• Author
    Leah Stevens
  • Discovery PI

    Cambria Garell, MD

  • Project Co-Author

  • Abstract Title

    Reducing Weight Bias in Pediatric Clinical Documentation: Impact of a Resident Weight Stigma Curriculum

  • Discovery AOC Petal or Dual Degree Program

    Healthcare Improvement & Health Equity Research

  • Abstract

    Background: Weight stigma in healthcare is associated with adverse outcomes such as healthcare avoidance, missed diagnoses, continued weight gain, body dissatisfaction, and disordered eating. With open notes, stigmatizing language in clinical documentation may further contribute to patient harm. There is limited data evaluating whether educational interventions for weight bias can elicit meaningful behavior change among providers. This study evaluates whether a resident-focused weight stigma curriculum reduces the use of stigmatizing language in pediatric clinical documentation.

    Methods: We developed a chart review tool using literature identifying stigmatizing weight-based language and clinical expertise. Using this tool, we conducted retrospective chart reviews of pediatric outpatient visit notes written by five second-year pediatric residents who completed the weight stigma curriculum at UCLA. For each resident, ten pre-curriculum and ten post-curriculum notes from the 2024–2025 academic year were analyzed. The primary outcome was the frequency of stigmatizing language per note. Mean language counts per resident were compared pre- and post-intervention using a paired t-test.

    Results: A total of 100 encounters were analyzed. Patient ages ranged from 2 to 18 years. Overall, 51% of patients had a BMI ≥85th percentile. The number of stigmatizing language instances per note ranged from 0 to 11 pre-intervention and 0 to 9 post-intervention. “Obesity/obese” used as a diagnosis was the most frequently documented term. The mean number of stigmatizing language instances per note decreased from 2.40 (SD 1.23) pre-intervention to 1.15 (SD 0.76) post-intervention, representing a mean reduction of 1.24 instances (95% CI: −1.01 to 3.50). This difference was not statistically significant (p = 0.201).

    Conclusion: Implementation of a weight stigma curriculum was associated with reduced stigmatizing language in clinical documentation. These preliminary findings suggest educational interventions may promote behavior change. Future work will include additional resident cohorts and a control group to further evaluate impact.

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