Skoko Rodriguez Monica, Thompson Julie A, Carter Brigit, Wallace Robin, Riley Katie, Johnson Ragan
Duke University School of Nursing, Durham, North Carolina, USA.
Planned Parenthood Federation of America, New York, New York, USA.
Health Equity. 2024 Jul 1;8(1):461-468. doi: 10.1089/heq.2024.0096. eCollection 2024.
Provider bias against patients of higher weights can contribute to poor health outcomes and decreased quality of care and patient experience. Addressing weight stigma in sexual and reproductive health settings is important, as these encounters can often be patients' only health care touchpoint. Health care providers must be educated about the harms of weight stigma, ways to recognize and confront their biases, and how to advocate for patients of all sizes.
In this quality improvement project, Planned Parenthood health center providers participated in a three-part virtual workshop to improve provider weight bias awareness and understanding using the Health at Every Size framework. Providers completed a pre- and post-survey, as well as a 3-month follow-up survey to assess changes in bias awareness and confidence in applying weight-neutral principles in care interactions.
Analysis of pre- and post-survey results showed significant improvements in provider awareness of bias as well as changes in implicit bias scores and confidence providing weight-neutral care.
Educating providers about weight contributes to equity of care for patients of higher weights. Formal education such as workshops have the potential to reduce the harms of weight stigma in health care as changing attitudes and confidence are a precursor to behavior change. Research is needed to assess ideal education modalities and whether receiving care from weight bias-prepared providers affects patient outcomes and experiences.
医疗服务提供者对体重较高患者的偏见可能导致不良的健康结果、医疗质量下降以及患者体验变差。在性健康和生殖健康环境中消除体重歧视很重要,因为这些接触往往可能是患者唯一的医疗保健接触点。必须对医疗服务提供者进行关于体重歧视危害的教育,告知他们识别和应对自身偏见的方法,以及如何为各种体型的患者提供支持。
在这个质量改进项目中,计划生育健康中心的提供者参加了一个由三部分组成的虚拟研讨会,使用“健康体重无歧视”框架来提高提供者对体重偏见的认识和理解。提供者完成了一份前后调查,以及一份为期3个月的随访调查,以评估偏见意识的变化以及在护理互动中应用体重中立原则的信心。
对前后调查结果的分析显示,提供者对偏见的认识有了显著提高,隐性偏见得分以及提供体重中立护理的信心也发生了变化。
对提供者进行关于体重的教育有助于为体重较高的患者提供公平的护理。像研讨会这样的正规教育有可能减少医疗保健中体重歧视的危害,因为态度和信心的改变是行为改变的先决条件。需要进行研究来评估理想的教育方式,以及接受来自有体重偏见防范意识的提供者的护理是否会影响患者的结果和体验。