动机性访谈治疗超重儿童：一项随机对照试验的24个月随访

Motivational Interviewing to Treat Overweight Children: 24-Month Follow-Up of a Randomized Controlled Trial.

作者信息

Broccoli Serena, Davoli Anna Maria, Bonvicini Laura, Fabbri Alessandra, Ferrari Elena, Montagna Gino, Panza Costantino, Pinotti Mirco, Storani Simone, Tamelli Marco, Candela Silvia, Bellocchio Eletta, Giorgi Rossi Paolo

机构信息

Epidemiology Unit, Azienda Unità Sanitaria Locale, Reggio Emilia, Italy; Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico - IRCCS, Reggio Emilia, Italy;

Primary Care Pediatrician.

出版信息

Pediatrics. 2016 Jan;137(1). doi: 10.1542/peds.2015-1979. Epub 2015 Dec 23.

DOI:10.1542/peds.2015-1979

PMID:26702030

Abstract

BACKGROUND

Pediatrician-led motivational interviewing can be an effective way of controlling BMI in overweight children in the short term. Its long-term efficacy is unknown. The primary aim was to determine whether the short-term (12-month) impact of family pediatrician-led motivational interviews on the BMI of overweight children could be sustained in the long term (24 months), in the absence of any other intervention.

METHODS

Children were recruited in 2011 by family pediatricians working in the province of Reggio Emilia, Italy, and randomly allocated to receive either 5 interviews delivered over a 12-month period or usual care. Eligible participants were all 4- to 7-year-old overweight children resident in the province of Reggio Emilia who had been receiving care from the pediatrician for ≥ 12 months. The primary outcome of this study was individual variation in BMI between the baseline visit and the 24-month follow-up, assessed by pediatricians not blinded to treatment group allocation.

RESULTS

Of 419 eligible families, 372 (89%) participated; 187 children were randomized to receive intervention and 185 to usual care. Ninety-five percent of the children attended the 12-month follow-up, and 91% attended the 24-month follow-up. After the 12-month intervention period, BMI in the intervention group increased less than in the control group (0.46 and 0.78, respectively; difference -0.32; P = .005). At the 24-month follow-up, the difference had disappeared (1.52 and 1.56, respectively; difference -0.04; P = .986).

CONCLUSIONS

The intervention lost its effectiveness within 1 year of cessation. Sustainable boosters are required for weight control and obesity prevention.

摘要

背景

由儿科医生主导的动机性访谈在短期内可能是控制超重儿童体重指数（BMI）的有效方法。但其长期疗效尚不清楚。主要目的是确定在没有任何其他干预措施的情况下，由家庭儿科医生主导的动机性访谈对超重儿童BMI的短期（12个月）影响能否长期（24个月）持续。

方法

2011年，意大利雷焦艾米利亚省的家庭儿科医生招募了儿童，并将其随机分配接受在12个月内进行的5次访谈或常规护理。符合条件的参与者是所有居住在雷焦艾米利亚省、年龄在4至7岁的超重儿童，他们接受儿科医生护理≥12个月。本研究的主要结局是在基线访视和24个月随访之间BMI的个体差异，由不了解治疗组分配情况的儿科医生进行评估。

结果

在419个符合条件的家庭中，372个（89%）参与；187名儿童被随机分配接受干预，185名接受常规护理。95%的儿童参加了12个月的随访，91%参加了24个月的随访。在12个月的干预期后，干预组的BMI增加幅度小于对照组（分别为0.46和0.78；差异为-0.32；P = 0.005）。在24个月的随访中，差异消失（分别为1.52和1.56；差异为-0.04；P = 0.986）。