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Trial registered on ANZCTR
Registration number
ACTRN12623001351606p
Ethics application status
Submitted, not yet approved
Date submitted
17/11/2023
Date registered
21/12/2023
Date last updated
21/12/2023
Date data sharing statement initially provided
21/12/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Weight bias in Australian healthcare students: Examining the effectiveness of an empathy vs science approach to stigma response
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Scientific title
Examining whether a video about empathy or the multifactorial causes of obesity is efficacious in addressing weight bias among Australian healthcare students.
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Secondary ID [1]
310980
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Weight stigma
332065
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Obesity stigma
332068
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Condition category
Condition code
Public Health
328803
328803
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0
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Health service research
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Diet and Nutrition
329023
329023
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0
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Healthcare students recruited from universities around Australia will be randomly assigned to watch one of two intervention videos. The intervention will take place online, implemented via Qualtrics. Participants will be able to take part in the intervention at a place and time of their choosing.
The two videos are:
1) Empathy: this video is 10 minutes long and is about an individual living with obesity. The video describes the individual's lifestyle habits (including diet and physical activity), weight loss, weight stigma experienced in healthcare, and participation in an organisation designed to end (and research) weight stigma. The video also shows how multiple practising healthcare professionals converse with the individual living with obesity on how they can approach patients living with overweight or obesity and treat them respectfully and impartially. Overall, this video is designed to induce empathy for people living with overweight or obesity.
2) Multifactorial causes of obesity: this video is animated and is 10 minutes in length. The video describes appetite, diet, metabolism, epigenetic and genetic influences of obesity, environmental and social influences of obesity, dietary habits of human ancestors, complications of obesity, and treatments for obesity. Overall, this video is designed to provide education about the multifactorial causes of obesity.
The two videos will be viewed by participants once: following the completion of baseline outcome measures (design: baseline measures > videos > immediate post-intervention measures > 2 WEEK PERIOD > follow-up outcome measures).
These videos have been developed by The Obesity Collective, the peak body for obesity in Australia. These videos are not yet available to the public. The videos will be embedded in Qualtrics, and participants will be able to view them as they complete the study. Monitoring the adherence to the intervention is not the primary goal of the study; however, will be monitored by the number of participants who complete the entire study vs. the number of participants who drop out.
Who will conduct the intervention: 4th-year PhD student Ravisha J will conduct the intervention. Ravisha has 5 years of experience in conducting psychological research.
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Intervention code [1]
327416
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Lifestyle
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Intervention code [2]
327417
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Behaviour
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Comparator / control treatment
One-third of the recruited healthcare students will also be randomly assigned to the active control condition. The control condition will involve students watching a video about smoking (a topic unrelated to obesity stigma). This video will be 10 minutes in length, and will include information such as why people smoke, risk factors for smoking, complications of smoking and treatments for smoking. The video will be compiled using relevant videos from YouTube or will be obtained from an organisation that has developed a video with the above information.
The video will be viewed by participants once: following the completion of baseline outcome measures (design: baseline measures > video > immediate post-intervention measures > 2 WEEK PERIOD > follow-up outcome measures).
This video will be designed specifically for this study; however, by using (combining) existing videos on YouTube (e.g., How do cigarettes affect the body? by Krishna Sudhir - TED-ED, Sep 13, 2018). The video will be embedded in Qualtrics, and participants will be able to view it as they complete the study. Monitoring the adherence to the intervention is not the primary goal of the study; however, will be monitored by the number of participants who complete the entire study vs. the number of participants who drop out.
All other details described above (description of intervention/exposure) also apply to this section.
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Control group
Active
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Outcomes
Primary outcome [1]
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Attitudes towards people living with overweight and obesity - Dislike
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Assessment method [1]
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Antifat Attitudes Questionnaire (AFA, Crandall, 1994)
Sub-scale - Dislike
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Timepoint [1]
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Primary outcome [2]
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Attitudes towards people living with overweight and obesity - Fear of Fat
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Assessment method [2]
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Antifat Attitudes Questionnaire (AFA, Crandall, 1994)
Sub-scale - Fear of Fat
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Timepoint [2]
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Primary outcome [3]
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Attitudes towards people living with overweight and obesity - Willpower
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Assessment method [3]
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Antifat Attitudes Questionnaire (AFA, Crandall, 1994)
Sub-scale - Willpower
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Timepoint [3]
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [1]
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Beliefs about the controllability of weight. Note that this is also a primary outcome.
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Assessment method [1]
429759
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Beliefs About Obese Persons Scale (Allison et al., 1991) - Validated measure, The total score will be used.
