DOES WEIGHT BIAS EXIST AMONGST GRADUATE PHYSICAL THERAPY STUDENTS?

S. Elgelid¹, S. Sullivan¹, N. DeMarco¹, K. Cox¹, K. Ortiz¹, C. Guy¹

Background: Research has shown that health care workers often demonstrate a negative bias towards patients who are overweight and obese. The prevalence of weight stigmatization has increased by over 65% in the last decade and is influenced by various factors including level of education, the media, demographics, and environment. Health care employees may develop a weight bias prior to entering their field of interest,  that can impact communication and observation skills resulting in development of an inappropriate plan of care. Students opinions reflected that obese patients were more likely to overeat, have lower self esteem, and were less likely to comply with treatment recommendations. While a few studies have investigated weight stigmas of health care professionals and medical students, there is a gap in research regarding weight biases and stigmas demonstrated by physical therapy students.  We hypothesized that graduate physical therapy students would possess a weight bias.

Purpose: To determine if a weight bias exists among graduate physical therapy students in the United States.

Methods: Between the months of September and October 2016,  students from 6 CAPTE accredited colleges in 8 APTA designated regions of the United States (48 programs) participated in an online self-report survey on qualtrics to assess weight bias. The survey consisted of questions from the NEW attitudes questionnaire and 7 additional questions. SPSS descriptive statistics was used to determine total scores, and analyze answers to the additional 7 questions. Multiple regressions and one way ANOVAs were run to predict associations between total score and age, gender, BMI, body type, clinical experience and region.

Results: One hundred and ninety seven students completed the survey and additional questions, 188 of which were included in the study. Surveys were excluded if questions were omitted. Generally, graduate physical therapy students scores on the NEW Attitudes questionnaire demonstrated a positive attitude towards overweight and obese individuals with scores ranging from -21 to 104  (mean 35.18, SD 20.362), where a positive total score indicated no weight bias (Figure 1). Only six percent of students produced negative scores, indicating they had a weight bias. Data analysis showed a significant difference between BMI and total score, F(1,189)= 5.753, p <0.05, adj R2 = 0.024 (Figure 2). There was no significant difference between total score and age, gender, clinical experience, perception of body type or region.

Conclusion(s): Six percent of graduate physical therapy students possess a weight bias. There is a significant correlation between BMI and total score on the NEW attitudes questionnaire indicating that individuals with a higher BMI may possess a decreased weight bias.
Future studies should explore implicit weight bias of physical therapy students and if weight bias is affected by cultural differences or geographical location between countries or provinces. A prospective study could also examine if there is a point after graduation that physical therapists obtain a weight bias.

Implications: Therapists and students should be aware of their own explicit and implicit biases to prevent detrimental effects on patient care. Employment of a biopsychosocial model may be beneficial to decrease biases prior to graduation.

Funding, acknowledgements: None

Keywords: Weight bias, PT education, Health Biases

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Nazareth College

Committee: HSRC Committee

Ethics number: HSRC #: SP2016-22