Jungnickel Tobias, von Jan Ute, Engeli Stefan, Albrecht Urs-Vito
Peter L. Reichertz Institute for Medical Informatics of the TU Braunschweig and Hannover Medical School, Hannover Medical School, Hannover, Germany.
Institute of Pharmacology, Center of Drug Absorption and Transport (C DAT), University Medicine Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany.
Ther Adv Endocrinol Metab. 2022 May 14;13:20420188221098881. doi: 10.1177/20420188221098881. eCollection 2022.
Obesity is common in many industrialized nations and often accompanied by related health issues. Furthermore, individuals living with overweight or obesity are often confronted with stigmatization in their daily lives. These problems may be aggravated if the objectivity of health care professionals is compromised due to (unconscious) prejudices. If pharmaceutical companies, regulatory agencies, and health insurers are also susceptible to these biases, decisions related to the development, approval, and reimbursement of obesity-related therapies may be negatively impacted.
The 'Implicit Association Test' (IAT) is a psychometric test allowing to measure these attitudes and could therefore assist to reveal unconscious preferences. A self-developed mobile version, in the form of a ResearchKit-based IAT app was employed in the presented study. The objective was to determine (potential) weight bias and its characteristics for professionals attending a national obesity-related conference in Germany (G1), compared to a control group (without stated interest in the topic, G2) - both using the mobile app - and a historical control (G3) based on data provided by Project Implicit acquired by a web app.
Explicit evaluations of G1 were neutral at a higher percentage compared with G2 and G3, while implicit preference toward lean individuals did not differ significantly between G2 and G3, and G1.
The greater discrepancy between the (more neutral) explicit attitude and the unconscious preference pointing in the anti-obesity direction could indicate an underestimated bias for the professional participants in G1. Implicit preference is often ingrained from childhood on, and difficult to overcome. Thus, even for professionals, it may unconsciously influence decisions made in the care they provide. Professionals in any given health care sector directed at obesity care should thus be made aware of this inconsistency to enable them to consciously counteract this potential effect.
肥胖在许多工业化国家很常见,且常常伴有相关健康问题。此外,超重或肥胖者在日常生活中常常面临污名化。如果医护人员的客观性因(无意识的)偏见而受到损害,这些问题可能会加剧。如果制药公司、监管机构和健康保险公司也容易受到这些偏见的影响,那么与肥胖相关疗法的研发、审批和报销相关的决策可能会受到负面影响。
“内隐联想测验”(IAT)是一种心理测量测试,能够测量这些态度,因此有助于揭示无意识的偏好。在本研究中,采用了一种基于ResearchKit的IAT应用程序形式的自行开发的移动版本。目的是确定参加德国全国肥胖相关会议的专业人员(G1组)与对照组(对该主题无明确兴趣,G2组)——两组均使用移动应用程序——以及基于网络应用程序从内隐项目获取的数据的历史对照组(G3组)相比的(潜在)体重偏见及其特征。
与G2组和G3组相比,G1组的明确评价在更高比例上呈中性,而G2组、G3组和G1组对瘦人的内隐偏好没有显著差异。
(更中性的)明确态度与指向反肥胖方向的无意识偏好之间的更大差异可能表明G1组专业参与者的偏见被低估了。内隐偏好通常从童年起就根深蒂固,难以克服。因此,即使对于专业人员来说,它也可能在无意识中影响他们提供护理时所做的决定。因此,任何针对肥胖护理的特定医疗保健领域的专业人员都应该意识到这种不一致,以便他们能够有意识地抵消这种潜在影响。