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Timepoint [1]
429759
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [2]
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Empathy towards people living with overweight or obesity - validated measure. Note that this is also a primary outcome.
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Assessment method [2]
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Empathy for Obese Patients (Kushner et al., 2014). The total score will be used.
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Timepoint [2]
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [3]
429761
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Confidence in interacting clinically with people living with overweight or obesity - validated measure. Note that this is also a primary outcome.
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Assessment method [3]
429761
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Confidence in Clinical Interaction with Obese Patients (Kushner et al., 2014). The total score will be used.
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Timepoint [3]
429761
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [4]
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Attitudes towards people living with overweight or obesity - Activism Orientation. Note that this is also a primary outcome
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Assessment method [4]
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Fat Attitudes Assessment Toolkit (FAAT; Cain et al., 2022) - validated measure
Sub-scale: Activism Orientation
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Timepoint [4]
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [5]
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Attitudes towards people living with overweight or obesity - Size Acceptance. Note that this is also a primary outcome
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Assessment method [5]
429763
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Fat Attitudes Assessment Toolkit (FAAT; Cain et al., 2022) - validated measure
Sub-scale: Size Acceptance
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Timepoint [5]
429763
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [6]
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Attitudes towards people living with overweight or obesity - Critical Health. Note that this is also a primary outcome
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Assessment method [6]
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Fat Attitudes Assessment Toolkit (FAAT; Cain et al., 2022) - validated measure
Sub-scale: Critical Health
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Timepoint [6]
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [7]
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Attitudes towards people living with overweight or obesity - Socioeconomic Complexity. Note that this is also a primary outcome.
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Assessment method [7]
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Fat Attitudes Assessment Toolkit (FAAT; Cain et al., 2022) - validated measure
Sub-scale: Socioeconomic Complexity
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Timepoint [7]
429765
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [8]
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Perceptions of obesity. Note that this is also a primary outcome
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Assessment method [8]
429766
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HealthEd - a measure developed by the Obesity Collective Australia - has not yet been validated. The total score will be used.
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Timepoint [8]
429766
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [9]
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Socially desirable responding. Note that this is also a primary outcome.
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Assessment method [9]
429767
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Marlowe-Crowne Social Desirability Scale - Short Form (Reynolds, 1982) - validated measure. The total score will be used.
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Timepoint [9]
429767
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up.
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Secondary outcome [10]
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Influential parts of the intervention
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Assessment method [10]
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To explore which parts of the intervention videos were most impactful to students, they will be asked to respond to an open-ended question (e.g., 'what are the 3 key take-home messages presented in the video?').
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Timepoint [10]
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Immediately post-intervention
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Secondary outcome [11]
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Empathy - Perspective taking
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Assessment method [11]
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Interpersonal Reactivity Index (IRI; Davis, 1983)
Sub-scale: Perspective Taking. Note that the IRI may be excluded from the study depending on the overall length of the survey.
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Timepoint [11]
430113
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [12]
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Empathy - Empathic Concern
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Assessment method [12]
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Interpersonal Reactivity Index (IRI; Davis, 1983)
Sub-scale: Empathic Concern. Note that the IRI may be excluded from the study depending on the overall length of the survey.
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Timepoint [12]
430114
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Secondary outcome [13]
430115
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Empathy - Personal distress
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Assessment method [13]
430115
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Interpersonal Reactivity Index (IRI; Davis, 1983)
Sub-scale: Personal Distress. Note that the IRI may be excluded from the study depending on the overall length of the survey.
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Timepoint [13]
430115
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Baseline, immediately post-intervention (primary timepoint), and 2 week follow-up
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Eligibility
Key inclusion criteria
Individuals will be eligible to participate in this study if they are currently enrolled (as at February 2024) in a healthcare course at an Australian tertiary institution either at the undergraduate or postgraduate level. Students from healthcare courses including (but not limited to) medicine, paramedicine, medical imaging, dentistry, oral health therapy, nursing, midwifery, dietetics, nutrition, psychology, counselling, social work, physiotherapy, occupational therapy, speech pathology, chiropractic, exercise science, audiology, optometry, public health/health promotion, and pharmacology are eligible to participate.
Additional inclusion criteria are for students to be at least 17 years of age, able to understand and write in English, able to provide informed consent to participate, and have normal or corrected to normal vision.
