Supplementary Material for: The effect of an education module to reduce weight bias among medical centers employees: A randomized controlled trial

Introduction: Weight bias, stigma, and discrimination are common among healthcare professionals. We aimed to evaluate whether an online education module affects weight bias and knowledge about obesity in a private medical center setting. Methods: An open-label randomized controlled trial was conducted among all employees of a chain of private medical centers in Israel (n=3,290). Employees who confirmed their consent to participate in the study were randomized into intervention or control (i.e., 'no intervention') arms. The study intervention was an online 15-minute educational module that included obesity, weight bias, stigma, and discrimination information. Questionnaires on Anti-Fat Attitudes ('AFA'), fat-phobia ('F-scale), and beliefs about the causes of obesity were answered at baseline (i.e., right before the intervention), 7-days, and 30-days post-intervention. Results: A total of 506, 230, and 145 employees responded to the baseline, 7-day, and 30-day post-intervention questionnaires, respectively. Mean participant age was 43.3±11.6 years, 84.6% were women, and 67.4% held an academic degree. Mean F-scale scores and percentage of participants with above-average fat-phobic attitudes (≥3.6) significantly decreased only within the intervention group over time (P≤0.042). However, no significant differences between groups over time were observed for AFA scores or factors beliefs to cause obesity. Conclusions: A single exposure to an online education module on weight bias and knowledge about obesity may confer only a modest short-term improvement in medical center employees fat-phobic attitudes toward people with obesity. Future studies should examine if re-exposure to such intervention could impact weight bias, stigma, and discrimination among medical center staff in the long-term.

研究背景：医护人员群体中普遍存在体重偏见、污名化与歧视现象。本研究旨在评估在线教育模块在私立医疗中心场景下，对医护人员体重偏见及肥胖相关认知的影响。

研究方法：本研究针对以色列某连锁私立医疗中心的全体员工（n=3290）开展了一项开放标签随机对照试验（open-label randomized controlled trial）。签署知情同意书参与本研究的员工被随机分配至干预组或对照组（即"无干预"组）。本次干预采用时长15分钟的在线教育模块，内容涵盖肥胖、体重偏见、污名化及歧视相关知识。研究分别在干预前（基线）、干预后7天及30天，对受试者开展反肥胖态度量表（Anti-Fat Attitudes, AFA）、肥胖恐惧量表（fat-phobia, F-scale）及肥胖成因认知相关问卷的调研。

研究结果：最终共有506名、230名及145名员工分别完成基线、干预后7天及30天的问卷调研。受试者平均年龄为43.3±11.6岁，其中84.6%为女性，67.4%拥有学术学位。随时间推移，仅干预组的F量表平均得分及具有高于平均水平肥胖恐惧态度（≥3.6）的受试者占比出现显著下降（P≤0.042）。但两组在随访期间的AFA得分及肥胖成因认知方面均未出现显著组间差异。

研究结论：单次接触体重偏见与肥胖相关知识的在线教育模块，仅能对医疗中心员工针对肥胖人群的肥胖恐惧态度带来轻度短期改善。未来研究可进一步探讨重复开展此类干预，能否长期改善医疗人员群体的体重偏见、污名化及歧视行为。