Addressing weight stigma in healthcare settings using an obesity checklist: a mixed-method development study.

Area of Science:

• Healthcare Inclusivity
• Patient Experience
• Obesity Stigma Reduction

Background:

• Weight stigma negatively impacts health and persists in healthcare settings.
• Hospital environments require enhanced inclusivity for people living with obesity (PLwO).
• Existing healthcare environments often lack adequate provisions for PLwO.

Purpose of the Study:

• To develop and refine a checklist for improving obesity inclusivity in UK National Health Service (NHS) hospitals.
• To incorporate feedback from healthcare professionals (HCPs), researchers, PLwO, and carers/family members (C/FM).

Main Methods:

• Sequential mixed methods approach combining checklist integration, surveys, and qualitative interviews.
• Phase 1: Integrated existing checklists and reviewed language for inclusivity.
• Phase 2 & 3: Gathered feedback from diverse stakeholders via surveys and interviews to refine the checklist and develop implementation recommendations.

Main Results:

• Five existing checklists were integrated into a comprehensive tool covering various hospital aspects.
• Feedback from 69 survey participants and 18 interviewees highlighted themes on checklist components, language, patient impact, and implementation.
• Key barriers included funding, space, infrastructure, and weight bias, while facilitators involved management support, training, and accreditation.

Conclusions:

• A practical, inclusive checklist can help hospitals reduce weight stigma and improve care for PLwO.
• The collaboratively developed checklist provides a tangible tool for enhancing hospital inclusivity.
• Effective implementation requires dedicated support, addressing identified barriers and leveraging facilitators.