Motivational Interviews With Parents Help Them Support Kids' Weight Management

By Lisa Rapaport

October 16, 2020

(Reuters Health) - Motivational interviews with parents appears to help them promote healthy habits in children, a systematic review suggests.

"Some more traditional approaches of doctor-patient communication have included confrontation -- you must lose weight; education -- obesity is harmful; and authority -- you should listen to me because I'm your doctor," said Dr. Stephen Pont, Medical Director of the Office of Science and Population Health for the Texas Department of State Health Services in Austin.

"Motivational interviewing uses a different model," Dr. Pont, who wasn't involved in the study, said by email. "Instead of confrontation, education, and authority, motivational interviewing relies on collaboration."

For the systematic review, researchers examined data from seven previously published randomized controlled trials that tested a variety of approaches to motivational interviewing and measured its impact on weight management based on children's BMI or BMI z-score. Some of the studies also measured secondary outcomes such as nutritional behaviors or adherence to weight management goals.

Combined, the studies in the review included a total of 3,576 children ranging in age from 9 months to 8 years. Six of the seven studies only included children with overweight or obesity.

Four of the seven studies found a statically significant impact of motivational interviewing on anthropometric outcomes, researchers report in Pediatrics.

For example, some studies found that children whose parents participated in motivational interviewing had lower BMI than a control group of kids whose parents didn't receive this as an add-on to usual care.

One of the studies suggested that more sessions of motivational interviewing might increase the benefit for children. In that study, children whose parents had six motivational interviewing sessions with a registered dietician plus four motivational interviewing sessions with a provider had a statistically lower BMI than kids whose parents received only the four sessions with a provider.

Three studies in the analysis, however, didn't find a statistically significant connection between motivational interviewing and children's BMI.

Several studies also looked at secondary outcomes involving changes in lifestyle behaviors and found motivational interviewing associated with positive changes in kids' eating habits, exercise habits, and reduced sedentary time and screen time.

One limitation of this systematic review is the high level of heterogeneity in the motivational interviewing interventions delivered. Each of the trials in the analysis varied in duration, size, number of motivational interviewing sessions, type of practitioner who delivered motivational interviewing sessions to parents, delivery setting, and other factors. There was also a lack of dose-matched controls in the trials.

Even so, the review provides a helpful summary of evidence supporting the efficacy of motivational interviewing, and suggests that it can be successfully implemented in a medical office setting, Dr. Pont said.

"Implementing motivational interviewing techniques can not only lead to a greater likelihood of a patient making a successful healthy change, but it also leads to a much more pleasant and enjoyable encounter for the health provider - and the patient," Dr. Pont added.

SOURCE: Pediatrics, online October 14, 2020.