Impact of the motivational interviewing for childhood obesity treatment: The Obemat2.0 randomized clinical trial.
adolescents
childhood obesity
children
clinical trial
motivational interview
paediatric obesity
primary care
Journal
Pediatric obesity
ISSN: 2047-6310
Titre abrégé: Pediatr Obes
Pays: England
ID NLM: 101572033
Informations de publication
Date de publication:
11 May 2024
11 May 2024
Historique:
revised:
19
12
2023
received:
19
07
2023
accepted:
22
04
2024
medline:
11
5
2024
pubmed:
11
5
2024
entrez:
11
5
2024
Statut:
aheadofprint
Résumé
The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials. Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8-14-year-old children with obesity, undergoing 1-11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction. The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was -0.27 (±0.31) in SC, versus -0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = -0.11 (95% CI: -0.20, -0.01, p = 0.025) for BMI z-score, and B = -2.06 (95% CI: -3.89, -0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified. Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials.
METHODS
METHODS
Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8-14-year-old children with obesity, undergoing 1-11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction.
RESULTS
RESULTS
The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was -0.27 (±0.31) in SC, versus -0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = -0.11 (95% CI: -0.20, -0.01, p = 0.025) for BMI z-score, and B = -2.06 (95% CI: -3.89, -0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified.
CONCLUSION
CONCLUSIONS
Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13125Subventions
Organisme : Instituto de Salud Carlos III
ID : PI15/00970
Organisme : Instituto de Salud Carlos III
ID : PI15/01411
Organisme : European Union
Organisme : Serra Hunter Fellowship of the Generalitat de Catalunya
Organisme : Martí-Franquès Research Programme
ID : 2019PMF-PIPF-30
Investigateurs
R Closa-Monasterolo
(R)
J Escribano
(J)
V Luque
(V)
N Ferré
(N)
J Muñoz-Hernando
(J)
D Gutiérrez-Marín
(D)
M Zaragoza-Jordana
(M)
M Gispert-Llauradó
(M)
M C Rubio-Torrents
(MC)
M Núñez-Roig
(M)
M Alcázar
(M)
S Sentís
(S)
M Esteve
(M)
R Monné-Gelonch
(R)
G Flores
(G)
P Hsu
(P)
C Rey-Reñones
(C)
C Alegret
(C)
N Guillen
(N)
C Alegret-Basora
(C)
R Ferre
(R)
F Arasa
(F)
A M Alejos
(AM)
M Diéguez
(M)
M A Serrano
(MA)
M Mallafré
(M)
R González-Hidalgo
(R)
L Braviz
(L)
A Resa
(A)
M Palacios
(M)
A Sabaté
(A)
L Simón
(L)
A C Losilla
(AC)
S De La Torre
(S)
L Rosell
(L)
N Adell
(N)
C Pérez
(C)
C Tudela-Valls
(C)
R Caro-Garduño
(R)
O Salvadó
(O)
A Pedraza
(A)
J Conchillo
(J)
S Morillo
(S)
S Garcia
(S)
E M Mur
(EM)
S Paixà
(S)
S Tolós
(S)
R Martín
(R)
F J Aguado
(FJ)
J L Cabedo
(JL)
L G Quezada
(LG)
M Domingo
(M)
M Ortega
(M)
R M Garcia
(RM)
O Romero
(O)
M Pérez
(M)
M Fernández
(M)
M E Villalobos
(ME)
G Ricomà
(G)
E Capell
(E)
M Bosch
(M)
A Donado
(A)
F J Sanchis
(FJ)
A Boix
(A)
X Goñi
(X)
E Castilla
(E)
M M Pinedo
(MM)
L Supersaxco
(L)
M Ferré
(M)
J Contreras
(J)
N Sanz-Manrique
(N)
A Lara
(A)
M Rodríguez
(M)
T Pineda
(T)
S Segura
(S)
S Vidal
(S)
M Salvat
(M)
G Mimbrero
(G)
A Albareda
(A)
J Guardia
(J)
M Lopez
(M)
S Ruiz-Escusol
(S)
S Gallardo
(S)
P Machado
(P)
R Bocanegra
(R)
T Espejo
(T)
M Vendrell
(M)
C Solé
(C)
R Urbano
(R)
M T Vázquez
(MT)
L Fernández-Antuña
(L)
M Barrio
(M)
A Baudoin
(A)
N González
(N)
R Olivé
(R)
R M Lara
(RM)
C Dinu
(C)
C Vidal
(C)
S González
(S)
E Ruiz-Morcillo
(E)
M E Ainsa
(ME)
B Aranda
(B)
A Boada
(A)
E Balcells
(E)
Informations de copyright
© 2024 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
Références
World Health Organization. Noncommunicable Diseases. 2021. Accessed November 23, 2021. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
NCD Risk Factor Collaboration (NCD‐RisC) L, Abdeen ZA, Hamid ZA, et al. Worldwide trends in body‐mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population‐based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627‐2642.
