An investigation of health care professionals' attitudes to obesity and the associated impact on clinical management : an online factorial survey

• Main Author: McAloon, Antoinette
• Published: Ulster University 2015
• Subjects: 616.3
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.695318

Background: The obesity pandemic is causing premature mortality, increasing morbidity and escalating healthcare costs. It is globally acknowledged that current obesity management strategies are failing. It is also accepted that clinicians may hold an Anti-fat bias. To-date it has not been established if there is a relationship between strategy failures and clinicians' attitudes. This 'uncharted territory' was the driving impetus to undertaken a study investigating possible links and consequences. Aims: To establish healthcare clinicians' attitudes towards patients with obesity and test the extent to which their attitudes influenced obesity management. Methods: Online vignettes were generated via Factorial Survey Design methods to assess obesity management by clinicians. The obesity Implicit Association Test (IAT) was used to assess subconscious Anti-fat bias. Data were collected anonymously from a multi-professional convenience sample in a virtual research site managed by Project Implicit®. Multiple gatekeepers in two health trusts and two universities emailed invitations to potential participants who entered the site via a hyperlink. These volunteers self-administered eight vignettes with integrated patient photographs, a demographic questionnaire and the IA T. On completion participants were instantly provided with personalised feedback on their implicit obesity attitude. Multivariate regression, ANOVA and summary statistics were utilised in analysis. Results: Of the 427 clinicians participating 79% were female, 48% were nurses, 35% doctors, 9% were dietitians with 59% of the total being post registrants and 33% pre registrants. A widespread Anti-fat bias was identified. Patient and clinician variables that influenced motivation to treat, the likelihood of discussing weight and the time spent with the patient were identified. All this information represented original data contributed to the literature base. Conclusion: This study has produced original data relating to obesity attitudes and clinical behaviour. Current healthcare strategies should be reviewed to take account of this new knowledge and its potential to improve current levels of intervention effectiveness. The data also suggests a new direction of travel for policy makers, clinical teachers and researchers.