Office-based motivational interviewing to prevent childhood obesity - A feasibility study
Office-based motivational interviewing to prevent childhood obesity - A feasibility study
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DOI：
10.1001/archpedi.161.5.495
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发表时间：
2007-05-01
影响因子：
--
通讯作者：
Resnicow, Kenneth A.
中科院分区：
文献类型：
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作者：
Schwartz, Robert P.;Hamre, Robin;Resnicow, Kenneth A.
目的：确定儿科医生和营养师是否可以实施以动机访谈为主要干预手段的办公室肥胖预防计划。设计：非随机临床试验。15名属于办公室儿科研究的儿科医生和5名注册营养师被分配到3组中的1组：(1)对照组；(2)最小干预(仅限儿科医生)；或(3)强化干预(儿科医生和注册营养师)。地点：初级保健儿科诊室。参与者：91名接受儿童保育访问的儿童符合资格标准，年龄在3-7岁，体重指数(体重除以身高，米)在第85百分位数或更高，但低于该年龄的第95百分位数，或体重正常，父母体重指数在30或更高。干预：干预组的儿科医生和注册营养师接受了激励性访谈培训。结果：在6个月的随访中，对照组、最小干预组和强化干预组儿童的体重指数分别下降了0.6、1.9和2.6个百分位数。3组间体重指数百分位数变化差异无统计学意义(P=.85)。对照组2例(10%)，轻度组13例(32%)，强化组15例(50%)。15名(94%)的家长报告说，干预帮助他们考虑改变家人的饮食习惯。结论：儿科医生和营养师的激励性访谈是预防儿童肥胖的一种有前景的办公室策略。然而，还需要更多的研究来证明这种干预在实践环境中的有效性。
Objective: To determine whether pediatricians and dietitians can implement an office-based obesity prevention program using motivational interviewing as the primary intervention.Design: Nonrandomized clinical trial. Fifteen, pediatricians belonging to Pediatric Research in Office Settings, a national practice-based research network, and 5 registered dietitians were assigned to 1 of 3 groups: (1) control; (2) minimal intervention (pediatrician only); or (3) intensive intervention (pediatrician and registered dietitian).Setting: Primary care pediatric offices.Participants: Ninety-one children presenting for well-child care visits met eligibility criteria of being aged 3 to 7 years and having a body mass index (calculated as the weight in kilograms divided by the height in meters squared) at the 85th percentile or greater but lower than the 95th percentile for the age or having a normal weight and a parent with a body mass index of 30 or greater.Interventions: Pediatricians and registered dietitians in the intervention groups received motivational interviewing training. Parents of children in the minimal intervention group received 1 motivational interviewing session from the physician, and parents of children in the intensive intervention group received 2 motivational inter-viewing sessions each from the pediatrician and the registered dietitian.Main Outcome Measure: Change in the body mass index-for-age percentile.Results: At 6 months' follow-up, there was a decrease of 0.6, 1.9, and 2.6 body mass index percentiles in the control, minimal, and intensive groups, respectively. The differences in body mass index percentile change between the 3 groups were nonsignificant (P =.85). The patient dropout rates were 2 (10%), 13 (32%), and 15 (50%) for the control, minimal, and intensive groups, respectively. Fifteen (94%) of the parents reported that the intervention helped them think about changing their family's eating habits.Conclusions: Motivational interviewing by pediatricians and dietitians is a promising office-based strategy for preventing childhood obesity. However, additional studies are needed to demonstrate the efficacy of this intervention in practice settings.