Presentations

Abstract

Introduction: Excess weight is a well-documented risk factor for developing many chronic conditions, including coronary heart disease, hypertension, type 2 diabetes, gallbladder disease, osteoarthritis, cataracts, certain types of cancers, asthma and obstructive sleep apnea, and even cognitive decline such as in Alzheimer's disease. Although weight loss in at-risk obese populations is associated with improvements in cardiometabolic health, it is usually followed by progressive regain and weight cycling, which has also been associated with an increased risk of cardiovascular events. Further nuance has been introduced by recent studies that emphasize substantial heterogeneity in metabolic health amongst moderately obese individuals, proposing that some individuals with obesity do not exhibit metabolic disorders traditionally associated with excess weight, such as insulin resistance, hypertension, and dyslipidemia. Because of the intricate ways that genetics, lifestyle, and environment affect body weight and the development of health outcomes, some propose that weight management intervention strategies should be tailored to individuals' metabolic profiles rather than a blanket approach for all overweight or obese people. Thus, physicians' comfort level in discussing issues of body weight and weight loss in an appropriately sensitive manner is paramount to improving patient health outcomes and strengthening patient-physician relationships. Unfortunately, historical studies have shown that healthcare providers and medical students display implicit bias against obese patients and are reluctant to devote time to discussing weight management strategies; recent studies have shown providers have a fear of offending patients and feel they have been insufficiently trained to discuss weight with patients comfortably. Training directed at developing knowledge, acknowledging and eliminating implicit biases, and improving communication skills, such as judging patient readiness and approaching sensitive topics, could bolster providers' confidence in initiating patient-centered conversations about body weight and weight loss in the clinical setting.

Methods: Participants: Participants will consist of current third-year medical students from Eastern Virginia Medical School (EVMS) who are completing their family medicine (FM) clerkship during the 2024-2025 academic year. The FM clerkship is six weeks long. Alteration to current curriculum: Students will have a lecture delivered on the first day of their second week within their FM clerkship that discusses the data on implicit bias among medical students, bias' relationship to discussions about weight loss, ways to recognize bias, what to do about bias, and a template for discussing weight loss. Data collection: During the lecture, the students will be asked a Likert-style question about their comfort when discussing weight loss. Answers will be recorded with no identifiers. During the sixth and last week of the clerkship, students will complete a survey with the same question about their level of comfort and additional questions to determine which aspects (if any) of the presentation students found useful. Students will not be asked to add any identifiers during the second survey. Data Analyses: Data will be analyzed using descriptive statistics and chi-square tests on Microsoft Excel, which will compare student comfort levels across the Likert scale before and after the implementation of the lecture. Statistical significance will be defined as p<0.05. Statistically significant differences in the frequency of students that answer "Somewhat comfortable" or "Very comfortable" will confirm the presentation had a positive effect. We will also record additional feedback we receive in the post-intervention survey. Data Safety: Only the investigators will have access to the deidentified RedCap data, which will be deleted after the study is completed. Data Collection Tools: • Pre-intervention question • Post-intervention survey

Results: Study is currently ongoing. Results will be available later this academic year.

Conclusion: Study is currently ongoing. Results will be available later this academic year.