15

physiologists, weight management programs, and support groups, as appropriate. ü Promote self-acceptance and encourage patients to lead a full and active life. Examples of specific and obtainable healthy behavior change goals for patients: When dining out, order grilled instead of fried items Replace sodas and juice drinks wth water Avoid eating while watching television Practice eating more slowly Take the stairs instead of the elevator as much as possible Walk 15 extra minutes – 5 days per week Park farther away from store entrances and walk Keep a food & physical activity diary for 3 days, then discuss it with a dietitian or other health professional 6 Part 5: Case Example: Tom Please read the case example and consider the questions to the right. Tom is 47 years old and weighs 357 pounds. He arrives at the office, and after checking in with the receptionist, he looks for a place to sit in the waiting room. He notices that all the chairs in the office are narrow and have armrests. His knees are hurting him and he can’t continue to stand, so he awkwardly squeezes himself into the nearest chair. When the nurse calls his name, she leads him to a scale in the hallway and asks him to get on it. Tom hesitates – he is ashamed of his weight and doesn’t feel comfortable being weighed where others might pass by. Not wanting to draw attention to himself, he reluctantly steps on the scale. To his humiliation, the scale only weighs up to 350 lbs. The nurse shakes her head and notes 350+ lbs. on his chart. The nurse then leads him into a small exam room where he struggles to take a seat on the narrow table. She reaches for the blood pressure cuff, then realizing her mistake, says, “One moment, I have to go get the big cuff.” When she returns and takes his blood pressure, it is 160/90. She comments, “Your pressure is too high, you’re going to have to do something about that.” By the time the doctor arrives to see him, Tom is feeling anxious and frustrated, wishing he was someplace else. He tells the doctor the reason for his visit – he is experiencing worsening knee and back pain. The doctor begins to discuss a plan for addressing his pain and his elevated blood pressure, including losing weight through diet and exercise. But Tom doesn’t want to listen. He asks his doctor for a prescription and leaves the office as quickly as possible. 1. What changes could be made to the office environment that might prevent Tom from becoming distressed? 2. How might this experience at the doctor’s office change Tom’s future health care utilization? 3. What kind of training could the doctor provide for his office staff to help them interact with obese patients more sensitively? 4. How could experiencing a more positive interaction with the nurse make Tom amenable to a discussion about diet and exercise with his doctor? 7 Part 5: Resources The Rudd Center for Food Policy and Obesity has created several free educational online resources about weight bias for health care providers and medical students. We encourage you to use these resources or share them with colleagues and students. This 17-minute video explains the nature and consequences of weight bias in health care settings, and summarizes strategies to reduce bias in patient care. In two published studies,9,10 medical trainees who watched this video improved attitudes and beliefs about patients with obesity, and decreased negative stereotypes about patients with obesity. EDUCATIONAL VIDEO This toolkit provides clinicians across various practice settings with easy-to implement solutions and resources to improve delivery of care for patients with overweight and obesity. They range from simple strategies to improve patientprovider communication and ways to make positive changes in the office environment, to profound ones, including self-examination of personal biases. TOOLKIT FOR CLINICIANS o To watch this video, please click here. o You may also request a free DVD copy of this video by e-mailing Young Suh at young.suh@uconn.edu o To access the toolkit, please click here. 8 Printable Resources Thank you for completing this course! We thank you for taking the time to complete this course in an effort to increase your awareness of weight bias in health care settings. We hope that the information and strategies provided throughout this course will be helpful to you in your clinical practice. Due the growing prevalence of overweight and obesity, weight bias is an important clinical concern for all health care providers. Please visit www.uconnruddcenter.org for more information on weight bias For Providers: 1) Assessing Weight Bias with Validated Measures 2) Checklist for Assessing the Office Environment 3) Promoting a Positive Office Environment for Patients with Obesity 4) Motivational Interviewing Strategies 5) Motivational Interview Example Scripts For your Patients: 1) How to be Informed and Assertive 2) How to Talk with your Doctor 3) Talking to your Doctor about your Weight 4) If you are the Target of Weight Bias For Pediatricians: 1) Pediatricians: How to Talk to Parents For Parents: 1) How to Talk to your Child about Weight 2) How to Talk to your Child about Weight Bias 3) Information about Weight Bias 4) Is your Child the Target of Weight Bias?