Motivational Interviewing for Overweight Children: A Systematic Review

Abstract

CONTEXT: Motivational interviewing (MI) is a communication method to help facilitate adherence to health behaviors through a series of person-centered strategies. MI’s evidence base supports its use as a potential intervention strategy at the parental decision-maker level to impact young children’s lifestyle behaviors to address childhood obesity; however, clarity is needed on the literature. OBJECTIVE: The purpose of this systematic review is to synthesize the literature examining the use of MI at the parental level to impact young children’s weight status. DATA SOURCES: A modified Cochrane method of systematic search and review was conducted in several databases (eg, PsycINFO, Academic Search Premier, Medline, Cumulative Index to Nursing and Allied Health Literature, Health Source: Nursing/Academic Edition, and SPORTDiscus). STUDY SELECTION: Criteria for retention included randomized controlled trials and studies using varied settings, methods, interventionists, target behaviors, and outcomes. DATA EXTRACTION: Extraction domains included study characteristics and risk of bias. RESULTS: Of the 352 references initially identified, 7 studies were included in the review. In most studies, authors reported significant anthropometric changes as well as significant changes in nonanthropometric outcomes related to weight management compared to usual care. LIMITATIONS: The heterogeneity of the included studies and lack of comparison with attention control groups may cloud generalizations. Studies not written in English were excluded, possibly biasing the results. CONCLUSIONS: MI, compared to usual care, revealed positive effects for parent influence on young child anthropometric measures when applied. Future research should be focused on sample diversity, using attention control groups, using exercise physiologists for MI delivery, and reporting sex-specific results.

Resource mobilization combined with motivational interviewing to promote healthy behaviors and healthy weight in low-income families: An intervention feasibility study

“…Based on this pilot, we recommend the following changes (described in detail above). To promote retention and in keeping with other recent research, 48 we recommend engaging families more often early in the intervention, including additional early HC visits, varied methods for contacting participants (e.g. putting notes in their fruit and vegetable boxes or texting) and creative ways to incentivize retention, such as raffles for those who update or confirm their contact information.…”

“…In addition, LWT included a low-income and ethnically and racially diverse population that still remains underrepresented in MI literature. 48 Most child obesity prevention trials are school-based. 18 , 25 Few obesity prevention studies have systematically included connection to resources, and none combined connection to resources with a MI-based intervention.…”

“…This concern is consistent with other MI studies in children with overweight showing higher attrition among minority participants. 48 We do not know all the reasons why families were lost, as most of these families did not actively withdraw. Families reported barriers to change related to lack of time, childcare, weather, transportation issues, and health problems, which may have also affected engagement with the program.…”

“…Though fathers were encouraged to participate in all intervention activities, further research on how to engage fathers is needed and more data collected on their response to the intervention. 48 Should the RCT prove successful, implementation research should examine how this approach could be replicated in different settings and adapted to the local resource environment. In addition, research should examine how this model could be incorporated into the patient-centered medical home 108 or integrated with the work of non-profits and the public health system.…”

Impact of motivational interviewing as a follow-up to an exercise intervention among women with or at risk for metabolic syndrome: A randomized controlled trial

“…MI is an empathetic and person-centered communication skill set that includes elicitation of change talk, autonomy and self-efficacy support, a compassionate and nonjudgmental approach, among others. 16 MI has demonstrated success in several areas related to metabolic syndrome including type 2 diabetes management, 17 weight management for overweight children, 18 overweight adults in primary care, 19 and overweight women. 20 Because of its person-centered, tailored approach, MI is complex and requires evidence-based training to achieve a beginner-level proficiency (90% MI adherent).…”