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Hassan A, Kerr DA, Begley A. 'It's Just Not Working', a Qualitative Exploration of the Weight-Related Healthcare Experiences of Individuals of Arab Heritage With Higher Weight in Australia. Health Expect 2024; 27:e14134. [PMID: 38967878 PMCID: PMC11225603 DOI: 10.1111/hex.14134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Culturally and linguistically diverse population groups disproportionately experience higher weight and other non-weight-related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight-related healthcare experiences of individuals of Arab heritage with higher weight in Australia. METHODS A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribed and thematically analysed. RESULTS Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8) and all were Muslim (n = 15). Four main themes were identified: (1) appearance-based judgement, (2) generalised advice and assumptions, (3) cultural responsiveness and (4) healthcare system constraints. CONCLUSION Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight-inclusive and acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reform and weight-inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holistic and culturally safe care. PATIENT OR PUBLIC CONTRIBUTION Insights gained from conversations with Arab heritage community members with lived experiences regarding weight-related healthcare encounters informed the study design and approach.
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Affiliation(s)
- Amira Hassan
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- Curtin Health Innovation Research InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Deborah A. Kerr
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- Curtin Health Innovation Research InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Andrea Begley
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- Curtin Health Innovation Research InstituteCurtin UniversityPerthWestern AustraliaAustralia
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Mihalache L, Popa AD, Gherasim A, Nita O, Graur M, Rosu OM, Arhire LI. Assessing Weight Stigma: Validating Attitudes and Beliefs Questionnaires Among Future Healthcare Professionals. Cureus 2024; 16:e66345. [PMID: 39113816 PMCID: PMC11304508 DOI: 10.7759/cureus.66345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 08/10/2024] Open
Abstract
Background This study aimed to establish the reliability and validity of the Anti-Fat Attitudes (AFA) questionnaire and the Beliefs About Obese Persons (BAOP) scale. Methodology A convenience sample of 257 students from three distinct sections of the University of Medicine and Pharmacy "Grigore T. Popa" Iasi (Medical Faculty, Nutrition and Dietetics, and Nursing) participated in an observational study. Construction validity was tested with exploratory factor analysis. The students completed a form containing sociodemographic data, the AFA questionnaire, and the BAOP scale. Weight and height were self-reported and used to determine the body mass index. Results The value of the Cronbach alpha coefficient for the AFA questionnaire indicated adequate internal consistency (0.862). The exploratory factor analysis identified the following three factors corresponding to the original questionnaire: Dislike, Fear of Fat, and Willpower. We validated a single-factor structure of the BAOP scale, which had adequate internal consistency (0.781). There were statistically significant differences (AFA: p = 0.02; BAOP: p = 0.03) between the scores of the students from Nutrition and Dietetics, Nursing, and General Medicine. Conclusions This study demonstrated that the AFA questionnaire and the BAOP scale could be used to evaluate weight stigma in healthcare students, providing a useful tool to assess the effects of weight stigma awareness interventions in this population.
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Affiliation(s)
- Laura Mihalache
- Internal Medicine II, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, ROU
| | - Alina Delia Popa
- Internal Medicine II/Nursing, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, ROU
| | - Andreea Gherasim
- Internal Medicine II, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, ROU
| | - Otilia Nita
- Internal Medicine II, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, ROU
| | - Mariana Graur
- Internal Medicine, University "Ștefan cel Mare" of Suceava, Suceava, ROU
| | - Oana Madalina Rosu
- Internal Medicine II, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, ROU
| | - Lidia Iuliana Arhire
- Internal Medicine II, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, ROU
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McGrath A, Lambe B, Matthews E, McDonnell K, Harrison M, Kehoe B. Determinants of physical activity promotion in primary care from the patient perspective of people at risk of or living with chronic disease: a COM-B analysis. BMC PRIMARY CARE 2024; 25:190. [PMID: 38807071 PMCID: PMC11134685 DOI: 10.1186/s12875-024-02440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/22/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Chronic disease (CD) accounts for more than half of the overall global disease burden and physical activity (PA) is an established evidence-based strategy for the prevention and management of CD. Global policy emphasises the value of embedding PA into primary healthcare, highlighting the positive effects on PA behaviour. However, there is limited implementation of PA protocols in primary care, and research is needed to guide its integration into routine practice. The voice of the patient is underrepresented in the literature, resulting in the absence of critical insights into determinants of PA promotion in primary care. The purpose of the research was to identify the perspectives of people at risk of or living with CD on the determinants of PA promotion in primary care and to map these determinants across the six COM-B constructs. METHODS Semi-structured interviews (n = 22), guided by the COM-B model were conducted with people aged 35-60 years, at risk of or living with CD and not meeting the PA guidelines. A hybrid analytic approach of thematic inductive and deductive analysis was applied to the participant transcripts guided by a COM-B informed coding framework. RESULTS In total, 37 determinants across constructs related to capability, opportunity and motivation were prominent, examples include; physical capability constraints, the conflation of exercise with weight management, credibility of the health services in PA advice, communication styles in PA promotion, expectations of tailored support for PA, social support, accessibility, and integration of PA into routine habits. CONCLUSION Exploring the determinants of PA promotion through the lens of the COM-B model facilitated a systematic approach to understanding the primary care user perspective of the healthcare professional (HCP) broaching the topic of PA. Findings emphasise the value of HCPs being supported to broach the issue of PA in a therapeutic and patient-centred manner using diverse and flexible approaches, while highlighting the importance of tailored, accessible PA opportunities that build self-efficacy and foster social support. The research provides valuable learnings to support PA promotion and the development of strategies in primary care through encompassing the perspective of those living with or at risk of CD.
