动机性访谈在小儿肥胖中的应用：对行为结局影响的Meta 分析。
Motivational Interviewing in Pediatric Obesity: A Meta-analysis of the Effects on Behavioral Outcomes.
机构信息
College of Nursing, Michigan State University, USA.
College of Human Medicine, Michigan State University, USA.
出版信息
Ann Behav Med. 2023 Jul 19;57(8):605-619. doi: 10.1093/abm/kaad006.
BACKGROUND
Currently, the effects of motivational interviewing (MI) on children's behavioral changes remain obscure.
PURPOSE
This systematic review and meta-analysis examined the effects of MI on children's lifestyle behavioral changes (fruits and vegetables [F/V], dairy, sugary beverages, calories, snacks, fat intake, moderate vigorous physical activity [MVPA], and screen time).
METHODS
Six databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2022 were searched. Thirty-one intervention studies with a comparison group met the criteria. Random-effects models were performed to estimate the pooled effects; exploratory moderation analyses with mixed-effects models were used to explore potential intervention moderators.
RESULTS
The pooled effect size was 0.10 (p = .334) on ↑F/V, 0.02 (p = .724) on ↑dairy, -0.29 (p < .001) on ↓calories, -0.16 (p = .054) on ↓sugary beverages, -0.22 (p = .002) on ↓snacks, -0.20 (p = .044) on ↓fat, 0.22 (p = .001) on ↑MVPA, and -0.06 (p = .176) on ↓screen time. The effects of MIs were moderated by ↑MI sessions regarding ↓snacks (B = -0.04, p = .010). Multicomponent and clinical programs had greater effects on dairy intake than their counterparts (0.09 vs. -0.21, p = .034; 0.12 vs. -0.14, p = .027, respectively). Similarly, interventions with a fidelity check resulted in greater dairy intake than those without a check (0.29 vs. -0.15, p = .014). A few long-term follow-up assessments revealed effects on ↓F/V (-0.18; p = .143, k = 2), ↓dairy (-0.13, p = .399, k = 4), ↓MVPA (-0.04; p = .611, k = 6), and ↑screen time (0.12; p = .242, k = 4).
CONCLUSIONS
Our findings support the short-term effects of MI on improving children's lifestyle behaviors. Additional investigations are needed to better sustain children's long-term behavioral changes.
背景
目前，动机性访谈（MI）对儿童行为改变的影响仍不清楚。
目的
本系统评价和荟萃分析旨在检验 MI 对儿童生活方式行为改变（水果和蔬菜[F/V]、乳制品、含糖饮料、卡路里、零食、脂肪摄入、中高强度体力活动[MVPA]和屏幕时间）的影响。
方法
从 2005 年至 2022 年，检索了六个数据库（CINAHL、Cochrane、Embase、PsycINFO、PubMed 和 Web of Sciences）。符合标准的 31 项干预研究有对照组。采用随机效应模型估计汇总效应；采用混合效应模型进行探索性调节分析，以探讨潜在的干预调节因素。
结果
F/V 增加的汇总效应大小为 0.10（p =.334），乳制品增加的汇总效应大小为 0.02（p =.724），卡路里减少的汇总效应大小为 -0.29（p <.001），含糖饮料减少的汇总效应大小为 -0.16（p =.054），零食减少的汇总效应大小为 -0.22（p =.002），脂肪减少的汇总效应大小为 -0.20（p =.044），MVPA 增加的汇总效应大小为 0.22（p =.001），屏幕时间减少的汇总效应大小为 -0.06（p =.176）。MI 次数的增加调节了 MI 对零食减少的影响（B = -0.04，p =.010）。多组分和临床方案对乳制品摄入的影响大于其对应方案（0.09 对 -0.21，p =.034；0.12 对 -0.14，p =.027）。同样，具有保真度检查的干预措施导致乳制品摄入的增加大于没有检查的干预措施（0.29 对 -0.15，p =.014）。几项长期随访评估显示，MI 对 F/V 减少（-0.18；p =.143，k = 2）、乳制品减少（-0.13，p =.399，k = 4）、MVPA 减少（-0.04；p =.611，k = 6）和屏幕时间增加（0.12；p =.242，k = 4）有短期效果。
结论
我们的研究结果支持 MI 在改善儿童生活方式行为方面的短期效果。需要进一步的研究来更好地维持儿童的长期行为改变。
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