Factors Affecting the Unconscious Bias of Healthcare Professionals in Obesity Care
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Published on: June 21, 2019
Jana Makuc1,2, Ana Ogrič Lapajne3, Špela Hvalec4
1Topolšica Hospital, Topolšica 64, 3326 Topolšica, Slovenia.
Abstract:
Background/Objectives: To assess the factors affecting the unconscious bias of healthcare professionals (HCPs) in obesity care. Methods: A cross-sectional, non-interventional, descriptive study collecting data via an online survey system was distributed via e-mail to 11,597 members of the Medical Chamber of Slovenia. Physicians were assigned into six HCP categories: (junior) resident physicians, primary care physicians (PCPs), internal medicine specialists, surgeons, dentists, and others. The online questionnaire was active for two weeks. Results: A total of 1248 physicians opened the survey link (10.8% response rate). Of the 898 physicians that engaged in the survey, 789 fully completed the questionnaire. Out of those physicians, 93.6% agreed that obesity is a disease, 83.7% were familiar with the definition, and 75.5% of HCPs were professionally interested in the subject. Overall, 39% of HCPs use the ICD obesity code, primarily primary care physicians and specialists in internal medicine. Notably, 82.0% of HCPs identified lifestyle change as the most effective intervention and believed that patients could lose weight with a serious attempt at a lifestyle change. This belief was particularly supported by male HCPs and HCPs under 40 years of age, who felt that patients were entirely responsible for their weight. The unconscious bias decreased with an increase in the HCPs' body mass index (BMI), but at the same time, physicians with a higher BMI found obesity to be less important than other diseases (p = 0.036). Using composite answers, we found that the unconscious bias of HCPs toward obesity and effective obesity care was significantly related to gender (p = 0.017), age (p < 0.001), and BMI (p = 0.005), and was independent of an area of expertise. Conclusions: HCPs' area of expertise impacted their professional standpoint (suggesting conscious bias), whereas male gender, a younger age, and a lower BMI affected unconscious bias toward obesity and its effective care. Despite their limitations, including the self-reported nature of the data, our findings can help to individualize educational strategies and create a more equitable environment in obesity healthcare.
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