Makin Harriet, Chisholm Anna, Fallon Victoria, Goodwin Laura
Department of Psychology, Institute of Population Health, University of Liverpool, Merseyside, UK.
Clin Obes. 2021 Aug;11(4):e12457. doi: 10.1111/cob.12457. Epub 2021 May 6.
This review aimed to identify whether motivational interviewing (MI) (a counselling approach for supporting behaviour change [BC]) helps to reduce bodyweight and BMI in an adult obesity context. This included evaluating effectiveness of MI interventions within this population and reporting the methodology used, including theoretical underpinnings and identification of BC and MI techniques. Eight databases were searched using controlled vocabulary. Eligible studies included adults with obesity (BMI ≥30 kg/m ), author-reported interventions using MI aiming to reduce body weight or BMI, and comparator groups not receiving an MI intervention. Data extraction and quality appraisal tools were used to identify study characteristics, intervention content was coded for techniques, and random-effects meta-analysis were conducted to investigate effects. Meta-analysis of 12 studies indicated no overall pooled effect on bodyweight and BMI outcomes between intervention and control groups (SMD = -0.01 [95%CI -0.13 to 0.12, P = .93]). Findings were limited by multiple sources accounting for risk of bias, and poor reporting of intervention fidelity and content. Intervention and control content descriptions indicated similar techniques, with social support, goal setting (behaviour) and self-monitoring of behaviour occurring most frequently across both. Findings do not contribute additional evidence for MI use in this context, however methodological limitations were identified which must be resolved to better identify the intervention effects on obesity-related outcomes.
本综述旨在确定动机性访谈(MI)(一种支持行为改变[BC]的咨询方法)是否有助于在成人肥胖背景下减轻体重和降低体重指数(BMI)。这包括评估MI干预措施在该人群中的有效性,并报告所使用的方法,包括理论基础以及BC和MI技术的识别。使用受控词汇检索了八个数据库。符合条件的研究包括肥胖成年人(BMI≥30kg/m²)、作者报告的使用MI旨在减轻体重或降低BMI的干预措施,以及未接受MI干预的对照组。使用数据提取和质量评估工具来识别研究特征,对干预内容的技术进行编码,并进行随机效应荟萃分析以研究效果。对12项研究的荟萃分析表明,干预组和对照组之间在体重和BMI结果上没有总体合并效应(标准化均数差= -0.01[95%置信区间-0.13至0.12,P = 0.93])。研究结果受到多种偏倚风险来源的限制,以及干预保真度和内容报告不佳的影响。干预组和对照组的内容描述表明,两者最常出现的技术包括社会支持、目标设定(行为)和行为自我监测。研究结果并未为此背景下使用MI提供更多证据,然而已确定了方法学上的局限性,必须加以解决,以便更好地确定干预对肥胖相关结果的影响。