Shelly Russell-Mayhew

Measures of interprofessional education and collaboration

Healthcare and social services professionals are being called to engage in interprofessional education (IPE) and interprofessional collaboration (IPC) in order to provide efficient and effective care to clients and patients. As such, it is important to conduct research that contributes to evaluation of collaborative practice. A necessary component to any strong quantitative research methodology is the type of instruments used for data collection. However, identifying valid and reliable instruments to use in this area of research can be a daunting task. The purpose of this paper is to review the quantitative measures (i.e., surveys and questionnaires) described in the interprofessional literature. Twenty-three instruments were identified and analyzed for validity and reliability statistics, sample size, ease of access to items on measure, and applicability of measure to diverse professional populations. The two primary measures reviewed are the Readiness for Interprofessional Learning Scale (Parsell & Bligh, ) and the Interdisciplinary Education Perception Scale (Luecht, Madsen, Taugher, & Petterson, ). Limited information existed for the remaining measures. Despite the number of measures available for assessing and evaluating IPE and IPC, most lack sufficient theoretical and psychometric development. Several issues that impact the development of sound measures are discussed and implications for future IPC are proposed.

Mental Health,Wellness, and Childhood Overweight/Obesity

Childhood obesity is a growing concern, and while progress has been made to understand the association between multiple biological factors (i.e., genetics, nutrition, exercise etc.), little is known about the relationship between mental health and childhood obesity. In this paper, we offer a review of current evidence about the association between mental health and childhood obesity. A systematic literature search of peer-reviewed, English-language studies published between January 2000 and January 2011 was undertaken and resulted in 759 unique records, of which 345 full-text articles were retrieved and 131 articles were included. A theoretical model is proposed to organize the paper and reflect the current state of the literature and includes psychological factors (i.e., depression and anxiety, self-esteem, body dissatisfaction, eating disordered symptoms, and emotional problems); psychosocial mediating variables (i.e., weight-based teasing and concern about weight and shape), and wellness factors (i.e., quality of life and resiliency/protective factors). We conclude with a number of recommendations to support the creation of solutions to the rise in childhood obesity rates that do not further marginalize overweight and obese children and youth and that can potentially improve the well-being of all children and youth regardless of their weight status.

Integrating Weight Bias Awareness and Mental Health Promotion Into Obesity Prevention Delivery: A Public Health Pilot Study

Introduction Promoting healthy weight is a top priority in Canada. Recent federal guidelines call for sustained, multisectoral partnerships that address childhood obesity on multiple levels. Current healthy weight messaging does not fully acknowledge the influence of social determinants of health on weight. Methods An interactive workshop was developed and implemented by a team of academic researchers and health promoters from the psychology and public health disciplines to raise awareness about 1) weight bias and its negative effect on health, 2) ways to balance healthy weight messaging to prevent the triggering of weight and shape preoccupation, and 3) the incorporation of mental health promotion into healthy weight messaging. We conducted a full-day workshop with 342 Ontario public health promoters and administered a survey at preintervention, postintervention, and follow-up. Results Participation in the full-day workshop led to significant decreases in antifat attitudes and the internalization of media stereotypes and to significant increases in self-efficacy to address weight bias. Participants reported that the training heightened their awareness of their own personal weight biases and the need to broaden their scope of healthy weight promotion to include mental health promotion. There was consensus that additional sessions are warranted to help translate knowledge into action. Buy-in and resource support at the organizational level was also seen as pivotal. Conclusion Professional development training in the area of weight bias awareness is associated with decreases in antifat attitudes and the internalization of media stereotypes around thinness. Health promoters’ healthy weight messaging was improved by learning to avoid messages that trigger weight and shape preoccupation or unhealthful eating practices among children and youth. Participants also learned ways to integrate mental health promotion and resiliency-building into daily practice.

Evaluating the Effects of a Peer-Support Model: Reducing Negative Body Esteem and Disordered Eating Attitudes and Behaviours in Grade Eight Girls

During adolescence girls become increasingly preoccupied with unrealistic ideals about body weight, often leading to dieting and unhealthy compensatory behaviours. These practices have been linked to adverse psychological, social, and health consequences. Peer-support groups offer promise in addressing risk factors for disordered eating. This study explored the effects of peer-support on measures of body satisfaction, weight loss/weight gain behaviour, internalization of media ideals, weight based teasing, and communication, for a cohort of grade 8 girls. High-risk participants demonstrated trends toward decreased internalization of media ideals and increased body satisfaction at post-test. Implications and future research direction are discussed.

Weight bias: a call to action

Weight-related issues (including excess weight, disordered eating and body concerns) are often considered as comprising distinct domains of ‘obesity’ and ‘eating disorders’. In this commentary we argue that the concept of weight bias is an important variable when considering wellbeing across the spectrum of weight-related issues. We make the following six points in support of this argument: i) weight bias is common and has adverse health consequences, ii) shaming individuals for their body weight does not motivate positive behaviour change, iii) internalized weight bias is particularly problematic, iv) public health interventions, if not carefully thought out, can perpetuate weight bias, v) weight bias is a manifestation of social inequity, and vi) action on weight bias requires an upstream, population-level approach. To achieve sustainable reductions in weight bias at a population level, substantive modifications and collaborative efforts in multiple settings must be initiated. We provide several examples of population-level interventions to reduce weight bias.