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Minimum age
17
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria include university students enrolled in non-healthcare courses (e.g., business), practising healthcare professionals (e.g., registered dietitians, practising GPs) and students who are unable to view short videos (e.g., animations) due to a health condition.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The online survey hosting platform Qualtrics will automatically and randomly allocate participants to the intervention or control conditions. The investigator will be blind to the random allocation process.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
An A-Priori sample size calculation was conducted via GLIMMPSE (Kreidler et al., 2013) for General Linear Mixed Models. With a target power of 0.8, a type I error rate of 0.05, the software indicated that a total of 27 participants (9 for each group (empathy video, video about the uncontrollable causes of obesity, and control)). However, the average sample size of previous weight bias reduction studies is 112 participants. Additionally, to account for attrition, significantly more participants will be recruited. Taking into account the previous sample sizes and attrition, it is anticipated that around 30 participants will be recruited for each condition, with a total sample size of 90.
Brief data analysis plan: all data will be analysed using SPSS statistics. Initially, descriptive statistics will be calculated to describe the sample (e.g., mean age, number of participants in each healthcare course). Then, General Linear Mixed Models (random effects) will be employed to determine the efficacy of the weight bias intervention (immediate post-test) and whether changes are sustained in the long-term (2-week follow-up).
Using the responses to the open-ended question, a thematic or content analysis (qualitative data analysis method) will be employed to explore the intervention components that were the most impactful for students.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
28/02/2024
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Actual
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Date of last participant enrolment
Anticipated
14/03/2024
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Actual
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Date of last data collection
Anticipated
28/03/2024
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Actual
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Sample size
Target
90
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Government, Department of Education - The Research Training Program (RTP) . The funding source has funded the entire PhD project and had no input in individual study design/implementation.
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Address [1]
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151 Royal Street, East Perth, WA 6004
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Country [1]
315215
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Australia
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Primary sponsor type
Individual
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Name
Ravisha S. Jayawickrama
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Address
Curtin University, Kent Street, Bentley, WA 6102
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Country
Australia
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Secondary sponsor category [1]
317245
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Individual
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Name [1]
317245
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Dr Blake Lawrence - primary project supervisor
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Address [1]
317245
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Curtin University, Kent Street, Bentley, WA 6102
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Country [1]
317245
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Australia
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Secondary sponsor category [2]
317282
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Individual
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Name [2]
317282
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Dr Briony Hill - primary project supervisor
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Address [2]
317282
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Monash University, Wellington Road, Clayton, VIC 3800
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Country [2]
317282
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
314139
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Curtin University Human Research Ethics Committee
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Ethics committee address [1]
314139
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Curtin University, Kent Street, Bentley, WA 6102
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Ethics committee country [1]
314139
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Australia
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Date submitted for ethics approval [1]
314139
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23/11/2023
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Approval date [1]
314139
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Ethics approval number [1]
314139
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Summary
Brief summary
The negative attitudes and beliefs towards people living with overweight or obesity exhibited by healthcare students have the potential to impact the care they provide to this population in future practice. Therefore, it becomes increasingly important to develop interventions that aim to reduce weight bias in healthcare students. This study aims to investigate whether evoking empathy towards people living with overweight or obesity or providing education about the multifactorial causes of obesity will be the most effective in reducing Australian healthcare students' explicit weight bias. Students will view one of 3 videos (about empathy evoking, multifactorial causes of obesity, and smoking) and answer several questionnaires. It is hypothesised that the empathy evoking video and the video about the multifactorial causes of obesity will be more effective in reducing students' explicit weight bias compared to the smoking video. We will also explore whether one of the two main videos (empathy evoking and multifactorial causes of obesity) is more effective in reducing students' explicit weight bias.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Miss Ravisha S. Jayawickrama
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Address
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Curtin University, Kent Street, Bentley, WA 6102
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Country
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Australia
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Phone
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+61 413 384 257
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Fax
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Email
130554
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[email protected]
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Contact person for public queries
Name
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Ravisha S. Jayawickrama
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Address
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Curtin University, Kent Street, Bentley, WA 6102
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Country
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Australia
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Phone
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+61 413 384 257
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Fax
130555
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Email
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[email protected]
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Contact person for scientific queries
Name
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Ravisha S. Jayawickrama
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Address
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Curtin University, Kent Street, Bentley, WA 6102
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Country
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Australia
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Phone
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+61 413 384 257
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Individual participant data will not be publicly available; however, may be available upon reasonable request from an appropriate individual/organisation (e.g., researcher).
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
21160
Informed consent form
[email protected]
This document may be provided upon reasonable requ...
[
More Details
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21161
Ethical approval
[email protected]
This document may be provided upon reasonable requ...
[
More Details
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Results publications and other study-related documents
Documents added manually
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No additional documents have been identified.
Download to PDF