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Phillips J. Weight bias and stigma in healthcare: What are we doing about it? Work 2024; 77:731-733. [PMID: 38393880 DOI: 10.3233/wor-246004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Weight bias and weight stigma is present in healthcare settings negatively affecting people with obesity. Healthcare professionals should be aware of how their potential bias and stigma may be impacting clients with obesity. With obesity projected to rise among the world, the healthcare environment needs to be more accepting and accommodating.
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Halberstadt J, Koetsier LW, Sijben M, Stroo J, van der Velde M, van Mil EGAH, Seidell JC. The development of the Dutch "National model integrated care for childhood overweight and obesity". BMC Health Serv Res 2023; 23:359. [PMID: 37046336 PMCID: PMC10091628 DOI: 10.1186/s12913-023-09284-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/14/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Childhood obesity is a chronic disease with negative physical and psychosocial health consequences. To manage childhood overweight and obesity, integrated care as part of an integrated approach is needed. To realise implementation of this integrated care, practical guidance for policy and practice is needed. The aim of this study is to describe the development of a Dutch national model of integrated care for childhood overweight and obesity and accompanying materials for policy and practice. METHODS The development of the national model was led by a university-based team in collaboration with eight selected Dutch municipalities who were responsible for the local realisation of the integrated care and with frequent input from other stakeholders. Learning communities were organised to exchange knowledge, experiences and tools between the participating municipalities. RESULTS The developed national model describes the vision, process, partners and finance of the integrated care. It sets out a structure that provides a basis for local integrated care that should facilitate support and care for children with overweight or obesity and their families. The accompanying materials are divided into materials for policymakers to support local realisation of the integrated care and materials for healthcare professionals to support them in delivering the needed support and care. CONCLUSIONS The developed national model and accompanying materials can contribute to improvement of support and care for children with overweight or obesity and their families, and thereby help improve the health, quality of life and societal participation of these children. Further implementation of the evidence- and practice-based integrated care while evaluating on the way is needed.
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Grants
- Grant numbers: 324043, 325989, 328544, 329657, 977473, 332401 Dutch Ministry of Health, Welfare and Sport
- Grant numbers: 324043, 325989, 328544, 329657, 977473, 332401 Dutch Ministry of Health, Welfare and Sport
- Grant numbers: 324043, 325989, 328544, 329657, 977473, 332401 Dutch Ministry of Health, Welfare and Sport
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Affiliation(s)
- J Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - L W Koetsier
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - M Sijben
- Sijben Advies, Veghel, The Netherlands
| | - J Stroo
- Department of Healthy Living, Public Health Service (GGD), City of Amsterdam, Amsterdam, The Netherlands
| | - M van der Velde
- Department of Healthy Living, Public Health Service (GGD), City of Amsterdam, Amsterdam, The Netherlands
| | - E G A H van Mil
- Department of Paediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
- Maastricht University, Brightlands Campus Greenport, Venlo, The Netherlands
| | - J C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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van der Voorn B, Camfferman R, Seidell JC, Puhl RM, Halberstadt J. Weight-biased attitudes about pediatric patients with obesity in Dutch healthcare professionals from seven different professions. J Child Health Care 2023:13674935221133953. [PMID: 36861392 DOI: 10.1177/13674935221133953] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Little is known about the prevalence of negative weight-biased attitudes among Dutch healthcare professionals (HCPs) when treating children and adolescents with obesity and whether interdisciplinary differences are present. Accordingly, we asked Dutch HCPs that treat pediatric patients with obesity to complete a validated 22-item self-report questionnaire about their weight-biased attitudes. In total, 555 HCPs participated from seven different disciplines: 41 general practitioners (GPs), 40 pediatricians, 132 youth healthcare physicians, 223 youth healthcare nurses, 40 physiotherapists, 40 dieticians, and 39 mental health professionals. HCPs from all disciplines reported to experience negative weight-biased attitudes among themselves. Pediatricians and GPs scored highest on negative weight-biased attitudes, including frustrations in treating children with obesity, and feeling less confident and prepared to treat children with obesity. Dieticians scored the least negative weight-biased attitudes. Participants from all groups perceived weight bias expressed by their colleagues, toward children with obesity. These findings are comparable to results reported by adult HCPs from other countries. Interdisciplinary differences were found and underscore the need for more research on contributing factors that impact explicit weight bias among pediatric HCPs.
