Background

Weight bias is present among pre-clinical students and clinicians, and can compromise the care provided to persons with obesity. Our objective was to test whether obesity education combined with Narrative Medicine (NM) methods, aimed at increasing levels of reflection and improving empathy, can decrease explicit weight bias in pre-clinical Doctor of Physical Therapy (DPT) students.

Methods

30 DPT students completed a pre-/post-survey, measuring self-reflection, knowledge, attitudes and beliefs about people with obesity, including the Antifat Attitudes Scale (AFAS) and the Groningen Reflection Ability Scale (GRAS).Didactic content on weight and obesity was delivered through eight video modules, integrated into a required course. Topics included weight regulation physiology, pathophysiology, environmental, and behavioral factors affecting weight. DPT students also participated in 6 weekly 1-hour NM sessions with trained facilitators.Within-subject/group, pre-/post-intervention differences in scores were analyzed using paired t-tests. Spearman correlations and linear regression analysis was performed to determine the relationship between pre-/post-intervention weight bias (AFAS) and reflection (GRAS).

Results

Post intervention, mean AFAS scores decreased [11.70 (2.82) vs. 10.67 (2.95); p=0.0253], indicating lower levels of anti-fat attitudes in 63.3% of participants. Mean GRAS scores increased [91.5 (7.99) vs. 93.2 (7.36); p=0.0284], indicating greater self-reflection. There was no correlation between GRAS and AFAS scores pre- or post-intervention; changes in GRAS did not predict changes in AFAS.

Conclusions

NM sessions with obesity education decreased weight bias and improved levels of self-reflection in DPT students. Small sample size in this pilot limits generalizability. Future directions include increasing group size and further analysis of survey results for factors predicting improvements. Supported by Columbia University CTSA Grant UL1TR001873.