title: Measuring medical student attitudes and beliefs regarding patients who are obese.
abstract: OBJECTIVE
  Research shows obesity bias to undermine the patient-doctor relationship and lead to substandard care. The authors developed and tested an instrument to measure medical students' attitudes and beliefs about obese patients.
  
  
  METHODS
  The authors conducted a literature search to identify validated measures of obesity bias. Because they identified no appropriate scale, they decided to design a novel survey instrument: the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale. An expert panel generated items which focus groups of third-year medical students then discussed. Next, experienced medical educators judged and weighted the remaining revised items. Then, second- and fourth-year medical students completed the scale alongside two previously validated measures of obesity bias, the Anti-Fat Attitudes Questionnaire (AFA) and Beliefs About Obese Persons Scale (BAOP). Third-year students completed the NEW Attitudes Scale before and after a simulated encounter with an obese standardized patient instructor. The authors tested the validity and reliability.
  
  
  RESULTS
  The final instrument comprised 31 items. A sample of 201 judges rated the items. A sample of 111 second- and fourth-year medical students completed the survey (mean score 24.4, range -37 to 76 out of a possible -118 to 118; higher scores indicate more positive attitudes). Pearson correlations between the NEW Attitudes Scale and AFA and BAOP were, respectively, -0.47 and 0.23. Test-retest reliability was 0.89. Students scored 27% higher after completing the standardized patient-instructor encounter (P < .001).
  
  
  CONCLUSIONS
  The NEW Attitudes Scale has good validity and reliability and may be used in future studies.
authors.affiliation: Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. eip@wakehealth.edu
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
authors.forename: Sarah
authors.initials: S
authors.lastname: Marshall
authors.forename: Mara
authors.initials: M
authors.lastname: Vitolins
authors.forename: Sonia J
authors.initials: SJ
authors.lastname: Crandall
authors.forename: Stephen
authors.initials: S
authors.lastname: Davis
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.forename: Donna
authors.initials: D
authors.lastname: Kronner
authors.forename: Karen
authors.initials: K
authors.lastname: Vaden
authors.forename: John
authors.initials: J
authors.lastname: Spangler
mesh_terms: D001291:Attitude of Health Personnel; D003469:Culture; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D010817:Physician-Patient Relations; D011287:Prejudice; D015203:Reproducibility of Results; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States