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Affiliation(s)
- Bibian van der Voorn
- Department of Health Science, 1190Vrije Universiteit, Amsterdam, The Netherlands
| | - Roxanna Camfferman
- Department of Health Science, 1190Vrije Universiteit, Amsterdam, The Netherlands
| | - Jacob C Seidell
- Department of Health Science, 1190Vrije Universiteit, Amsterdam, The Netherlands
| | - Rebecca M Puhl
- Rudd Center for Food Policy & Health, Department of Human Development & Family Sciences, University of Connecticut, Hartfort, CT, USA
| | - Jutka Halberstadt
- Department of Health Science, 1190Vrije Universiteit, Amsterdam, The Netherlands
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Puhl RM, Lessard LM, Foster GD, Cardel MI. Patient and Family Perspectives on Terms for Obesity. Pediatrics 2022; 150:190093. [PMID: 36404759 DOI: 10.1542/peds.2022-058204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Parent communication about body weight is a sensitive topic, but limited research has studied youth preferences for words used to talk about their weight with parents. We assessed perspectives of weight-based terminology in 2 racially/ethnically diverse samples of youth and parents. METHODS We collected online survey data from 2 panel survey samples between September and December 2021: youth aged 10 to 17 years (n = 2032) and parents of youth aged 10 to 17 years (n = 1936). Participants rated 27 different terms and phrases to describe body weight; parents reported on their usage of this terminology and youth reported their preferences for and emotional responses to terminology. Patterns were examined across sex, race/ethnicity, sexual orientation, and weight status. RESULTS Youth reported preferences for words such as "healthy weight" and dislike of terms such as "obese," "fat," and "large," which induced feelings of sadness, shame, and embarrassment. Differences in youth preferences and emotional reactions were present across sex, sexual orientation, race/ethnicity, and weight status. This included a general pattern of lower preference ratings among girls (versus boys) and sexual minority (versus heterosexual) youth, and stronger preferences for words such as "thick" or "curvy" among racial/ethnic minority, sexual minority, and higher-weight youth. Use of most weight terms was higher among fathers compared with mothers, and by Hispanic/Latinx parents compared with white and Black/African American parents. CONCLUSIONS Our findings underscore diversity of youth preferences and the need for individualized approaches that support effective parent and youth communication by using their preferred terms when discussing weight-related health.
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Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut.,Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Leah M Lessard
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Gary D Foster
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,WW International, Inc, New York, New York
| | - Michelle I Cardel
- WW International, Inc, New York, New York.,Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida
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Woo S, Song HJ, Kim Y, Lim H, Park KH. Factors associated with the perception of parents and children regarding obesity-related terminology used by healthcare professionals in a sample of Korean children and adolescents with obesity. Obes Res Clin Pract 2022; 16:421-428. [PMID: 35989180 DOI: 10.1016/j.orcp.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/17/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE This study aimed to compare how children with overweight or obesity and their parents perceive the obesity-related terms used by healthcare professionals and investigate the factors associated with these perceptions. METHODS Children and adolescents aged 8-16 years with overweight or obesity (n = 192) and their parents participated in the cross-sectional study by responding to a 5-point Likert-scale questionnaire on 10 obesity-related terms, including "chubby," "weight problem," "weight," "overweight," "BMI," "obese," "heavy," "fleshy," "fat," and "severely obese." RESULTS For both children and parents, "chubby" was the most desirable term (mean ± standard deviation: 3.50 ± 1.12 and 2.95 ± 0.83, respectively), and "severely obese" was the least acceptable term (2.83 ± 1.17 and 2.02 ± 1.02, respectively). Although the parents preferred all the terms less than the children did (p < 0.001), "weight problem" was considered most motivating for a child to lose weight (3.93 ± 0.94). Among children, older age and a larger self-perceived body size were associated with a more positive response towards obesity-related terms, whereas having internalized or externalized problems were negatively associated with these terms. Parents with a history of cardiovascular disease considered "severely obese" (β = -0.419, [95% CI: -0.739, -0.099]) and "fat" (β = -0.457, [95% CI: -0.750, -0.164]) less desirable. CONCLUSIONS Children and adolescents had a higher preference for obesity-related terms than their parents and preferred that healthcare professionals use euphemistic terms such as "chubby," or neutral terms such as "weight problem." Children with larger self-perceived body sizes or older age had a higher preference for obesity-related words. The terms used by healthcare professionals to describe excess weight must be motivating and respectful for all family members participating in the treatment.