Positioning of Weight Bias: Moving towards Social Justice

Weight bias is a form of stigma with detrimental effects on the health and wellness of individuals with large bodies. Researchers from various disciplines have recognized weight bias as an important topic for public health and for professional practice. To date, researchers from various areas have approached weight bias from independent perspectives and from differing theoretical orientations. In this paper, we examined the similarities and differences between three perspectives (i.e., weight-centric, non-weight-centric (health-centric), and health at every size) used to understand weight bias and approach weight bias research with regard to (a) language about people with large bodies, (b) theoretical position, (c) identified consequences of weight bias, and (d) identified influences on weight-based social inequity. We suggest that, despite differences, each perspective acknowledges the negative influences that position weight as being within individual control and the negative consequences of weight bias. We call for recognition and discussion of weight bias as a social justice issue in order to change the discourse and professional practices extended towards individuals with large bodies. We advocate for an emphasis on social justice as a uniting framework for interdisciplinary research on weight bias.

Future research in weight bias: What next?

The 2015 Canadian Weight Bias Summit disseminated the newest research advances and brought together 40 experts, stakeholders, and policy makers in various disciplines in health, education, and public policy to identify future research directions in weight bias. In this paper we aim to share the results of the Summit as well as encourage international and interdisciplinary research collaborations in weight bias reduction. Consensus emerged on six research areas that warrant further investigation in weight bias: costs, causes, measurement, qualitative research and lived experience, interventions, and learning from other models of discrimination. These discussions highlighted three key lessons that were informed by the Summit, namely: language matters, the voices of people living with obesity should be incorporated, and interdisciplinary stakeholders should be included.

A call for social justice and best practices for the integrated prevention of eating disorders and obesity

Weight-related issues such as eating disorders (ED) and obesity (OB) are prevalent, and related public health concerns have amassed considerable scientific, political, and media attention. The spectrum of weight-related issues (i.e., ED, OB, subclinical variants, body dissatisfaction, etc.) is complex and at the core of human development and identity. However, much of what we currently understand about ED prevention is based on individual change models. Research is needed to capture the complexity of social inequity as it relates to food, weight, power, health, and gender. By addressing weight-related issues on a more structural level, we create greater capacity for impactful and equitable individual and societal change in the prevention of ED. ED prevention is embedded in a Westernized societal context of visual and social media that glamorizes the thin ideal, perpetuates fat stigma and prejudice, and reinforces the misconception that the size of one’s body can be easily controlled and manipulated. Therefore, first, we argue for an integrative approach to prevention that is informed by best practices in both the ED and OB prevention fields. Next, we argue that ED prevention needs to be contextualized in light of globalization and the macro-level influences that are acting on populations worldwide. A call to social justice, although complex, is important in order to advance integrative prevention efforts.

Addressing weight bias and discrimination: moving beyond raising awareness to creating change.

Weight discrimination is the unjust treatment of individuals because of their weight. There have been very few interventions to address weight discrimination, due in part to the lack of consensus on key messages and strategies. The objective of the third Canadian Weight Bias Summit was to review current evidence and move towards consensus on key weight bias and obesity discrimination reduction messages and strategies. Using a modified brokered dialogue approach, participants, including researchers, health professionals, policy makers and people living with obesity, reviewed the evidence and moved towards consensus on key messages and strategies for future interventions. Participants agreed to these key messages: (1) Weight bias and obesity discrimination should not be tolerated in education, health care and public policy sectors; (2) obesity should be recognized and treated as a chronic disease in health care and policy sectors; and (3) in the education sector, weight and health need to be decoupled. Consensus on future strategies included (1) creating resources to support policy makers, (2) using personal narratives from people living with obesity to engage audiences and communicate anti‐discrimination messages and (3) developing a better clinical definition for obesity. Messages and strategies should be implemented and evaluated using consistent theoretical frameworks and methodologies.

An exploratory study of eating disorder psychopathology among Overeaters Anonymous members

Overeaters Anonymous (OA) is a widely available, 12-step, self-help treatment program primarily used for weight loss that also offers to address eating disorder (ED) symptoms. However, because of OA’s tradition of avoiding contact with “outside enterprises,” little research has examined eating pathology among OA members. The present, uncontroled study examined current, self-reported ED psychopathology with the Eating Disorder Examination Questionnaire among 20 self-selected OA members. Consistent with OA’s aim to address compulsive overeating, rates of subjective and objective bulimic episodes and eating concern were significantly elevated among OA members relative to norms for adult women, demonstrating medium effects, and restraint showed a significant, small effect. Other ED symptoms, including weight concern and compensatory behaviors, were not statistically different from norms, yet demonstrated small effect sizes. We conclude that many OA members may experience ED psychopathology that extends beyond binge eating.