Office-Based Motivational Interviewing to Prevent Childhood Obesity: A Feasibility Study

Harvard University, Cambridge, Massachusetts, United States
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 06/2007; 161(5):495-501. DOI: 10.1001/archpedi.161.5.495
Source: PubMed


To determine whether pediatricians and dietitians can implement an office-based obesity prevention program using motivational interviewing as the primary intervention.
Nonrandomized clinical trial. Fifteen pediatricians belonging to Pediatric Research in Office Settings, a national practice-based research network, and 5 registered dietitians were assigned to 1 of 3 groups: (1) control; (2) minimal intervention (pediatrician only); or (3) intensive intervention (pediatrician and registered dietitian).
Primary care pediatric offices.
Ninety-one children presenting for well-child care visits met eligibility criteria of being aged 3 to 7 years and having a body mass index (calculated as the weight in kilograms divided by the height in meters squared) at the 85th percentile or greater but lower than the 95th percentile for the age or having a normal weight and a parent with a body mass index of 30 or greater.
Pediatricians and registered dietitians in the intervention groups received motivational interviewing training. Parents of children in the minimal intervention group received 1 motivational interviewing session from the physician, and parents of children in the intensive intervention group received 2 motivational interviewing sessions each from the pediatrician and the registered dietitian.
Change in the body mass index-for-age percentile.
At 6 months' follow-up, there was a decrease of 0.6, 1.9, and 2.6 body mass index percentiles in the control, minimal, and intensive groups, respectively. The differences in body mass index percentile change between the 3 groups were nonsignificant (P=.85). The patient dropout rates were 2 (10%), 13 (32%), and 15 (50%) for the control, minimal, and intensive groups, respectively. Fifteen (94%) of the parents reported that the intervention helped them think about changing their family's eating habits.
Motivational interviewing by pediatricians and dietitians is a promising office-based strategy for preventing childhood obesity. However, additional studies are needed to demonstrate the efficacy of this intervention in practice settings.

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Available from: Gema G Dumitru, Jan 13, 2014
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    • "It could be explained by the dietetic patterns, the lack of physical activity, and the sedentary behavior of studied subjects. Our results agree with those that have reported nutritional and physical activity and motivational interviewing training interventions in similar populations [33,34]. "
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    • "Studies presenting outcomes, however, are still few. A feasibility study in which pediatricians and dieticians applied motivational interviewing to parents of overweight children showed no significant change in the children's weights (Schwartz et al., 2007). Three study design articles were published from randomized clinical trials on motivational interviewing for childhood overweight and obesity, as yet with no outcomes (Bean et al., 2011; Dalton et al., 2011; Taylor et al., 2010). "
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    • "In 2007, a U.S. expert committee recommended that obesity counseling be conducted in the primary care setting, specifically suggesting that pediatricians use patient-centered techniques such as motivational interviewing to counsel patients about improving health behaviors [2]. The use of motivational interviewing techniques in clinical settings has been reported to be programmatically feasible and effective in improving health behaviors [3,4], but it is also important to assess the time and financial resources needed to implement such programs. Decision makers such as health providers, health care payers, and policymakers can use analyses of the costs of health interventions to assess the affordability of interventions and to prioritize resources among competing programs. "
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