Motivational interviewing to reduce anthropometrics among children: A meta‐analysis, moderation analysis and Grading of Recommendations Assessment, Development and Evaluation assessment

Abstract

Summary Background Limited systematic reviews exist to evaluate the effects of motivational interviewing (MI) on children's anthropometric factors. Objective This review examined the effects of MI interventions for children and/or parents on children's anthropometric factors and included moderation analyses and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement, we searched Cochrane Library, PubMed, CINAHL, EMBASE, PsycINFO, Sociological Abstracts, SPORTDiscus, Education Resources Information Center, and Web of Science in December 2020. A two‐step double screening approach was applied: (1) screening titles and abstracts, and (2) screening full‐text articles obtained in step 1. At each step, discussion occurred until reaching consensus. The Cochrane risk‐of‐bias tool was used to evaluate risk of bias, and GRADE system was applied to assess overall quality of evidence. We performed meta‐analyses using the Comprehensive Meta‐Analysis software. Results A total of 2209 records were found, and 45 eligible articles were retained. MI interventions had a pooled effect of −0.15 on body mass index (BMI; 95% confidence interval [CI]: −0.24 to −0.06), −0.36 on waist circumference (WC; 95% CI: −0.71 to −0.01) and −0.22 on percent body fat (95% CI: −0.41 to −0.03). Child baseline weight status and percent low‐income families were identified as significant intervention moderators. According to the GRADE assessment, the quality of evidence on BMI percentile, BMI z‐score and percent body fat was moderate, while quality on BMI and WC was low. Conclusions In conclusion, culturally appropriate clinic‐ or home‐based MI interventions with adequate duration, dose and active parental involvement are promising in reducing anthropometrics among children.

Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives

“…Integrating this awareness into motivational interviewing approaches used with parents and children could be beneficial, and help enhance the positive effects of motivational interviewing demonstrated on youth health outcomes and attrition. 34,35 Further, it may be beneficial for paediatric providers to talk to parents about ways that they can simultaneously promote their child's healthy lifestyle behaviours, body esteem, and self-acceptance. Scholars have begun to respond to this need with evidence-based resources to foster positive weight-related conversations with families in paediatric care.…”

“…Acknowledging these parental motivations can help paediatric providers approach weight‐related topics with increased sensitivity and focus conversations on their child's health rather than a primary emphasis on weight. Integrating this awareness into motivational interviewing approaches used with parents and children could be beneficial, and help enhance the positive effects of motivational interviewing demonstrated on youth health outcomes and attrition 34,35 . Further, it may be beneficial for paediatric providers to talk to parents about ways that they can simultaneously promote their child's healthy lifestyle behaviours, body esteem, and self‐acceptance.…”

Motivational Interviewing Education in North American Family Medicine Clerkships: A CERA Study

“…5,6 Recent meta-analyses support the use of MI to positively influence patient health behaviors, including smoking cessation, reduction in alcohol use, weight loss, and medication adherence, with demonstrated improvements in cardiovascular health, diabetes care, and childhood obesity. [6][7][8][9][10][11][12][13] Although the literature has shown the benefit of MI on behavior changes, the impact of MI may be less among patients who identify as Black, Indigenous, and People of Color (BIPOC), 14 particularly in situations where the patient is seeking direct instruction from the clinician about making behavior changes. 15 We look forward to future research on unique factors that influence BIPOC community members to embark on behavior change to improve their health.…”