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Motivational interviewing linked to reductions in childhood BMI
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Significant reductions in children’s BMI were achieved with motivational interviewing delivered by primary care providers and registered dietitians to parents, according to study findings published in Pediatrics.
Kenneth Resnicow, PhD, of the University of Michigan School of Public Health, and colleagues evaluated 42 practices from the Pediatric Research in Office Settings Network of the American Academy of Pediatrics to determine the effectiveness of motivational interviewing delivered by PCPs and registered dietitians to parents of children (aged 2-8 years) who are overweight.
Practices were randomly assigned to one of three groups: usual care that measured BMI percentile at baseline and 1- and 2-year follow-up visits, routine care from a PCP and standard educational materials for parents (group 1; n = 158); the group 1 program plus four PCP-delivered motivational interview counseling sessions with parents (group 2; n = 145); or the group 2 care plus six sessions motivational interview sessions from a registered dietitian (group 3; n = 154). Motivational interviewing is a recommended counseling tool for childhood obesity and is used to modify health behavior.
At 2-year follow-up, group 3 had a significantly lower mean BMI compared with group 1 (P = .02). The adjusted BMI percentiles at follow-up were as follows: 90.3 for group 1, 88.1 for group 2 and 87.1 for group 3.
Group 3 also yielded a greater change in mean BMI percentile from baseline at 4.9 followed by group 2 (3.8) and group 1 (1.8).
“This is among the first large-scale trials to show statistically significant reductions in BMI by using [motivational interviewing] delivered by PCPs and [registered dietitians],” the researchers wrote. “Research is needed to determine the clinical significance and persistence of the BMI effects observed. Given the relatively modest dose, the intervention appears to have considerable dissemination potential, which can be explored in future studies. How the intervention can be brought to scale (in particular, how to train physicians to effectively use [motivational interviewing] and how best to train [registered dietitians] and integrate them into primary care settings) merits future research.”
In an accompanying editorial, Cara B. Ebbeling, PhD, of the New Balance Foundation Obesity Prevention Center, and Richard C. Antonelli, MD, MS, of Boston Children’s Hospital, wrote that the study may lead clinicians to ask important questions when developing models for pediatric obesity.
“Clearly, answers to these questions require collaboration among numerous stakeholders,” the researchers wrote. “Substantial effort must be directed toward coordinating care across settings to integrate services centered on the comprehensive needs of patients/families and measuring performance of care-coordination activities.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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