Cambria Garell, MD

Jordan Levinson, PhD

A. Janet Tomiyama, PhD

Background: Children with obesity face weight stigma from their community, families, media, and healthcare providers. Many physicians hold biases against larger-bodied patients. Healthcare related weight stigma negatively affects patients’ quality of life and can have deleterious effects on health.

Objective: Develop and evaluate a weight bias curriculum for pediatric residents using Transformative Learning Theory, with sessions fulfilling the elements of the disorienting experience, critical reflection, acquiring skills, and role modeling new behavior.

Methods: The curriculum contained six didactic, role play, or reflection activities. Learners’ reaction to the curriculum was collected anonymously online immediately after the rotation as well as through a post rotation discussion. Explicit bias using the Fat Attitudes Assessment Toolkit (FAAT) was measured at baseline before the curriculum, immediately after the curriculum, and again 16 weeks post-curriculum. Non-PHABB second year residents served as a comparison group.

Results: 19 second year pediatric residents enrolled in the UCLA Public Health Ambulatory Basics and Beyond (PHABB) track completed the curriculum over two weeks. Residents completed an online anonymous evaluation asking how much they agreed the material was informative, engaging, and delivered effectively on a 5 point Likert scale. Residents (n=17) reported an average score of 4.7 out of 5 for the weight bias curriculum. The averages for all 5 subscales of the FAAT increased from pre- to post-curriculum. Results showed significant differences between PHABB residents’ post-curriculum scores and non-PHABB residents, with PHABB residents reporting higher scores. PHABB and non-PHABB residents’ baseline scores showed significant differences on 3/5 FAAT subscales. 

Conclusion: A weight bias curriculum for pediatric residents using Transformative Learning Theory is well received and may decrease explicit weight bias in pediatric residents.