P2.J187: Development and Pilot Test of a Pediatric Resident Workshop: “How to Effectively and Sensitively Talk to Patients and Families about Body Weight”

Background: Childhood is a crucial time for developing lifelong eating and activity habits, but is also a period of high-risk for body dissatisfaction and disordered eating, which is why the AAP emphasizes that these conversations need to be sensitive to children’s developing body esteem. Unfortunately, evidence suggests that both children and their parents commonly report negative interactions with healthcare providers when discussing body weight. In order for pediatricians to provide optimal weight-related care, it is imperative that they receive training to develop their weight communication skills. To fill this gap, the current study developed and pilot tested a workshop on sensitive weight communication for pediatric residents that could be integrated into residency programs.

Methods: The workshop content was inspired by Holland Bloorview’s Knowledge Translation Casebook for Healthcare Professionals and consists of videos, discussion questions, and case studies reviewing the complex causes of obesity, weight stigma considerations, and weight conversation best practices. Specifically, the workshop features two skills that pediatricians can apply in their clinical practice: the Edmonton Obesity Staging System for Pediatrics (EOSS-P) and the 5As conversation strategy. Our workshop consists of two, one-hour sessions that were integrated into our medical school’s residency curriculum. The residents participated in the workshop in small groups during their regularly scheduled conferences. Selected residents served as workshop facilitators, leading their peers through the material.

We collected post-workshop feedback from participants via six Likert questions and four open-ended questions. The Likert questions assessed awareness of the importance of sensitive weight conversations, preparedness for and level of comfort with having such conversations, and intention to apply the new skills taught in the workshop. Residents were also invited to participate in a standardized patient interaction to evaluate their new skills, the data for which we are currently collecting.

Results: Fifty-one residents and 17 medical students attended at least one day of the workshop with the majority attending both days. Forty-four participants filled out the feedback survey and over 85% agreed or strongly agreed with each of the six questions indicating greater awareness, preparedness, comfort, and intention to apply the skills. Additional feedback through open-ended responses revealed that the EOSS-P, 5As, and general conversation techniques were valuable elements of the workshop. Suggestions for improving the workshop included using videos with more realistic patient encounters and wanting guidance on addressing barriers such as patient financial burdens and patient/family reluctance to address weight issues.

Conclusion: This workshop was well-received by pediatric residents, and participants indicated that they learned new skills that will be useful in their clinical practice. We will work to revise the workshop to address the residents’ feedback, including making our own videos to better highlight the EOSS-P and 5As, as well as showing how to best address difficult situations.