Joshi SM, Katre PA, Kumaran K, et al. Tracking of cardiovascular risk factors from childhood to young adulthood—the Pune Children's Study. Int J Cardiol. 2014;175(1):176‐178.
Al‐Khudairy L, Loveman E, Colquitt JL, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. Cochrane Database Syst Rev. 2017;6(6):CD012691.
Colquitt JL, Loveman E, O'Malley C, et al. Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years. Cochrane Database Syst Rev. 2016;3(3):CD012105.
Mead E, Brown T, Rees K, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev. 2017;6:CD012651.
Rajjo T, Mohammed K, Alsawas M, et al. Treatment of pediatric obesity: an umbrella systematic review. J Clin Endocrinol Metab. 2017;102(3):763‐775.
Ziser K, Decker S, Stuber F, et al. Barriers to behavior change in parents with overweight or obese children: a qualitative interview study. Front Psychol. 2021;12:631678.
Kelleher E, Davoren MP, Harrington JM, Shiely F, Perry IJ, McHugh SM. Barriers and facilitators to initial and continued attendance at community‐based lifestyle programmes among families of overweight and obese children: a systematic review. Obes Rev. 2017;18(2):183‐194.
Bradbury D, Chisholm A, Watson PM, Bundy C, Bradbury N, Birtwistle S. Barriers and facilitators to health care professionals discussing child weight with parents: a meta‐synthesis of qualitative studies. Br J Health Psychol. 2018;23(3):701‐722.
Samdal GB, Eide GE, Barth T, Williams G, Meland E. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta‐regression analyses. Int J Behav Nutr Phys Act. 2017;14(1):42.
Poobalan AS, Aucott LS, Precious E, Crombie IK, Smith WCS. Weight loss interventions in young people (18 to 25 year olds): a systematic review. Obes Rev. 2010;11(8):580‐592.
Miller WR. Motivational interviewing: research, practice, and puzzles. Addict Behav. 1996;21(6):835‐842.
Feliu Rovira A, París Miró N, Zaragoza‐Jordana M, et al. Eficacia clínica y metabólica de una nueva terapia motivacional (OBEMAT) para el tratamiento de la obesidad en la adolescencia. Anal Pediatr. 2013;78(3):157‐166.
Ahmed U, Mahmood MS, Parsons M, et al. A systematic review looking at the current best practices as well as primary care practitioner's views on the diagnosis and treatment of childhood obesity. Cureus. 2023;15(1):e34346.
Dirección Xeral de Saúde Pública (Xunta de Galicia). Epidat. 2004.
Luque V, Feliu A, Escribano J, et al. The obemat2.0 study: a clinical trial of a motivational intervention for childhood obesity treatment. Nutrients. 2019;11(2):419.
Hernández M, Castellet J, Narvaiza J, et al. Curvas y tablas de crecimiento. Instituto de Investigación sobre Crecimiento y Desarrollo. Fundación Orbegozo [Growth charts and tables. Growth and Development Research Institute. Orbegozo Foundation]. Editorial Garsi. 1988.
Grupo de trabajo de la Guía de Práctica Clínica sobre la Prevención y el Tratamiento de la Obesidad Infantojuvenil. Ministerio de Ciencia e Innovación [Spanish Ministry of Sciencee and Innovation]. Guía de Práctica Clínica sobre la Prevención y el Tratamiento de la Obesidad Infantojuvenil. Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad y Política Social. Centro Cochrane Iberoamericano Coordinador, editor. 2009.
