Motivational Interviewing in Pediatric Obesity: A Meta-analysis of the Effects on Behavioral Outcomes.

Tsui-Sui A Kao, Jiying Ling, Christina Vu, Rachel Hawn, Harrietta Christodoulos
Author Information
  1. Tsui-Sui A Kao: College of Nursing, Michigan State University, USA. ORCID
  2. Jiying Ling: College of Nursing, Michigan State University, USA. ORCID
  3. Christina Vu: College of Nursing, Michigan State University, USA.
  4. Rachel Hawn: College of Nursing, Michigan State University, USA.
  5. Harrietta Christodoulos: College of Human Medicine, Michigan State University, USA.

Abstract

BACKGROUND: Currently, the effects of motivational interviewing (MI) on children's behavioral changes remain obscure.
PURPOSE: This systematic review and meta-analysis examined the effects of MI on children's lifestyle behavioral changes (fruits and vegetables [F/V], dairy, sugary beverages, calories, snacks, fat intake, moderate vigorous physical activity [MVPA], and screen time).
METHODS: Six databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2022 were searched. Thirty-one intervention studies with a comparison group met the criteria. Random-effects models were performed to estimate the pooled effects; exploratory moderation analyses with mixed-effects models were used to explore potential intervention moderators.
RESULTS: The pooled effect size was 0.10 (p = .334) on ↑F/V, 0.02 (p = .724) on ↑dairy, -0.29 (p < .001) on ↓calories, -0.16 (p = .054) on ↓sugary beverages, -0.22 (p = .002) on ↓snacks, -0.20 (p = .044) on ↓fat, 0.22 (p = .001) on ↑MVPA, and -0.06 (p = .176) on ↓screen time. The effects of MIs were moderated by ↑MI sessions regarding ↓snacks (B = -0.04, p = .010). Multicomponent and clinical programs had greater effects on dairy intake than their counterparts (0.09 vs. -0.21, p = .034; 0.12 vs. -0.14, p = .027, respectively). Similarly, interventions with a fidelity check resulted in greater dairy intake than those without a check (0.29 vs. -0.15, p = .014). A few long-term follow-up assessments revealed effects on ↓F/V (-0.18; p = .143, k = 2), ↓dairy (-0.13, p = .399, k = 4), ↓MVPA (-0.04; p = .611, k = 6), and ↑screen time (0.12; p = .242, k = 4).
CONCLUSIONS: Our findings support the short-term effects of MI on improving children's lifestyle behaviors. Additional investigations are needed to better sustain children's long-term behavioral changes.

