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. 2023 Feb 16:57:101855.
doi: 10.1016/j.eclinm.2023.101855. eCollection 2023 Mar.

Effect of health-care professionals' weight status on patient satisfaction and recalled advice: a prospective cohort study

Martin Čadek  1 , Susanne Täuber  2 , Blake J Lawrence  3 , Stuart W Flint  4   5
Affiliations

Effect of health-care professionals' weight status on patient satisfaction and recalled advice: a prospective cohort study

Martin Čadek et al. EClinicalMedicine. .

Abstract

Background: Research has demonstrated that healthcare professionals are not immune to weight stigma attitudes, with evidence showing that people living with overweight or obesity may experience direct and indirect stigma and discrimination. This can impact the quality of care provided and impact patients' engagement in healthcare. Despite this, there is a paucity of research examining patient attitudes towards healthcare professionals living with overweight or obesity, which can also hold implications for the patient-practitioner relationship. Thus, this study examined whether healthcare professionals' weight status impacts patient satisfaction and recalled advice.

Methods: In this prospective cohort study, using an experimental design, 237 participants (113 women, 125 men) aged 32 ± 8.92 with a body mass index of 25.87 ± 6.79 kg m2 were recruited through a participant pooling service (ProlificTM), word of mouth, and social media. The majority of participants were from the UK: 119, followed by participants from the USA: 65, Czechia: 16, Canada: 11, and other countries (N = 26). Participants completed an online experiment consisting of questionnaires assessing satisfaction with healthcare professionals and recalled advice after exposure to one of eight conditions assessing the impact of healthcare professional weight status (lower weight or obesity), gender (woman or man) and profession (psychologist or dietitian). A novel approach to creating the stimuli was used to exposure participants to healthcare professionals of different weight status. All of the participants responded to the experiment hosted on Qualtrics™ in the period from June 8, 2016 to July 5, 2017. Study hypotheses were examined using linear regression with dummy variables and follow up post-hoc analysis to estimate marginal means with adjustment for planned comparisons.

Findings: The only statistically significant result was a difference with a small effect in patient satisfaction, where satisfaction was significantly higher in healthcare professional who was a women living with obesity compared to healthcare professional who was a man living with obesity (estimate = -0.30; SE = 0.08; df = 229; ωₚ2 = 0.05; CI = -0.49 to -0.11; p < 0.001), and healthcare professional who was a women living with lower weight compared to healthcare professional who was a man living with lower weight (estimate = -0.21; SE = 0.08; df = 229; CI = -0.39 to -0.02; ωₚ2 = 0.02; p = 0.02). There were no statistically significant differences in satisfaction of healthcare professionals and recall of advice in the lower weight compared to obesity conditions.

Interpretation: This study has used novel experimental stimuli to examine weight stigma towards healthcare professionals which is vastly under-researched and holds implications for the patient-practitioner relationship. Our findings showed statistically significant differences and a small effect where satisfaction with healthcare professionals both living with obesity and with a lower weight were higher when the healthcare professional was a woman compared to man. This research should act as a stimulus for further research that aims to examine the impact of healthcare professional gender on patient responses, satisfaction and engagement, and weight stigma from patients towards healthcare professionals.

Funding: Sheffield Hallam University.

Keywords: Healthcare; Patient–practitioner relationship; Weight bias; Weight stigma.

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Conflict of interest statement

SWF reports research grants from 10.13039/501100000272National Institute for Health Research, the Office of Health Improvement & Disparities, 10.13039/501100002141Public Health England, Doncaster Council, West Yorkshire Combined Authority, 10.13039/100004331Johnson and Johnson, 10.13039/501100004191Novo Nordisk and the 10.13039/501100000777University of Leeds, personal fees from the 10.13039/100010334Royal College of General Practitioners, Institutional fees from 10.13039/501100002141Public Health England, and support for attendance at meetings from UK Parliament, Novo Nordisk Johnson & Johnson and Safefood. SWF also reports unpaid roles with Obesity UK. MC, SL, and BJL declare no competing interests.

Figures

Fig. 1
Fig. 1
Participant's point of view in the experiment.
Fig. 2
Fig. 2
Satisfaction (Top) and recalled advice (Bottom) towards healthcare professionals (HCPs) with a lower weight (LW) and living with obesity (OB). RAQ = recalled advise questionnaire; H1 = hypothesis 1.
Fig. 3
Fig. 3
Satisfaction (Left) and recalled advice (Right) towards women and men healthcare professionals (HCPs) with a lower weight (LW) and living with obesity (OB). RAQ = recalled advise questionnaire; H2 = hypothesis 2.
Fig. 4
Fig. 4
Comparison of satisfaction by healthcare professional (HCP) profession, weight status and gender. AHCP = Satisfaction questionnaire; Attitudes towards Healthcare Professionals; H3 = hypothesis 3; OB = obesity; LW = lower weight.
Fig. 5
Fig. 5
Comparison of recalled advice by healthcare professionals (HCPs) profession, weight status and gender. RAQ = Recalled advice questionnaire; H3 = hypothesis 3; OB = obesity; LW = lower weight.
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