Georgetown University School of Nursing, Washington, District of Columbia.
Vanderbilt University School of Nursing, Nashville, Tennessee.
J Midwifery Womens Health. 2024 May-Jun;69(3):342-352. doi: 10.1111/jmwh.13616. Epub 2024 Mar 15.
Weight bias toward individuals with higher body weights is present in health care settings. However, there has been limited quantitative exploration into weight bias among perinatal care providers and its potential variations based on demographic characteristics. The aim of this study was to examine if the direction and extent of weight bias among midwives certified by the American Midwifery Certification Board (AMCB) varied across age, years since certification, body mass index (BMI), race, ethnicity, and US geographic region.
Through direct email listservs, postcard distribution, social media accounts, and professional networks, midwives were invited to complete an online survey of their implicit weight bias (using the Implicit Association Test) and their explicit weight bias using the Anti-Fat Attitudes Questionnaire (AFA), Fat Phobia Scale (FPS), and Preference for Thin People (PTP) measure.
A total of 2106 midwives who identified as Black or White and resided in one of 4 US geographic regions participated in the survey. Midwives with a lower BMI expressed higher levels of implicit (P <.01) and explicit (P ≤.01) weight bias across all 4 measures except for the AFA Fear of Fat Subscale. Implicit weight bias levels also varied by age (P <.001) and years since certification (P <.001), with lower levels among younger midwives (vs older) and those with fewer years (vs more) since certification. Only age and BMI remained significant (P <.001) after adjusting for other demographic characteristics. Lower explicit weight bias levels were found among midwives who identified as Black (vs White) on 2 measures (FPS: adjusted β = -0.07, P = .004; PTP: P = .01).
This was the first quantitative study of how weight bias varies across demographic characteristics among a national sample of midwives. Further exploration is needed in more diverse samples. In addition, research to determine whether weight bias influences clinical decision-making and quality of care is warranted.
在医疗保健环境中，人们对体重较高的个体存在体重偏见。然而，对于围产期护理提供者的体重偏见及其基于人口统计学特征的潜在变化，定量研究还很有限。本研究旨在探讨美国围产期护理提供者（美国母婴保健认证委员会认证的助产士）的体重偏见的方向和程度是否因年龄、认证后年限、体重指数（BMI）、种族、民族和美国地理位置而有所不同。
通过直接电子邮件列表、明信片分发、社交媒体账户和专业网络，邀请助产士在线完成他们的隐性体重偏见（使用内隐联想测验）和显性体重偏见（使用反肥胖态度问卷、肥胖恐惧症量表和喜欢瘦人的偏好）的调查。
共有 2106 名自认为是黑种人或白种人且居住在美国 4 个地理区域之一的助产士参与了这项调查。较低 BMI 的助产士在所有 4 项测量中（除反肥胖态度问卷的肥胖恐惧子量表外），显性（P ≤.01）和隐性（P <.01）体重偏见的水平更高。隐性体重偏见水平还因年龄（P <.001）和认证后年限（P <.001）而异，年轻（与年老）和认证后年限较短（与较长）的助产士的水平较低。在调整其他人口统计学特征后，只有年龄和 BMI 仍然显著（P <.001）。在 2 项测量中（肥胖恐惧症量表：调整后β=-0.07，P =.004；喜欢瘦人的偏好：P =.01），自认为是黑人（与白人）的助产士表现出较低的显性体重偏见水平。
这是第一项关于全国性助产士样本中体重偏见如何因人口统计学特征而异的定量研究。在更多样化的样本中需要进一步探索。此外，有必要进行研究以确定体重偏见是否会影响临床决策和护理质量。
