Jayawickrama Ravisha S, Hill Briony, O'Connor Moira, Flint Stuart W, Hemmingsson Erik, Ellis Lucy R, Du Yaxing, Lawrence Blake J
School of Population Health, Curtin University, Western Australia, Australia.
Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
Obes Rev. 2025 Feb;26(2):e13847. doi: 10.1111/obr.13847. Epub 2024 Oct 8.
We conducted a systematic review and meta-analysis to determine the efficacy of interventions aimed at reducing weight bias in healthcare students, and to explore factors that may impact intervention success. A systematic review and random-effects meta-analyses were conducted by including studies that examined the efficacy of weight bias reduction interventions for healthcare students. Of the 3463 journal articles and dissertations screened, 67 studies (within 64 records) met inclusion criteria, with 35 studies included in the meta-analyses (explicit = 35, implicit [and explicit] = 10) and 32 studies included in the narrative synthesis (explicit = 34, implicit [and explicit] = 3). Weight bias interventions had a small but positive impact, g = -0.31 (95% CI = -0.43 to -0.19, p < 0.001), in reducing students' explicit weight bias but there was no intervention effect on implicit weight bias, g = -0.12 (95% CI = -0.26 to 0.02, p = 0.105). There was considerable heterogeneity in the pooled effect for explicit bias (I = 74.28, Q = 132.21, df = 34, p < 0.001). All subgroup comparisons were not significant (p > 0.05) and were unable to explain the observed heterogeneity. Narrative synthesis supported meta-analytic findings. The small but significant reduction of explicit weight bias encourages the continued testing of interventions, irrespective of variation in individual intervention components. Contrarily, reductions in implicit weight bias may only be possible from a large societal shift in negative beliefs and attitudes held towards people living in larger bodies.
我们进行了一项系统综述和荟萃分析，以确定旨在减少医学生体重偏见的干预措施的效果，并探索可能影响干预成功的因素。通过纳入研究医学生体重偏见减少干预措施效果的研究，进行了系统综述和随机效应荟萃分析。在筛选的3463篇期刊文章和学位论文中，67项研究（在64条记录中）符合纳入标准，35项研究纳入荟萃分析（明确的 = 35，隐含的[和明确的] = 10），32项研究纳入叙述性综述（明确的 = 34，隐含的[和明确的] = 3）。体重偏见干预措施对减少学生的明确体重偏见有微小但积极的影响，g = -0.31（95%CI = -0.43至-0.19，p < 0.001），但对隐含体重偏见没有干预效果，g = -0.12（95%CI = -0.26至0.02，p = 0.105）。明确偏见的合并效应存在相当大的异质性（I = 74.28，Q = 132.21，df = 34，p < 0.001）。所有亚组比较均无统计学意义（p > 0.05），无法解释观察到的异质性。叙述性综述支持荟萃分析结果。明确体重偏见虽微小但显著降低，这鼓励继续对干预措施进行测试，无论个体干预成分如何变化。相反，只有通过对体型较大者持有的负面信念和态度进行大规模的社会转变，才可能减少隐含体重偏见。
