Fat stigma and anti-fat bias are deeply rooted in our society and affect large-bodied individuals in most settings. For example, some may experience unwanted comments from family members at family functions, negative comments while walking on the sidewalk or stares while eating in a restaurant. In the health care setting, rooms often don’t have accommodating seating, gowns for large-bodied patients or appropriately-sized blood pressure cuffs, amplifying the implicit bias larger patients experience. This year’s winning BRIght Futures Prize project aims to improve the patient experience for large-bodied individuals by creating a trauma-informed care program for health care providers.

At the core of the collaboration between Janet Rich-Edwards, ScD, MPH, Mara Hampson and Chioma Tomlinson, PA-C, is the passion for revolutionizing the way large-bodied individuals are treated in the health care setting. The group’s combined expertise, tenacity and lived experiences allow them to trailblaze the way providers care for their large-bodied patients.

“What we want to do is bring a trauma-informed care perspective into the room, which emphasizes a partnership rather than the top-down power differential that we’re used to,” said Hampson. “The program emphasizes that clinicians need to talk to the patient, listen to them and reminds them that the patient is the expert on their own body.”

More Voices at the Research Table

Originally, Rich-Edwards was working on a grant focused on the association between childhood trauma and obesity later in life. Upon proofreading the white pages of the grant, Hampson recommended Rich-Edwards read blogs and other materials created by fat advocates to offer an essential perspective. “Mara’s advocacy helped me see that we needed more voices at the table,” said Rich-Edwards.

The two met with the fat advocates, who acknowledged the link between disordered eating and childhood trauma — and raised that the team was missing the larger picture: the ongoing trauma, discrimination, and harassment that those who live in a larger body often face. The fat advocates encouraged the team to rethink the project and focus on improving the health provided to people living in larger bodies. With no additional pilot funding, this work became a passion project for Rich-Edwards and Hampson.

To keep the project going, the two continued to meet with advocates, industry professionals and members from the Brigham and Harvard communities. That’s when they were connected with Tomlinson, a physician assistant who practices obesity medicine in primary care. Tomlinson is interested in supporting larger-bodied individuals and optimizing their experience in the health care setting, which aligned with the duo’s vision.

“It was an immediate click for all of us,” said Rich-Edwards.

From Passion Project to Prize Winner

Hampson, Rich-Edwards and Tomlinson took the next step in their project’s development by submitting an application for the BRIght Futures Prize, a competition determined by public voting that awards $100,000 to support Brigham researchers and clinicians as they work to transform and improve patient care. Titled, “Stop the Stigma! Trauma-Informed Care for Patients with Large Bodies,” their project competed against three other finalists and won the 2023 prize.

In their project description, the team proposes developing and testing the effectiveness of an e-course for clinicians, clinic staff and medical students to raise awareness of anti-fat bias in health care and how redesigning clinical services can better serve the needs of patients with large bodies.

With a cohesive group and funding from the BRIght Futures Prize, the trauma-informed program is now a passion project and a prioritized initiative. “This is the kind of project that is really hard to get funding for and the BRIght Futures Prize changes everything for us,” said Rich-Edwards.

The funds will allow the team to buy the necessary software to create an online course with patient and clinician testimonials, knowledge checks, quizzes and more. The trio can now hire a research assistant dedicated to moving the project forward. The prize also fast tracks the program’s development and testing stages. Rich-Edwards predicts bringing the program to publication within a year, which did not seem possible before winning the prize.

The 2023 BRIght Futures Prize winners also cite the Brigham’s dedication to health equity and partnerships as an additional factor that helps accelerate the program’s development and distribution.

“Winning this prize is a real testament to Mass General Brigham’s strong commitment to addressing systemic barriers to care for our patients and our communities,” said Tomlinson.

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