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Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI?Values randomized controlled trial.

ABSTRACT: Adherence is a challenge in obesity treatment. Motivational interviewing (MI) may promote patient adherence. MI?Values is a randomized controlled trial of MI implemented as an adjunct to an adolescent obesity treatment [Teaching Encouragement Exercise Nutrition Support (T.E.E.N.S.)].Assess effects of MI?Values on T.E.E.N.S. attrition and adherence.Participants were randomized to MI (n?=?58) or control (n?=?41). At weeks 1 and 10, MI participants had brief MI sessions; controls viewed health education videos. All participants continued with T.E.E.N.S. (biweekly dietitian and behavioural support visits; 3 times per week supervised physical activity). Assessments were repeated at baseline, 3 and 6 months. T-tests and chi-square analyses examined T.E.E.N.S. attrition and adherence by group.Adolescents (N?=?99) were primarily African-American (73%) females (74%); age?=?13.8?±?1.8 years, body mass index percentile?=?98.0?±?1.2. Compared with controls, MI participants had greater 3-month adherence overall (89.2% vs. 81.0%, P?=?0.040), and to dietitian (91.3% vs. 84.0%; P?=?0.046) and behavioural support (92.9% vs. 85.2%; P?=?0.041) visits, and greater 6-month adherence overall (84.4% vs. 76.2%, P?=?0.026) and to behavioural support visits (87.5% vs. 78.8%, P?=?0.011).MI enhanced adherence to this obesity intervention. MI?Values is the first study to examine the impact of MI on treatment adherence among obese, primarily African-American adolescents.

SUBMITTER: Bean MK

PROVIDER: S-EPMC4197118 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial.

Bean M K MK Powell P P Quinoy A A Ingersoll K K Wickham E P EP Mazzeo S E SE

Pediatric obesity 20140414 2

<h4>Background</h4>Adherence is a challenge in obesity treatment. Motivational interviewing (MI) may promote patient adherence. MI Values is a randomized controlled trial of MI implemented as an adjunct to an adolescent obesity treatment [Teaching Encouragement Exercise Nutrition Support (T.E.E.N.S.)].<h4>Objective</h4>Assess effects of MI Values on T.E.E.N.S. attrition and adherence.<h4>Methods</h4>Participants were randomized to MI (n = 58) or control (n = 41). At weeks 1 and 10, MI participan ...[more]

PMID: 24729537

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Project description:BackgroundMany women in the UK stop breastfeeding before they would like to, and earlier than is recommended by the World Health Organization (WHO). Given the potential health benefits for mother and baby, new ways of supporting women to breastfeed for longer are required. The purpose of this study was to develop and characterise a novel Motivational Interviewing (MI) informed breastfeeding peer-support intervention.MethodsQualitative interviews with health professionals and service providers (n = 14), and focus groups with mothers (n = 14), fathers (n = 3), and breastfeeding peer-supporters (n = 15) were carried out to understand experiences of breastfeeding peer-support and identify intervention options. Data were audio-recorded, transcribed, and analysed thematically. Consultation took place with a combined professional and lay Stakeholder Group (n = 23). The Behaviour Change Wheel (BCW) guided intervention development process used the findings of the qualitative research and stakeholder consultation, alongside evidence from existing literature, to identify: the target behaviour to be changed; sources of this behaviour based on the Capability, Opportunity and Motivation (COM-B) model; intervention functions that could alter this behaviour; and; mode of delivery for the intervention. Behaviour change techniques included in the intervention were categorised using the Behaviour Change Technique Taxonomy Version 1 (BCTTv1).ResultsBuilding knowledge, skills, confidence, and providing social support were perceived to be key functions of breastfeeding peer-support interventions that aim to decrease early discontinuation of breastfeeding. These features of breastfeeding peer-support mapped onto the BCW education, training, modelling and environmental restructuring intervention functions. Behaviour change techniques (BCTTv1) included social support, problem solving, and goal setting. The intervention included important inter-personal relational features (e.g. trust, honesty, kindness), and the BCTTv1 needed adaptation to incorporate this.ConclusionsThe MI-informed breastfeeding peer-support intervention developed using this systematic and user-informed approach has a clear theoretical basis and well-described behaviour change techniques. The process described could be useful in developing other complex interventions that incorporate peer-support and/or MI.

Dataset Information

Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI?Values randomized controlled trial.

Publications

Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial.

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