TPCJournal-13.2

The Professional Counselor | Volume 13, Issue 2 82 To prevent recruitment bias and confirmation bias during data collection, we omitted the terms weight and weight bias and modified the study title to read “Counselor Attributes that Impact Client’s Selection, Trust, and Advice Following.” The call for participation informed potential participants that we were conducting a study about the attributes of a hypothetical counselor. The end of the questionnaire contained a full disclosure of the study’s purpose. Of the 255 participants who began the study questionnaire, 189 completed the study, representing a 74% completion rate. No data was collected from the 66 non-completers other than an average of 76 seconds with the survey open before ending the survey. Participants A sample of 189 participants from 26 states participated in the study. Table 1 presents a summary of the sample characteristics. The majority of participants were from North Carolina (n = 72, 38%), Ohio (n = 23, 12%), California (n = 19, 10%), Utah (n = 11, 6%), and New York (n = 10, 5%). Participants primarily identified as female (n = 158, 84%). The majority of participants identified as White (n = 153, 81.4%), with other participants identifying as Asian (n = 13, 6.9%), Black/African American (n = 12, 6.4%), Latine/Hispanic (n = 5, 2.7%), and American Indian (n = 3, 1.6%). The majority of participants were over the age of 30 (n = 139, 74%), more than half had previously participated in personal counseling (n = 135, 71.8%), and just over a quarter indicated a previous ED diagnosis (n = 52, 27.7%). Given the focus of this study, all participants were asked to indicate their height and weight but were informed that such information (like all demographic information) was optional to submit. One hundred and eighty-four participants (97%) shared their height and weight, from which we calculated their BMI—a person’s weight in kilograms divided by the square of height in meters. The mean BMI was 28 (SD = 6.8) among the participants who shared their height and weight. This BMI is designated as “overweight” by the CDC (2022). Study Design and Instrumentation Physician Weight Survey Revised We used a quasi-experimental research design in this study. With permission from Puhl and colleagues (2013), we revised the Physician Weight Survey (PWS), a 44-item questionnaire designed to assess patient weight bias of physicians who are obese, overweight, or seen as average weight. The instrument measures five constructs: physician health behaviors, physician selection, physician compassion, physician trust, and adherence to physician advice. Cronbach’s alpha tests instrument reliability and the internal consistency of the questions on a scale. Alpha scores over .70 are considered acceptable (Taber, 2018). Each subscale of the PWS has demonstrated sufficient internal consistency, with a Cronbach’s alpha of at least .90 (Puhl et al., 2013). We adapted the questionnaire to address participants’ willingness to trust, follow the advice of, and select a hypothetical counselor based on the weight of that counselor. We replaced the term, physician with counselor and added the underweight category instead of the obese category. Using the underweight category allowed for consideration that weight bias exists on both ends of the weight spectrum. Because of differences in occupational responsibilities and limiting the dependent variables of our study, we did not use the subscales for health behaviors or compassion. The Health Behavior subscale incorporated the physicians’ use of substances, health screenings, and illness prevention. The Compassion subscale measured the physician’s bedside manner. Without those two additional subscales, our revised measure had 23 items.

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