Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Katie Lais, DNP

Abstract

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to systematically review research-based evidence and best practice guidelines brought forth by other researchers, experts and organizations. The goal was to implement an enlightening and educational intervention via seminar to Pre-licensure RN students, APRN students and APRNs on the topics of the non-controllable causes of obesity, weight bias in healthcare and patient-centered approaches to ultimately improve the delivery and quality of care provided to patients living with obesity.

Background: The prevalence of overweight and obesity has been steadily increasing over the past three decades with up to 42% of American adults experiencing obesity. Weight bias, stigma and discrimination have been found in physicians, nurses and other healthcare disciplines and is as prevalent in healthcare as it is in the general population which is estimated to be as prevalent as racial bias. Weight bias in healthcare has been shown to actually perpetuate obesity, causing negative physical, psychological, and social consequences. Individuals who feel weight stigmatized by their healthcare providers have reported decreased treatment adherence, reduced preventative health participation, diminished trust in their provider and avoidance of follow-up care which can delay treatment and worsen health further.

Methods: A one-hour educational seminar was provided via Zoom and in-person to participants that consisted of education on implicit/explicit weight bias, the consequences of weight bias, the non-controllable factors of obesity (biogenetic, environmental and social factors) and weight stigma reduction strategies which are evidenced based interventions used to decrease weight bias in healthcare professionals. Attendees were required to complete two pre-seminar activities anonymously. The first was the Harvard Weight 'Fat - Thin' Implicit Association Test (IAT) to measure implicit bias. The second activity was the Attitudes Towards Obese Persons Scale (ATOP) which is an explicit bias measuring tool. Four weeks post-intervention attendees were asked to take the ATOP via the survey link again.

Results: The Harvard Weight IAT results showed that the majority of students showed slight to moderate automatic preference towards thin people compared to fat people. Pre and post-intervention ATOP scores showed almost no differences. However, there was one important change regarding ATOP question #17, where more participants agreed that obese people were just as healthy as nonobese people. All attendees agreed that this education was relevant to their nursing practice. At one-month post-seminar, 100% participants reported that they had been able to implement weight bias reduction strategies in their personal nursing practice in the care of patients living with obesity.

Evaluation: Future projects on weight bias in healthcare should include re-exposure to interventions that include the non-controllable factors of obesity, the effects of weight bias to individual health and education on ways to reduce weight bias, stigma, and discrimination in healthcare.

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