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Affiliation(s)
- Aisling McGrath
- Centre for Health Behaviour Research, Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Barry Lambe
- Centre for Health Behaviour Research, Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland.
| | - Evan Matthews
- Centre for Health Behaviour Research, Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Karolyn McDonnell
- National Centre for Men's Health, South East Technological University, Carlow, Ireland
| | - Michael Harrison
- Centre for Health Behaviour Research, Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Bróna Kehoe
- Centre for Health Behaviour Research, Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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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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Madsen M, Michaelsen L, DeCosta P, Grabowski D. Stigma-Generating Mechanisms in Families Enrolled in a Pediatric Weight Management Program: A Qualitative Study of Health Identities and Healthcare Authenticity. CHILDREN (BASEL, SWITZERLAND) 2023; 11:46. [PMID: 38255360 PMCID: PMC10813986 DOI: 10.3390/children11010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
In recent years, there has been increased awareness of obesity as a condition that carries a high level of stigma, as well as growing recognition of its prevalence and harm. Despite the increasing body of research on this topic, there is a gap in the literature regarding mechanisms that generate or exacerbate perceptions of weight stigma, especially within families and pediatric healthcare settings. The present study aims to identify potential stigma-generating mechanisms by focusing on inter-relational dynamics within these contexts. We conducted in-depth, semi-structured interviews with 11 families and analyzed the data by applying sociological theories on health identities and authenticity. Our study found four themes that represent potential stigma-generating mechanisms by being explicitly related to familial health identities and healthcare authenticity: (1) negotiating and reconstruction familial self-understanding, (2) between guilt, shame and conflicts, (3) navigating weight perceptions, and (4) the necessity of positivity and relevance. Our study shows the complexities of weight stigma within family and pediatric healthcare settings, emphasizing the need for sensitive and tailored support, as well as the value of working authentically as crucial aspects in preventing and/or reducing stigma.
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Affiliation(s)
- Mie Madsen
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; (P.D.); (D.G.)
| | - Lene Michaelsen
- The Centre for Children and Youths Health, Mimersgade 47A, 2nd Floor, 2200 Copenhagen, Denmark;
| | - Patricia DeCosta
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; (P.D.); (D.G.)
| | - Dan Grabowski
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; (P.D.); (D.G.)
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Langenbach BP, Thieme A, van der Veen R, Reinehr S, Neuendorff NR. Attitudes towards sex workers: a nationwide cross-sectional survey among German healthcare providers. Front Public Health 2023; 11:1228316. [PMID: 37744482 PMCID: PMC10513093 DOI: 10.3389/fpubh.2023.1228316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Background Worldwide, sex workers face stigmatization and discrimination, also within healthcare. Only few studies on healthcare providers' attitudes towards care of sex workers have been performed. This study assessed attitudes and knowledge of healthcare providers in Germany towards sex workers and their specific health risks. Methods German healthcare professionals and medical students were invited to participate in a nationwide cross-sectional study in 2022. The online survey used a German translation of the "Attitudes towards Prostitutes and Prostitution Scale" by Levin and Peled for assessment of attitudes towards sex work and workers, together with prevalence estimates of common mental and physical disorders. Results A total of 469 questionnaires were included into analysis. Older participants tended to regard sex work as less of a choice (p < 0.004) and sex workers as more victimized (p < 0.001). The frequency of professional contact to sex workers neither affected the perception of sex workers' status as victims vs. independent individuals, nor the perceived moral status. Moreover, healthcare professionals overestimated the prevalence of various disorders which was influenced by participants' attitudes towards sex workers. Discussion A comparison to a recent Allensbach survey demonstrated similar attitudes of healthcare providers and the general population towards sex workers. Our results suggest that German healthcare professionals are not free of prejudices against sex workers, as has been shown for other marginalized groups in society. Instead, they seem to be influenced by personal opinion rather than by objective facts which they should have acquired during their professional education. Future interventions (e.g., better training regarding marginal societal groups) are necessary to encounter these issues in order to improve healthcare for sex workers.
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Affiliation(s)
- Benedikt P. Langenbach
- Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Thieme
- Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Raquel van der Veen
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sabrina Reinehr
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Nina R. Neuendorff
- Department of Haematology and Stem Cell Transplantation, University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Hufelandstr, Essen, Germany
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Goh GBB, Tham KW. Combating obesity: a change in perspectives. Singapore Med J 2023; 64:153-154. [PMID: 36876620 PMCID: PMC10071856 DOI: 10.4103/singaporemedj.smj-2023-043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- George Boon Bee Goh
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Kwang Wei Tham
- Singapore Association for the Study of Obesity; Endocrinology Services, Woodlands Health, Singapore
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