Grant recipients:
Rhona Hanning, Amanda Raffoul, Rachel Acton, Kirsten Lee, Katie Burns, and Katelyn Godin, School of Public Health and Health Systems
(Project timeline: May 2018-April 2019)
Description
Weight bias and discrimination are highly pervasive; however, there is a severe lack of weight bias education in public health and health care education settings. The current project aims to use innovative approaches to develop (1) a collection of online resources with content related to weight bias that is easily accessible to course instructors, and (2) an online educational module directed at students containing information and resources related to weight bias. Given the current lack of weight-bias education across the faculty of Applied Health Sciences (AHS), developing and promoting these materials for use by instructors and students will ensure strong and consistent weight bias messaging across AHS courses. The project will enhance educator and student knowledge on the gravity and implications of weight bias and stigma.
Research Questions
The purpose of the research project was to develop an online weight bias educational module for both undergraduate students enrolled in health- and weight-related courses offered through the Faculty of Applied Health Sciences (AHS), as well as a complementary module for instructors. Further, we assessed the feasibility of online delivery in regards to content relevance, delivery (specifically elements of interactivity and engagement), and impact. We specifically aimed to answer the following research questions:
- Did participating course instructors find the online module useful and engaging?
- Did students find the online module useful and engaging?
- Should additional content, resources, or activities be provided to further support understanding of weight bias content?
Findings/Insight
We assembled a working group of graduate students and course instructors to guide content development and project implementation. The online module consisted of (1) a 20-minute video; (2) a resource inventory (e.g., links to open-access image banks with non-stigmatizing images of individuals living with obesity); and (3) a 10-minute online survey to evaluate the module and included both quantitative and open-ended questions.
In Fall 2018 and Winter 2019, we piloted the module with six undergraduate health courses in AHS: three first-year introductory courses, one second-year health course, one third-year nutrition course, and one fourth-year kinesiology course. Greater student participation was observed in courses where the instructor integrated the module into their courses (e.g., included it in the course syllabus). Across both study terms, 211 students completed the evaluation survey of the online module. Most students were enrolled in one of four AHS programs (Kinesiology=39%; Health Studies=28%; Recreation & Leisure Studies=12%; and Public Health=6%), while 15% of students reported their program of study as a non-health program. Nearly two-thirds (68%) of the respondents were recruited from an introductory health course that is mandatory for all students enrolled in AHS.
We identified four themes from the thematic analysis of qualitative data: (1) delivery and applicability of weight bias content; (2) online engagement, interaction and delivery; (3) personal takeaways and relevance to health training; and (4) resistance to weight bias content. We have organized relevant quantitative findings according to these four themes.
Theme 1: Delivery and applicability of weight bias content
- Most students agreed or strongly agreed that the module provided useful information about weight bias and stigma (n=174, 82.5%).
- The majority agreed or strongly agreed that the module was easy to understand (n=204, 96.7%).
Theme 2: Online engagement, interaction and delivery
- Three-quarters of students (n=158, 74.9%) felt the 20-minute educational video was just the right length.
- Just over half (n=110, 52.4%) found the video to be engaging/very engaging and kept their attention.
- Close to two-thirds (n=133, 63.0%) found the quizzes and prompts for reflective thinking to be engaging/very engaging and kept their attention.
Theme 3: Personal takeaways and relevance to health training
- Over two-thirds of students (n=143, 68.1%) agreed or strongly agreed that the module was relevant to their program of study.
- Over three-quarters (n=164, 77.7%) agreed or strongly agreed with the importance of using person-first language when discussing overweight/obesity.
- Most (n=183, 86.7%) agreed or strongly agreed that weight bias and stigma are important health problems.
While the majority of respondents did agree or strongly agree that weight bias and stigma are important health problems, a small minority of students disagreed or strongly disagreed with this statement (n=9, 4.2%), signaling a resistance to weight bias content (theme 4) and reinforcing the importance of continued implementation and expansion of this module.
Less than half (n=101, 47.9%) of students agreed or strongly agreed that the module challenged their personal perceptions about weight bias and stigma; however, we did not assess weight-biased attitudes pre- and post- module, therefore this could signal very low weight-biased attitudes among participants or a lack of awareness of implicit weight-biased attitudes. Regardless, future evaluations of this module should aim to elucidate the effectiveness of the module on reducing weight-biased attitudes.
Two of the six participating instructors completed the online evaluation. While their feedback was positive, we have amended our ethics applications to conduct the voluntary evaluation in person (during the Spring 2019 term) to gather as much feedback as possible.
Implications
Through our knowledge translation efforts, we have made connections with leading researchers in the area of weight bias (i.e., presenting at the Canadian Obesity Summit) as well as other public health professionals locally, provincially, and nationally. Further, because of the lack of weight bias related educational material available online, our project has generated interest from others in public health settings.
Our next step is to evaluate this impact of the module among both AHS students and other pre-service health students. This will require continued promotion to other faculties at UW and collaborations with their course instructors. If effective and widely adopted, broad-scale implementation of this online module has the potential to contribute positively to health and wellbeing through the training of weight-sensitive practitioners and the creation of a non-stigmatizing learning environment.