Efficacy of Using Brief Motivational Interviewing and Parent Group Visits In Primary Care to Treat Child Overweight and Obesity
It is currently estimated that over one-third of children aged 6-11 years in the United States are overweight or obese with some of the highest rates documented in Southern Appalachia. Primary care providers are uniquely positioned to intervene, however, lack of time as well as training and confidence in using behavioral techniques have been cited as barriers. Recommended strategies include use of a multidisciplinary team approach, family-centered communication, behavioral strategies, and care delivery following the chronic care model, including enhancement of parent self-management.
The purpose of this study was to develop and evaluate a parent-mediated approach utilizing physician’s brief motivational interviewing and parent group sessions to treat child overweight and obesity in the primary care setting in Southern Appalachia.
The current study enrolled 67 children (5-11 years) with BMI≥85th percentile and a parent/primary caregiver from four primary care practices in Southern Appalachia. The two participating Pediatric practices and two Family Medicine practices were randomized to intervention or usual care control groups. Providers in the intervention group were trained to deliver two individual visits, using brief motivational interviewing and following the AAP 15-minutes obesity prevention protocol, and four group visits using the NIH We Can! Curriculum with parents over an 8-10 week period. Trained study staff also completed four phone calls using brief motivational interviewing with parents following each group visit. Child weight and height and parent surveys were collected for both intervention and control groups at baseline, three, and six months. Additionally, parents in the intervention group completed We Can! surveys at baseline and following the fourth group session. An analysis of covariance (ANCOVA) was performed to test for the effect of treatment on zBMI at three and six months post-intervention. We Can! survey results were analyzed using paired t-tests.
Data on 53 (82%) and 46 (69%) of participants was available at 3 and 6 months, respectively. While the point estimate of the treatment effect was in the expected direction, the effect of treatment assignment did not have a statistically significant effect on the zBMI at either three or six months. However, significant (p
This study provides preliminary data on the use of a combination of individual and group visits with parents to treat overweight and obesity in children in primary care.
Schetzina, Karen E.; Dalton, William T.; Tudiver, Fred; Holt, Nicole; Robinson, Hazel; Lo, Ai-Lieng; and McBee, Matt. 2011. Efficacy of Using Brief Motivational Interviewing and Parent Group Visits In Primary Care to Treat Child Overweight and Obesity. Poster Presentation. American Academy of Pediatrics National Conference and Exhibition, Boston, MA. https://aap.confex.com/aap/2011/webprogram/Paper15213.html