Keywords

References

  1. BMC Pediatr. 2019 Apr 11;19(1):104 [PMID: 30975106]
  2. Community Dent Oral Epidemiol. 2018 Jun;46(3):310-316 [PMID: 29461622]
  3. BMC Med Res Methodol. 2014 Dec 19;14:135 [PMID: 25524443]
  4. Pediatrics. 2010 Aug;126(2):280-8 [PMID: 20660556]
  5. J Clin Nurs. 2013 Sep;22(17-18):2519-30 [PMID: 23472881]
  6. BMJ. 2022 Oct 27;379:e067678 [PMID: 36302523]
  7. Arch Pediatr Adolesc Med. 2007 May;161(5):495-501 [PMID: 17485627]
  8. Am J Clin Nutr. 2014 Oct;100(4):1173-81 [PMID: 25240080]
  9. Pediatr Obes. 2020 May;15(5):e12608 [PMID: 31883218]
  10. J Pediatr. 2015 Aug;167(2):372-7.e1 [PMID: 26073106]
  11. J Consult Clin Psychol. 2014 Dec;82(6):1212-8 [PMID: 24841861]
  12. J Am Coll Health. 2015;63(4):286-90 [PMID: 25580630]
  13. Clin Child Fam Psychol Rev. 2019 Mar;22(1):52-62 [PMID: 30725307]
  14. Pediatrics. 2010 Feb;125(2):e396-418 [PMID: 20083531]
  15. Perm J. 2014 Summer;18(3):88-93 [PMID: 25102521]
  16. Int J Adolesc Med Health. 2017 May 25;30(6): [PMID: 28599379]
  17. Stat Methods Med Res. 2018 Jun;27(6):1785-1805 [PMID: 27683581]
  18. Pediatr Clin North Am. 2016 Jun;63(3):539-62 [PMID: 27261549]
  19. J Obes. 2013;2013:575016 [PMID: 23589771]
  20. Perspect Public Health. 2017 Jan;137(1):38-44 [PMID: 28449616]
  21. Appetite. 2015 Apr;87:137-42 [PMID: 25542774]
  22. Am J Prev Med. 2010 Nov;39(5):421-32 [PMID: 20965379]
  23. Int J Behav Nutr Phys Act. 2012 Oct 02;9:120 [PMID: 23031205]
  24. J Public Health Dent. 2017 Jun;77 Suppl 1:S8-S31 [PMID: 28600842]
  25. Altern Ther Health Med. 2021 Jan;27(1):48-55 [PMID: 32663184]
  26. Int J Behav Nutr Phys Act. 2016 Jan 21;13:4 [PMID: 26795378]
  27. Clin Rehabil. 2014 Dec;28(12):1159-71 [PMID: 24942478]
  28. Am J Prev Med. 2008 Nov;35(5 Suppl):S359-64 [PMID: 18929982]
  29. J Consult Clin Psychol. 2014 Jun;82(3):521-35 [PMID: 24547922]
  30. Pediatr Obes. 2019 Nov;14(11):e12559 [PMID: 31267695]
  31. J Community Med Health Educ. 2018;8(1): [PMID: 29732240]
  32. Pediatrics. 2016 May;137(5): [PMID: 27244793]
  33. Pediatrics. 2015 Mar;135(3):e644-52 [PMID: 25667250]
  34. Hisp Health Care Int. 2019 Sep;17(3):103-110 [PMID: 30922186]
  35. Child Obes. 2018 Jan;14(1):4-10 [PMID: 29019418]
  36. Pediatrics. 2013 Nov;132(5):e1236-46 [PMID: 24144717]
  37. Front Psychol. 2015 Nov 12;6:1732 [PMID: 26617555]
  38. Int J Obes (Lond). 2022 Mar;46(3):466-475 [PMID: 34987203]
  39. PLoS One. 2015 Feb 13;10(2):e0116876 [PMID: 25680096]
  40. Behav Res Ther. 2018 Feb;101:71-81 [PMID: 29050636]
  41. Arch Pediatr Adolesc Med. 2011 Aug;165(8):714-22 [PMID: 21464376]
  42. J Paediatr Child Health. 2014 Jun;50(6):461-70 [PMID: 24617494]
  43. Med Sci Sports Exerc. 2011 Nov;43(11):2195-203 [PMID: 21502883]
  44. Psychol Health. 2016 Aug;31(8):907-30 [PMID: 26849996]
  45. Br J Gen Pract. 2021 Apr 29;71(706):e399-e405 [PMID: 33824160]
  46. Am J Prev Med. 2012 May;42(5):e57-64 [PMID: 22516504]
  47. SAGE Open Med. 2017 May 15;5:2050312117707152 [PMID: 28567283]
  48. Clin Obes. 2018 Oct;8(5):323-326 [PMID: 29931804]
  49. J Adolesc Health. 2012 Feb;50(2):201-3 [PMID: 22265118]
  50. J Pediatr Nurs. 2013 Nov-Dec;28(6):536-47 [PMID: 23531463]
  51. Appetite. 2018 May 1;124:4-9 [PMID: 28551113]
  52. Int J Nurs Stud. 2016 Jan;53:331-41 [PMID: 26493130]
  53. Nutr Metab Cardiovasc Dis. 2019 Jun;29(6):561-571 [PMID: 31078362]
  54. J Am Acad Child Adolesc Psychiatry. 2014 Feb;53(2):135-7 [PMID: 24472248]
  55. Public Health Nutr. 2015 Aug;18(11):2055-66 [PMID: 25374257]
  56. Int J Behav Nutr Phys Act. 2019 Feb 4;16(1):16 [PMID: 30717746]
  57. J Am Diet Assoc. 2006 Dec;106(12):2024-33 [PMID: 17126634]
  58. Appl Psychol Health Well Being. 2015 Mar;7(1):22-40 [PMID: 25346476]
  59. BMC Public Health. 2014 Apr 09;14:335 [PMID: 24717011]
  60. J Clin Lipidol. 2014 Mar-Apr;8(2):187-93 [PMID: 24636178]
  61. Int J Behav Med. 2022 Feb;29(1):78-103 [PMID: 34268708]
  62. EJIFCC. 2019 Oct 11;30(3):317-324 [PMID: 31695588]
  63. Obes Rev. 2021 Oct;22(10):e13308 [PMID: 34170612]
  64. Pediatr Clin North Am. 2015 Oct;62(5):1241-61 [PMID: 26318950]
  65. Psychol Health. 2013 Nov;28(11):1265-86 [PMID: 23756082]
  66. BMJ Open Sport Exerc Med. 2021 May 5;7(2):e001088 [PMID: 34192013]
  67. Epidemiol Prev. 2015 Sep-Dec;39(5-6):393 [PMID: 26554693]
  68. Pediatrics. 2020 Nov;146(5): [PMID: 33055225]
  69. Einstein (Sao Paulo). 2020;18:eAO5268 [PMID: 32428066]
  70. J Nutr Educ Behav. 2020 Dec;52(12):1111-1119 [PMID: 33036918]
  71. Pediatrics. 2018 Nov;142(5): [PMID: 30348753]
  72. Obes Rev. 2018 Feb;19(2):164-177 [PMID: 29076610]

MeSH Term

Child
Humans
Pediatric Obesity
Motivational Interviewing
Energy Intake
Feeding Behavior
Fruit
Vegetables

Word Cloud

Created with Highcharts 10.0.0=p-0effects0children'skMIbehavioralchangesdairybeveragesintaketimevslifestyleactivityinterventionmodelspooled2900122↓snacks04greater12checklong-term4BACKGROUND:CurrentlymotivationalinterviewingremainobscurePURPOSE:systematicreviewmeta-analysisexaminedfruitsvegetables[F/V]sugarycaloriessnacksfatmoderatevigorousphysical[MVPA]screenMETHODS:SixdatabasesCINAHLCochraneEmbasePsycINFOPubMedWebSciences20052022searchedThirty-onestudiescomparisongroupmetcriteriaRandom-effectsperformedestimateexploratorymoderationanalysesmixed-effectsusedexplorepotentialmoderatorsRESULTS:effectsize10334↑F/V02724↑dairy<↓calories16054↓sugary00220044↓fat↑MVPA06176↓screenMIsmoderated↑MIsessionsregardingB010Multicomponentclinicalprogramscounterparts092103414027respectivelySimilarlyinterventionsfidelityresultedwithout15014follow-upassessmentsrevealed↓F/V181432↓dairy13399↓MVPA6116↑screen242CONCLUSIONS:findingssupportshort-termimprovingbehaviorsAdditionalinvestigationsneededbettersustainMotivationalInterviewingPediatricObesity:Meta-analysisEffectsBehavioralOutcomesEatingLifestylemodificationPhysicalSnacksSurgery

Similar Articles

Cited By