Reinehr T, Kleber M, Lass N, Toschke AM. Body mass index patterns over 5 y in obese children motivated to participate in a 1‐y lifestyle intervention: age as a predictor of long‐term success. Am J Clin Nutr. 2010;91(5):1165‐1171.
URLEC C. Granmo v7.12. 2011.
Luque V, Feliu A, Guillen N, et al. Obemat 2.0. Childhood Obesity Motivational Treatment. 1st ed. Publicacions URV; 2020.
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school‐aged children and adolescents. Bull World Health Organ. 2007;85(9):660‐667.
World Health Organization. WHO Anthro Software for PC. 2009.
Siri WE. Body composition from fluid spaces and density: analysis of methods. In: Brozek JHA, ed. Techniques for Measuring Body Composition. National Academy of Sciencies, National Research Council; 1961:223‐224.
Lohman TG. Assessment of body composition in children. Pediatr Exerc Sci. 1989;1(1):19‐30.
Gutiérrez‐Marín D, Luque V, Ferré N, Fewtrell MS, Williams JE, Wells JCK. Associations of age and body mass index with hydration and density of fat‐free mass from 4 to 22 years. Eur J Clin Nutr. 2019;73(10):1422‐1430.
Gutiérrez‐Marín D, Escribano J, Closa‐Monasterolo R, et al. A novel approach to assess body composition in children with obesity from density of the fat‐free mass. Clin Nutr. 2021;40(3):1102‐1107.
Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291‐303.
Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45(239):13‐23.
Flynn JT, Kaelber DC, Baker‐Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta‐cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412‐419.
UNESCO Institute of Statistics. International Standard Classification of Education ISCED 2011. Vol. UIS/TD/06. UNESCO Library; 2006.
National Institute of Statistics. National Classification of Occupations [Clasificación Nacional de Ocupaciones]. 2011.
van Buuren S, Groothuis‐Oudshoorn K. Mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45(3):1‐67. https://www.jstatsoft.org/index.php/jss/article/view/v045i03
World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;284(23):3043‐3045.
Suire KB, Kavookjian J, Wadsworth DD. Motivational interviewing for overweight children: a systematic review. Pediatrics. 2020;146(5): e20200193.
Resnicow K, McMaster F, Bocian A, et al. Motivational interviewing and dietary counseling for obesity in primary care: an RCT. Pediatrics. 2015;135(4):649‐657.
Davoli AM, Broccoli S, Bonvicini L, et al. Pediatrician‐led motivational interviewing to treat overweight children: an RCT. Pediatrics. 2013;132(5):e1236‐e1246.
Sim LA, Lebow J, Wang Z, Koball A, Murad MH. Brief primary care obesity interventions: a meta‐analysis. Pediatrics. 2016;138(4):e20160149.
Liebhart JL, Goodman AB, Lindros J, et al. Key predictors of primary care providers' self‐efficacy in caring for children with overweight or obesity. Acad Pediatr. 2022;22:1158‐1166.
Taveras EM, Marshall R, Kleinman KP, et al. Comparative effectiveness of childhood obesity interventions in pediatric primary care: a cluster‐randomized clinical trial. JAMA Pediatr. 2015;169(6):535‐542.
Taylor RW, Cox A, Knight L, et al. A tailored family‐based obesity intervention: a randomized trial. Pediatrics. 2015;136(2):281‐289.
Pollak KI, Coffman CJ, Alexander SC, et al. Weight's up? Predictors of weight‐related communication during primary care visits with overweight adolescents. Patient Educ Couns. 2014;96(3):327‐332.
Woolford SJ, Resnicow K, Davis MM, et al. Cost‐effectiveness of a motivational interviewing obesity intervention versus usual care in pediatric primary care offices. Obesity (Silver Spring). 2022;30(11):2265‐2274.
Dhaliwal J, Nosworthy NMI, Holt NL, et al. Attrition and the management of pediatric obesity: an integrative review. Child Obes. 2014;10(6):461‐473.
Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12(5):e273‐e281.