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Affiliation(s)
- Sarah Woo
- Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon-si, Gangwon-do 24252, Republic of Korea.
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do 14068, Republic of Korea.
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon 21983, Republic of Korea.
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea.
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do 14068, Republic of Korea.
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Eilander MMA, van Mil MMA, Koetsier LW, Seidell JC, Halberstadt J. Preferences on how to measure and discuss health related quality of life within integrated care for children with obesity. J Patient Rep Outcomes 2021; 5:106. [PMID: 34648095 PMCID: PMC8517052 DOI: 10.1186/s41687-021-00381-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/26/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Childhood obesity can affect physical as well as psychosocial wellbeing. Therefore, childhood obesity care aims to improve all dimensions of health related quality of life (HRQoL). HRQoL can be measured with the generic questionnaire PedsQL4.0 and the weight-specific IWQOL-Kids. In the Netherlands, HRQoL assessment is conducted by the coordinating professional (CP). The aim of this qualitative study was to examine how and when to implement the measurement and discussion of HRQoL using the PedsQL4.0 and IWQOL-Kids within the integrated care for children with obesity in the Netherlands. Semi-structured interviews were conducted with fourteen CPs, in which the following was discussed: a) familiarity and attributions with regard to the assessment of HRQoL; b) wishes and needs with regard to the usage of the questionnaires; c) its practical incorporation. RESULTS Interviews revealed that most CPs gained insight into the HRQoL by talking with families. One CP used the PedsQL4.0, the remaining CPs were unfamiliar with the two questionnaires. Even though some barriers, for instance a lack of time, might hinder the implementation of the PedsQL4.0 and IWQOL-Kids, all participants think the usage of either one or both questionnaires would have additional value to the support and care for children with obesity. There was no consensus about the questionnaire of preference. CONCLUSIONS When the right preconditions are met, HRQoL questionnaires have the potential to support CPs in improving the care for children with obesity, tailored to each individual child.
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Affiliation(s)
- Minke M A Eilander
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Marieke M A van Mil
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leandra W Koetsier
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jutka Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Auckburally S, Davies E, Logue J. The Use of Effective Language and Communication in the Management of Obesity: the Challenge for Healthcare Professionals. Curr Obes Rep 2021; 10:274-281. [PMID: 34003446 PMCID: PMC8408082 DOI: 10.1007/s13679-021-00441-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Initial conversations about weight with patients are important to set the tone for future dialogue and management of obesity. There is often reluctance in raising the topic of overweight or obesity in consultations. We aimed to evaluate literature to discover the perceived barriers to optimal discussion about weight status and preferred weight-based terminology for adults, adolescents and parents of younger children. RECENT FINDINGS Fear of offending patients, insufficient training and lack of knowledge of referral pathways were identified as factors hindering healthcare professionals' ability to discuss weight with patients. Neutral terms, such as 'weight', were preferred by patients, with 'fat' and 'obese' viewed as undesirable and stigmatising words. There is a need for greater support and provision of specific training, including education on communicating weight status, for those involved in the management of obesity. More research is necessary to assess the impact of interventions to improve initial discussions with patients about weight.
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Affiliation(s)
- Sameera Auckburally
- Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK.
- Department of Paediatrics, Blackpool Victoria Hospital, Whinney Heys Rd, Blackpool, FY3 8NR, UK.
| | - Elena Davies
- Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK
| | - Jennifer Logue
- Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK
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