针对饮食和体育活动的动机性访谈可提高儿童肥胖症治疗的依从性：MI Values随机对照试验的结果。
Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial.
作者信息
Bean M K, Powell P, Quinoy A, Ingersoll K, Wickham E P, Mazzeo S E
机构信息
Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, USA; Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
出版信息
Pediatr Obes. 2015 Apr;10(2):118-25. doi: 10.1111/j.2047-6310.2014.226.x. Epub 2014 Apr 14.
BACKGROUND
Adherence is a challenge in obesity treatment. Motivational interviewing (MI) may promote patient adherence. MI Values is a randomized controlled trial of MI implemented as an adjunct to an adolescent obesity treatment [Teaching Encouragement Exercise Nutrition Support (T.E.E.N.S.)].
OBJECTIVE
Assess effects of MI Values on T.E.E.N.S. attrition and adherence.
METHODS
Participants were randomized to MI (n = 58) or control (n = 41). At weeks 1 and 10, MI participants had brief MI sessions; controls viewed health education videos. All participants continued with T.E.E.N.S. (biweekly dietitian and behavioural support visits; 3 times per week supervised physical activity). Assessments were repeated at baseline, 3 and 6 months. T-tests and chi-square analyses examined T.E.E.N.S. attrition and adherence by group.
RESULTS
Adolescents (N = 99) were primarily African-American (73%) females (74%); age = 13.8 ± 1.8 years, body mass index percentile = 98.0 ± 1.2. Compared with controls, MI participants had greater 3-month adherence overall (89.2% vs. 81.0%, P = 0.040), and to dietitian (91.3% vs. 84.0%; P = 0.046) and behavioural support (92.9% vs. 85.2%; P = 0.041) visits, and greater 6-month adherence overall (84.4% vs. 76.2%, P = 0.026) and to behavioural support visits (87.5% vs. 78.8%, P = 0.011).
CONCLUSIONS
MI enhanced adherence to this obesity intervention. MI Values is the first study to examine the impact of MI on treatment adherence among obese, primarily African-American adolescents.
背景
依从性是肥胖治疗中的一项挑战。动机性访谈（MI）可能会促进患者的依从性。MI价值观是一项随机对照试验，将MI作为青少年肥胖治疗[教学、鼓励、运动、营养支持（T.E.E.N.S.）]的辅助手段实施。
目的
评估MI价值观对T.E.E.N.S.损耗率和依从性的影响。
方法
参与者被随机分为MI组（n = 58）或对照组（n = 41）。在第1周和第10周，MI组参与者接受简短的MI疗程；对照组观看健康教育视频。所有参与者继续接受T.E.E.N.S.（每两周与营养师进行一次会面并获得行为支持；每周进行3次有监督的体育活动）。在基线、3个月和6个月时重复进行评估。采用t检验和卡方分析按组检查T.E.E.N.S.的损耗率和依从性。
结果
青少年（N = 99）主要为非裔美国人（73%），女性（74%）；年龄 = 13.8 ± 1.8岁，体重指数百分位数 = 98.0 ± 1.2。与对照组相比，MI组参与者在3个月时总体依从性更高（89.2%对81.0%，P = 0.040），对营养师会面的依从性更高（91.3%对84.0%；P = 0.046）以及对行为支持的依从性更高（92.9%对85.2%；P = 0.041），在6个月时总体依从性更高（84.4%对76.2%，P = 0.026）以及对行为支持会面的依从性更高（87.5%对78.8%，P = 0.011）。
结论
MI提高了对这种肥胖干预措施的依从性。MI价值观是第一项研究MI对肥胖的、主要是非裔美国青少年治疗依从性影响的研究。
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