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Development and Psychometric Testing of a Weight Sensitivity Instrument to Assess Weight Bias.

Tracy L Oliver¹, Margaret Brace², Rebecca Shenkman³

¹M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA tracy.oliver@villanova.edu tracy_oliver@hotmail.com.

Journal of Nursing Measurement

|May 11, 2026

Summary

A new tool, the Weight Sensitivity Instrument (WSI), is being developed to measure provider weight bias in healthcare settings. This instrument shows promise in assessing clinical behaviors during patient encounters.

Keywords:

instrument development interprofessional education nursing education weight bias weight prejudice

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Concept Development and Use of an Automated Food Intake and Eating Behavior Assessment Method

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Published on: February 19, 2021

Area of Science:

Healthcare Education
Medical Simulation
Patient Care

Background:

Healthcare settings face increasing efforts to reduce weight bias.
Few tools exist to measure the translation of behavioral improvements into patient care.
Provider weight bias can negatively impact patient outcomes and experiences.

Purpose of the Study:

To develop and refine the Weight Sensitivity Instrument (WSI).
To assess provider weight bias-related clinical behaviors during simulated patient encounters.
To establish the validity and reliability of the WSI.

Main Methods:

WSI item development utilized implicit bias theory, literature review, and e-Delphi expert review.
Pilot testing involved advanced practice nursing students and standardized patients with obesity.
Interrater reliability was assessed using Gwet's AC1 statistic.

Main Results:

Content validity index (CVI) of .91 achieved after expert review.
Initial pilot showed good-to-very-good interrater reliability for 14/20 items.
Revised WSI demonstrated high interrater agreement (Gwet's AC1 > 0.90) for 17/18 items.

Conclusions:

The Weight Sensitivity Instrument (WSI) shows potential for measuring provider weight bias.
Further assessment of WSI validity, reliability, and psychometric properties is warranted.
The WSI can be a valuable tool in healthcare education and practice improvement.