Parent interviews may prevent obesity in child

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Researchers are developing a potential new weapon in the battle against obesity: training pediatricians and dietitians in a special interviewing technique designed to motivate parents of overweight kids to make healthy changes in their family lifestyles.

The technique, motivational interviewing, involves asking open-ended questions (for example, “could you tell me how you feel about your weight"), listening and repeating the interviewee’s answers, and encouraging them to recognize what is holding them back from making changes, Dr. Robert P. Schwartz of Wake Forest University School of Medicine in Winston-Salem, North Carolina, the study’s lead author, told Reuters Health. 

"What you want to do is get the patient to take responsibility for their behaviors,” Schwartz said in an interview. “What motivational interviewing does is help people get unstuck from their ambivalence.”

Motivational interviewing has been used successfully to help people with substance abuse problems, but employing the approach to address physical activity and nutrition is something new, he added.

Schwartz and his team conducted a pilot study of the approach with 91 children aged 3 to 7 and their parents. The children were either overweight or normal weight but had an obese parent. They were randomized to a control group, given safety handouts lee; a minimal intervention group, which had one motivational interviewing session with the pediatrician; or an intensive group, made up of two sessions with either a pediatrician or nutritionist.

Six months later, the researchers found, there were drops in body mass index percentile for children in each group, but these reductions weren’t statistically significant. One third of patients dropped out of the program overall, and dropout rates were particularly high in the intensive group, half of whom left the program.

Parents of children in the minimal intervention group said their children cut down on eating snacks after the interview session, while those in the intensive group reported eating out less often. There were no significant differences among the groups or before and after the intervention in terms of time spent watching TV, amount of fruit and vegetables consumed, or consumption of sweetened drinks. However, 94 percent of parents said the interview sessions “helped them think about changing their eating habits.”

Schwartz and his team are now planning a larger, longer-term study of the intervention, after making a number of changes to the program, such as cutting down on paperwork for clinicians, adding a training DVD, and building in more phone interviews. They plan to enroll 600 overweight children 2 to 8 years old, and to follow them for five ears.

“This was a feasibility study to try to work out the bugs in doing this, and we certainly found many,” Schwartz said.

SOURCE: Archives of Pediatrics and Adolescent Medicine, May 2007.

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