.
One John Marshall Drive
Huntington, WV 25755
The authors wish to thank the Rudd Center for Food Policy and Obesity at The University of Connecticut for their support of this project.