Weight Bias Reducation Intervention With Nursing Students Using Simulation: The BRAVE Study
ConditionWeight Bias
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-35
SponsorVillanova University
About this trial
This randomized controlled trial will be a curriculum-embedded weight sensitivity training program. There will be two groups. The control group will receive the standard obesity lecture (SOL) and the intervention group will receive the BRAVE Intervention (BRAVE: Building Respect and Acceptance through Valuing Everybody); a Weight Bias Reduction (WBR) intervention. Both groups will have two simulation encounters with standardized patients who are living with obesity and the outcome will be to improve weight bias and increase weight sensitivity over one year. Participants will include second- and fourth-year nursing students. Two cohorts of nursing students will be recruited over two years during orientation for their NUR courses (n = 368); a combined total of 420 students are typically enrolled in these courses. Study participants will be randomized by 8-person simulation groups (clusters) to either the BRAVE intervention or SOL control group. They will then participate in the two simulation-based experiences and weight bias reduction education or standard obesity lecture, respectively, with a debriefing segment and educational components. To compare the efficacy of BRAVE groups to SOL groups in validated questionnaires will assess changing attitudes, beliefs, and clinical communication behaviors when comparing baseline to 3 months post-intervention, and one year after the intervention.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Nursing students aged 18-35
Nursing students during their second or fourth year of the traditional or FLEX BSN undergraduate curriculum (in specified nursing courses)
Disqualifiers
Non-nursing students
Nursing students taking courses out of the normal curriculum sequence
Nursing students who are not of traditional undergraduate ages (18-35 years)
Students who decline to consent
Trial design
Design model
Parallel
Treatments tested in this trial
BRAVE
BehavioralIn addition to the two simulation encounters, the BRAVE arm will include an initial one-hour educational presentation on weight bias in health care; prevalence, and influences of weight bias on health/health care, factors affecting obesity, approaching weight-related discussions with patients with sensitivity and empathy, and effective communication strategies. Clinical communication behaviors will also be taught, such as asking permission, using non-stigmatizing language, and engaging in judgment-free weight-related discussions with patients. They will also have role-play and case-study scenarios to integrate and practice the communication strategies. Following the second simulation and DML, students in the BRAVE arm will participate in a continuation of the weight bias reduction education including concepts of Motivational Interviewing, Shared Decision Making, and weight management conversations to prevent weight bias in the clinical environment.
SOL: Standard Obesity Lecture
BehavioralSOL: (Standard Obesity Lecture) SOL arm education will include a presentation on obesity as a disease, its prevalence, causes, health risks, psychological and socioeconomic impact, and a standard obesity assessment. Following the second simulation, students in the SOL groups will participate in a continuation of the standard obesity education to build on concepts from session 1. The second presentation will be a recap on weight management in clinical practice. Readings will focus on the medical consequences of obesity, and the economic cost of obesity. Both Debriefing for Meaningful Learning segments will focus on the disease itself and not include components of obesity or body weight.
Treatment groups
368 Participants
are divided into 2 treatment groupsGroup A: BRAVE InterventionExperimental treatment 1 intervention
Group B: SOLPlacebo comparator 1 intervention
Trial outcomes
Primary outcomes
1
Attitudes Towards Higher Weight Persons (ATOP-HW)
Estimated Mean Change Score.The ATOP-HW is a 20-item Likert rating scale that focuses on perceptions and attitudes about people living with obesity. Higher scores reflect more positive attitudes toward persons with obesity.
Time frame
Baseline to 3 Months2
Beliefs About Obese Persons Scale (BAOP)
The BAOP is an eight-item Likert rating scale that assesses beliefs about the causes of obesity. Each question asks individuals to indicate the extent of agreement or disagreement (+3 to -3) to a specific statement, such as "obesity is really caused by a lack of willpower." Higher scores indicate beliefs that obesity is not controllable.
Time frame
Baseline to 3 Months3
SE-12 (Self-Efficacy) Scale
The SE-12 is a 12-item questionnaire assessing self-efficacy by clinicians in clinical communications.
Time frame
Baseline to 3 MonthsSecondary outcomes
1
SEGUE Framework
The SEGUE Checklist is a valid and reliable checklist designed to be used in various settings to teach, assess, and improve communication skills with medical providers.The SEGUE acronym stands for Set the Stage, Elicit information, Give information, Understand the patient's perspective, and End the encounter. SEGUE includes a 25-item dichotomous checklist to evaluate whether a task was completed.
Time frame
Baseline and 3 Months2
Weight Sensitivity Instrument (WSI)
The WSI is a 15-item checklist that will assess aspects of physical assessment skills, patient psychological safety, and weight sensitivity of the session.
Time frame
Baseline and 3 Months3
Attitudes Towards Higher Weight Persons (ATOP-HW) Questionnaire
The ATOP-HW is a 20-item Likert rating scale that focuses on perceptions and attitudes about obese people. Higher scores reflect more positive attitudes toward persons with obesity.
Time frame
Baseline to 1 Year; 3 months to 1 Year4
Beliefs About Obese Persons Scale (BAOP)
The BAOP is an eight-item Likert rating scale that assesses beliefs about the causes of obesity. Each question asks individuals to indicate the extent of agreement or disagreement (+3 to -3) to a specific statement, such as "obesity is really caused by a lack of willpower." Higher scores indicate beliefs that obesity is not controllable
Time frame
Baseline to 1 Year; 3 months to 1 yearSponsors and contacts
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Source ClinicalTrials.gov