Resnicow K, McMaster F, Woolford S, Slora E, Bocian A, Harris D, Drehmer J, Wasserman R, Schwartz R, Myers E, Foster J, Snetselaar L, Hollinger D, Smith K
Department of Health Behavior & Health Education, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Pediatr Obes. 2012 Feb;7(1):3-15. doi: 10.1111/j.2047-6310.2011.00001.x. Epub 2011 Dec 13.
This study will test the efficacy of motivational interviewing (MI) conducted by primary care providers and dieticians among children ages 2-8 years old with a body mass index (BMI) ≥ 85th and ≤ 97th percentile.
Forty-two practices from the American Academy of Pediatrics, Pediatric Research in Office Settings Network were assigned to one of three groups. Group 1 (usual care) measures BMI percentile at baseline, and at 1- and 2-year follow-ups and receives standard health education materials. Group 2 providers deliver three proactive MI counselling sessions with a parent of the index child in Year 1 and one additional 'booster' visit in Year 2. Group 3 adds six MI counselling sessions from a trained dietician. The primary outcome is the child's BMI percentile at 2-year follow-up. Secondary outcomes include parent report of the child's screen time, physical activity, intake of fruits and vegetables, and sugar-sweetened beverages.
We enrolled 633 eligible children whose mean BMI percentile was 92.0 and mean age of 5.1. The cohort was 57% female. Almost 70% of parents reported a household income of ≥ $40,000 per year, and 39% had at least a college education. The cohort was 63% white, 23% Hispanic, 7% black and 7% Asian. Parent self-reported confidence that their child will achieve a healthy weight was on average an 8 (out of 10).
To date, several aspects of the study can inform similar efforts including our ability to use volunteer clinicians to recruit participants and their willingness to dedicate their time, without pay, to receive training in MI.
本研究将测试初级保健提供者和营养师对体重指数(BMI)处于第85至97百分位的2至8岁儿童进行动机性访谈(MI)的效果。
美国儿科学会办公室环境下的儿科研究网络中的42家医疗机构被分为三组。第一组(常规护理)在基线、1年和2年随访时测量BMI百分位,并接收标准健康教育材料。第二组的提供者在第1年与指标儿童的家长进行三次积极的MI咨询会议,并在第2年进行一次额外的“强化”访问。第三组增加了由一名经过培训的营养师进行的六次MI咨询会议。主要结果是儿童在2年随访时的BMI百分位。次要结果包括家长报告的孩子的屏幕使用时间、身体活动、水果和蔬菜摄入量以及含糖饮料摄入量。
我们招募了633名符合条件的儿童,他们的平均BMI百分位为92.0,平均年龄为5.1岁。该队列中57%为女性。近70%的家长报告家庭年收入≥40,000美元,39%的家长至少拥有大学学历。该队列中63%为白人,23%为西班牙裔,7%为黑人,7%为亚裔。家长自我报告的孩子将达到健康体重的信心平均为8分(满分10分)。
迄今为止,该研究的几个方面可为类似研究提供参考,包括我们利用志愿临床医生招募参与者的能力以及他们无偿投入时间接受MI培训的意愿。