Unspoken: Decreasing Attitudes of Stigma Towards Obese Women By Healthcare Providers

There is evidence of significant implicit and explicit bias towards obese individuals by health care providers (Sabin, Marini, & Nosek,2012). Goffman’s theory of stigma states that when a person is perceived different from others in a negative way, they become discounted as a full person. Stigma is a relationship between an attribute and a stereotype (Goffman, 1963). Adult obese women may delay or avoid gynecological care due to stigma secondary to implicit or explicit bias of health care providers, exacerbated by societal stigma, resulting in decreased empathy caused by lack of knowledge and training about the care of obese women (Mold & Forbes, 2013).

This will be a quality improvement project with a pre and post test of explicit and implicit bias of health care providers in an OB/GYN practice. The post-test will be conducted after an intervention that includes provider education on improving the environment of care for obese women as well as viewing a video of obese women’s experience of stigma and bias in the health care setting. Data about explicit and implicit bias will be collected from providers. Demographic data about providers will be collected including professional role, age, gender, years of practice, race, ethnicity, and BMI. The Implicit Association Test for obesity and the Anti-fat Attitudes Test for explicit bias will be administered pre and post intervention. The Implicit Association test has been validated by a multitrait, multimethod validation that has found the instrument to be a credible measure of implicit attitudes (Nosek and Smyth, 2007). The Antifat Attiudes Test of explicit bias has 47 items in 3 major categories found to have r values>.60 validating the acceptable quality of this instrument (Lewis, Cash, Jacobi, & Bubb-Lewis,1995). Data will be collected and the educational intervention will be facilitated over approximately 1 month at a chosen OB/GYN practice.

 The goal of this project is to improve the quality of care and empathy towards obese women by health care providers in an OB/GYN practice through provider education about experience of obese women who receive healthcare and provision of resources to improve comfort and quality of care to obese women in an OB/GYN practice.