Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design

BMC Public Health, Jun 2011

Background Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of readiness to change and motivation to maintain adherence to healthy behavior changes. Motivational Interviewing (MI) is a method of therapy found to resolve ambivalence, enhance intrinsic motivation and promote confidence in a person's ability to make behavior changes. While MI has shown promise in the adult obesity literature as effecting positive lifestyle change, little is known about the effectiveness of MI with overweight and obese youth. This study aims to: 1) demonstrate that MI is an effective intervention for increasing a person's self-efficacy; 2) demonstrate that exposure to MI will facilitate healthy behavior changes; 3) explore psychological changes related to participation in MI and 4) compare physiological and anthropometric outcomes before and after intervention. Methods/Design The current investigation is a prospective study conducted with ongoing participants who regularly attend an outpatient pediatric care center for weight-loss. Overweight youth (BMI > 85th %ile) between the ages of 10 and 18 who meet eligibility criteria will be recruited. Participants will be randomly assigned to a control group (social skills training) or a treatment group (MI). Participants will meet with the therapist for approximately 30 minutes prior to seeing the dietician, over the course of 6 months. Participants will also undergo a full day assessment at the beginning and end of psychology intervention to evaluate body fat, and metabolic risk (screening for diabetes, high cholesterol, high blood pressure and fitness level). The paper and pencil portions of the assessments as well as the clinical testing will occur at baseline and at the conclusion of the intervention (6 months) with a repeat assessment 6 months following the completion of the intervention. Discussion Results from this study are expected to enhance our understanding of the efficacy of MI with children and adolescents who are overweight or obese. Trial registration Current Controlled Trials #NCT00326404.

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Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design

Beverly Walpole 2 Elizabeth Dettmer 1 Barbara Morrongiello 0 Brian McCrindle 4 Jill Hamilton 3 0 University of Guelph , Guelph , Canada 1 Hospital for Sick Children , Toronto , Canada 2 Department of Psychology, University of Guelph , Guelph , Canada 3 Division of Endocrinology, Hospital for Sick Children , Toronto , Canada 4 Division of Cardiology, Hospital for Sick Children , Toronto , Canada Background: Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of readiness to change and motivation to maintain adherence to healthy behavior changes. Motivational Interviewing (MI) is a method of therapy found to resolve ambivalence, enhance intrinsic motivation and promote confidence in a person's ability to make behavior changes. While MI has shown promise in the adult obesity literature as effecting positive lifestyle change, little is known about the effectiveness of MI with overweight and obese youth. This study aims to: 1) demonstrate that MI is an effective intervention for increasing a person's self-efficacy; 2) demonstrate that exposure to MI will facilitate healthy behavior changes; 3) explore psychological changes related to participation in MI and 4) compare physiological and anthropometric outcomes before and after intervention. Methods/Design: The current investigation is a prospective study conducted with ongoing participants who regularly attend an outpatient pediatric care center for weight-loss. Overweight youth (BMI > 85th %ile) between the ages of 10 and 18 who meet eligibility criteria will be recruited. Participants will be randomly assigned to a control group (social skills training) or a treatment group (MI). Participants will meet with the therapist for approximately 30 minutes prior to seeing the dietician, over the course of 6 months. Participants will also undergo a full day assessment at the beginning and end of psychology intervention to evaluate body fat, and metabolic risk (screening for diabetes, high cholesterol, high blood pressure and fitness level). The paper and pencil portions of the assessments as well as the clinical testing will occur at baseline and at the conclusion of the intervention (6 months) with a repeat assessment 6 months following the completion of the intervention. Discussion: Results from this study are expected to enhance our understanding of the efficacy of MI with children and adolescents who are overweight or obese. Trial registration: Current Controlled Trials #NCT00326404. - Background The prevalence of overweight and obesity has risen dramatically among North American children and adolescents over the past 30 years [1]. Although the etiology of obesity remains a topic of great debate, evidence clearly shows that obesity is associated with serious, physiological and psychological consequences. Physical consequences related to obesity include type 2 diabetes, * Correspondence: 5Division of Endocrinology, Hospital for Sick Children, Toronto, Canada Full list of author information is available at the end of the article hypertension, hyperlipidemia, insulin resistance, asthma, sleep-apnea, and increased likelihood of mortality [2,3]. Moreover, it has be shown that by age 10, 60% of overweight children have at least one biochemical or clinical cardiovascular risk factor and 25% have more than two [4]. Even more alarming are future projections which indicate that if current trends continue, one third of the children born in the year 2000 will eventually develop type 2 diabetes [5]. In addition to the physiological outcomes associated with being overweight or obese, these children are also likely to experience severe psychological and emotional problems as a result of the harmful social stigma and ridicule. Specifically, research has shown that these children are stereotyped as unhealthy, academically unsuccessful, socially inept, unhygienic, and lazy [6]. Furthermore, overweight and obese youth are more likely to be the victims of verbal, physical, and relational bullying, and they experience more teasing and peer rejection than do their normal-weight peers [7]. The aforementioned social problems are predictive of both short and long-term psychological consequences, including: body dissatisfaction, low self-esteem, poorer health-related quality of life and higher rates of depression [8,9]. Traditional Psychological Interventions for Weight-Loss Improving childhood weight status and health outcomes will require concerted effort at multiple levels of intervention and counseling by health care professionals represents an important component of the public health response [10]. Cognitive-behavioral treatment has been found to effect positive behavior changes for weight-loss [11]. This psychological method of treatment is based o (...truncated)


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Beverly Walpole, Elizabeth Dettmer, Barbara Morrongiello, Brian McCrindle, Jill Hamilton. Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design, BMC Public Health, 2011, pp. 459, 11, DOI: 10.1186/1471-2458-11-459