Obesity educational interventions in U.S. medical schools: a systematic review and identified gaps.

Mara Z Vitolins, Sonia Crandall, David Miller, Eddie Ip, Gail Marion, John G Spangler
Author Information
  1. Mara Z Vitolins: Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Abstract

BACKGROUND: obesity is the second leading cause of preventable death in the United States. However, physicians feel poorly trained to address the obesity epidemic. This article examines effective training methods for overweight and obesity intervention in undergraduate medical education. Using indexing terms related to overweight, obesity, and medical student education, we conducted a literature searched PubMed PsycINFO, Cochrane, and ERIC for relevant articles in English. References from articles identified were also reviewed to located additional articles.
SUMMARY: We included all studies that incorporated process or outcome evaluations of obesity educational interventions for U.S. medical students. Of an initial 168 citations, 40 abstracts were retrieved; 11 studies were found to be pertinent to medical student obesity education, but only 5 included intervention and evaluation elements. Quality criteria for inclusion consisted of explicit evaluation of the educational methods used. Data extraction identified participants (e.g., year of medical students), interventions, evaluations, and results. These 5 studies successfully used a variety of teaching methods including hands on training, didactic lectures, role-playing, and standardized patient interaction to increase medical students' knowledge, attitudes, and skills regarding overweight and obesity intervention. Two studies addressed medical student bias toward overweight and obese patients. No studies addressed health disparities in the epidemiology and bias of obesity.
CONCLUSIONS: Despite the commonly cited "obesity epidemic," there are very few published studies that report the effectiveness of medical school obesity educational programs. Gaps still exist within undergraduate medical education including specific training that addresses obesity and long-term studies showing that such training is retained.

References

  1. South Med J. 2011 Aug;104(8):598-603 [PMID: 21886071]
  2. Eur J Clin Nutr. 1999 May;53 Suppl 2:S89-96 [PMID: 10406445]
  3. Educ Health (Abingdon). 2001;14(3):405-15 [PMID: 14742005]
  4. Women Health. 1993;20(2):45-57 [PMID: 8372479]
  5. Int J Obes Relat Metab Disord. 2001 Dec;25 Suppl 4:S16-9 [PMID: 11916100]
  6. JAMA. 2004 Mar 10;291(10):1238-45 [PMID: 15010446]
  7. Int J Obes Relat Metab Disord. 1992 Nov;16(11):859-68 [PMID: 1337340]
  8. Health Aff (Millwood). 2009 Sep-Oct;28(5):w822-31 [PMID: 19635784]
  9. Nutr Rev. 1998 Apr;56(4 Pt 1):106-14 [PMID: 9584495]
  10. BMJ. 2003 Nov 8;327(7423):1085 [PMID: 14604931]
  11. Percept Mot Skills. 1997 Jun;84(3 Pt 1):848-50 [PMID: 9172192]
  12. Prev Med. 2003 Jun;36(6):669-75 [PMID: 12744909]
  13. Cochrane Database Syst Rev. 2001;(2):CD000984 [PMID: 11405970]
  14. J Am Diet Assoc. 1999 Aug;99(8):976-8 [PMID: 10450317]
  15. Arch Fam Med. 1994 Oct;3(10):888-92 [PMID: 8000560]
  16. JAMA. 2010 Jan 20;303(3):235-41 [PMID: 20071471]
  17. Eur J Intern Med. 2008 May;19(3):173-80 [PMID: 18395160]
  18. Obes Res. 2003 Sep;11(9):1033-9 [PMID: 12972672]
  19. Acad Med. 2000 May;75(5):550 [PMID: 10824832]
  20. J Gen Intern Med. 2001 Apr;16(4):262-5 [PMID: 11318928]
  21. Am J Prev Med. 1994 Sep-Oct;10(5):308-11 [PMID: 7848674]
  22. Arch Fam Med. 1998 Jul-Aug;7(4):381-4 [PMID: 9682694]
  23. Med Educ Online. 2004 Dec;9(1):4359 [PMID: 28253118]
  24. Am J Public Health. 2003 Aug;93(8):1342-8 [PMID: 12893625]
  25. Int J Epidemiol. 2001 Oct;30(5):1136-7 [PMID: 11689535]
  26. Int J Obes Relat Metab Disord. 2001 Oct;25(10):1525-31 [PMID: 11673776]
  27. Acad Med. 2006 May;81(5):454-62 [PMID: 16639201]
  28. Md Med J. 1999 Jan-Feb;48(1):26-32 [PMID: 10048282]
  29. Obes Res. 1997 Nov;5(6):603-12 [PMID: 9449146]
  30. J Nutr. 2003 Feb;133(2):547S-9S [PMID: 12566500]
  31. Obes Surg. 2001 Dec;11(6):677-9 [PMID: 11775563]
  32. J Gen Intern Med. 2008 Jul;23(7):1028-32 [PMID: 18612738]
  33. Obes Surg. 1991 Jun;1(2):171-176 [PMID: 10775912]
  34. Eat Disord. 2004 Spring;12(1):21-34 [PMID: 16864302]
  35. J Gen Intern Med. 2005 Dec;20(12):1139-41 [PMID: 16423105]
  36. J Contin Educ Health Prof. 2005 Fall;25(4):248-58 [PMID: 16365897]
  37. J Cancer Educ. 2000 Fall;15(3):144-7 [PMID: 11019761]
  38. Int J Obes Relat Metab Disord. 2002 Oct;26(10):1393-7 [PMID: 12355337]
  39. Obes Res. 2000 Sep;8(6):459-66 [PMID: 11011913]
  40. Med Sci Sports Exerc. 2004 Mar;36(3):468-74 [PMID: 15076789]
  41. Circulation. 1993 Sep;88(3):1391-6 [PMID: 8353906]

Grants

  1. R25 CA117887/NCI NIH HHS
  2. R25CA117887-01/NCI NIH HHS

MeSH Term

Curriculum
Education, Medical, Undergraduate
Educational Status
Health Education
Health Knowledge, Attitudes, Practice
Health Promotion
Health Status Disparities
Humans
Obesity
Patient Education as Topic
Schools, Medical
Social Marketing
United States

Word Cloud

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