Motivational interviewing and dietary counseling for obesity in primary care: an RCT

Kenneth Resnicow; Fiona McMaster; Alison Bocian; Donna Harris; Yan Zhou; Linda Snetselaar; Robert Schwartz; Esther Myers; Jaquelin Gotlieb; Jan Foster; Donna Hollinger; Karen Smith; Susan Woolford; Dru Mueller; Richard C Wasserman

doi:10.1542/peds.2014-1880

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Motivational interviewing and dietary counseling for obesity in primary care: an RCT

Journal article

Open access

Peer reviewed

Motivational interviewing and dietary counseling for obesity in primary care: an RCT

Kenneth Resnicow, Fiona McMaster, Alison Bocian, Donna Harris, Yan Zhou, Linda Snetselaar, Robert Schwartz, Esther Myers, Jaquelin Gotlieb, Jan Foster, …

Pediatrics (Evanston), Vol.135(4), pp.649-657

04/2015

DOI: 10.1542/peds.2014-1880

PMCID: PMC4379459

PMID: 25825539

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Abstract

Few studies have tested the impact of motivational interviewing (MI) delivered by primary care providers on pediatric obesity. This study tested the efficacy of MI delivered by providers and registered dietitians (RDs) to parents of overweight children aged 2 through 8. Forty-two practices from the Pediatric Research in Office Settings Network of the American Academy of Pediatrics were randomly assigned to 1 of 3 groups. Group 1 (usual care) measured BMI percentile at baseline and 1- and 2-year follow-up. Group 2 (provider only) delivered 4 MI counseling sessions to parents of the index child over 2 years. Group 3 (provider + RD) delivered 4 provider MI sessions plus 6 MI sessions from a RD. The primary outcome was child BMI percentile at 2-year follow up. At 2-year follow-up, the adjusted BMI percentile was 90.3, 88.1, and 87.1 for groups 1, 2, and 3, respectively. The group 3 mean was significantly (P = .02) lower than group 1. Mean changes from baseline in BMI percentile were 1.8, 3.8, and 4.9 across groups 1, 2, and 3. MI delivered by providers and RDs (group 3) resulted in statistically significant reductions in BMI percentile. Research is needed to determine the clinical significance and persistence of the BMI effects observed. How the intervention can be brought to scale (in particular, how to train physicians to use MI effectively and how best to train RDs and integrate them into primary care settings) also merits future research.

Counseling

United States

Body Mass Index

Nutritionists

Follow-Up Studies

Parents - education

Humans

Diet, Reducing - psychology

Child, Preschool

Cooperative Behavior

Male

Pediatric Obesity - therapy

Combined Modality Therapy

Interdisciplinary Communication

Motivation

Parents - psychology

Pediatric Obesity - psychology

Female

Feeding Behavior - psychology

Primary Health Care

Motivational Interviewing

Child

Details

Title: Subtitle: Motivational interviewing and dietary counseling for obesity in primary care: an RCT
Creators: Kenneth Resnicow - Department of Health Behavior & Health Education, School of Public Health, and kresnic@umich.edu
Fiona McMaster - Department of Health Behavior & Health Education, School of Public Health, and
Alison Bocian - Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois
Donna Harris - American Academy of Pediatrics
Yan Zhou - Department of Health Behavior & Health Education, School of Public Health, and
Linda Snetselaar - University of Iowa, College of Public Health, Iowa City, Iowa
Robert Schwartz - Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Esther Myers - Academy of Nutrition and Dietetics, Chicago, Illinois; and
Jaquelin Gotlieb - Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois
Jan Foster - Academy of Nutrition and Dietetics
Donna Hollinger - University of Iowa, College of Public Health, Iowa City, Iowa
Karen Smith - University of Iowa, College of Public Health, Iowa City, Iowa
Susan Woolford - Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan
Dru Mueller - University of Iowa, College of Public Health, Iowa City, Iowa
Richard C Wasserman - University of Vermont College of Medicine, Burlington, Vermont
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.135(4), pp.649-657
DOI: 10.1542/peds.2014-1880
PMID: 25825539
PMCID: PMC4379459
NLM abbreviation: Pediatrics
ISSN: 1098-4275
eISSN: 1098-4275
Publisher: American Academy of Pediatrics; United States
Grant note: R01 HL085400 / NHLBI NIH HHS HL085400 / NHLBI NIH HHS
Language: English
Date published: 04/2015
Academic Unit: Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
Record Identifier: 9983995026802771

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