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Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Study protocol

Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design

Authors: Beverly Walpole, Elizabeth Dettmer, Barbara Morrongiello, Brian McCrindle, Jill Hamilton

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of readiness to change and motivation to maintain adherence to healthy behavior changes. Motivational Interviewing (MI) is a method of therapy found to resolve ambivalence, enhance intrinsic motivation and promote confidence in a person's ability to make behavior changes. While MI has shown promise in the adult obesity literature as effecting positive lifestyle change, little is known about the effectiveness of MI with overweight and obese youth. This study aims to: 1) demonstrate that MI is an effective intervention for increasing a person's self-efficacy; 2) demonstrate that exposure to MI will facilitate healthy behavior changes; 3) explore psychological changes related to participation in MI and 4) compare physiological and anthropometric outcomes before and after intervention.

Methods/Design

The current investigation is a prospective study conducted with ongoing participants who regularly attend an outpatient pediatric care center for weight-loss. Overweight youth (BMI > 85th %ile) between the ages of 10 and 18 who meet eligibility criteria will be recruited. Participants will be randomly assigned to a control group (social skills training) or a treatment group (MI). Participants will meet with the therapist for approximately 30 minutes prior to seeing the dietician, over the course of 6 months. Participants will also undergo a full day assessment at the beginning and end of psychology intervention to evaluate body fat, and metabolic risk (screening for diabetes, high cholesterol, high blood pressure and fitness level). The paper and pencil portions of the assessments as well as the clinical testing will occur at baseline and at the conclusion of the intervention (6 months) with a repeat assessment 6 months following the completion of the intervention.

Discussion

Results from this study are expected to enhance our understanding of the efficacy of MI with children and adolescents who are overweight or obese.

Trial registration

Current Controlled Trials #NCT00326404.
Appendix
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Literature
1.
go back to reference Finkelstein E, Fiebelkorn I, Wang G: State-level estimates of annual medical expenditures attributable to obesity. Obesity Research. 2004, 12: 18-24. 10.1038/oby.2004.4.CrossRefPubMed Finkelstein E, Fiebelkorn I, Wang G: State-level estimates of annual medical expenditures attributable to obesity. Obesity Research. 2004, 12: 18-24. 10.1038/oby.2004.4.CrossRefPubMed
2.
go back to reference Fagot-Campagna A, Saaddine J, Flegal K, Beckles G: Diabetes, impaired fasting glucose, and elevated HbA1c in U.S. adolescents: the Third National Health and Nutrition Examination Survey. Diabetes Care. 2001, 24: 834-837. 10.2337/diacare.24.5.834.CrossRefPubMed Fagot-Campagna A, Saaddine J, Flegal K, Beckles G: Diabetes, impaired fasting glucose, and elevated HbA1c in U.S. adolescents: the Third National Health and Nutrition Examination Survey. Diabetes Care. 2001, 24: 834-837. 10.2337/diacare.24.5.834.CrossRefPubMed
3.
go back to reference Ebbeling C, Pawlak D, Ludwig D: Childhood obesity: Public-health crisis, common sense cure. The Lancet. 2002, 360: 473-482. 10.1016/S0140-6736(02)09678-2.CrossRef Ebbeling C, Pawlak D, Ludwig D: Childhood obesity: Public-health crisis, common sense cure. The Lancet. 2002, 360: 473-482. 10.1016/S0140-6736(02)09678-2.CrossRef
4.
go back to reference Freedman D, Dietz W, Srinivasan S, Berenson G: The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics. 1999, 103: 1175-1182. 10.1542/peds.103.6.1175.CrossRefPubMed Freedman D, Dietz W, Srinivasan S, Berenson G: The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics. 1999, 103: 1175-1182. 10.1542/peds.103.6.1175.CrossRefPubMed
5.
go back to reference Narayan K, Boyle J, Thompson T, Sorensen S, Williamson D: Lifetime risk for diabetes mellitus in the United States. Journal of the American Medical Association. 2003, 290: 1884-1890. 10.1001/jama.290.14.1884.CrossRefPubMed Narayan K, Boyle J, Thompson T, Sorensen S, Williamson D: Lifetime risk for diabetes mellitus in the United States. Journal of the American Medical Association. 2003, 290: 1884-1890. 10.1001/jama.290.14.1884.CrossRefPubMed
6.
go back to reference Wardle J, Volz C, Golding C: Social variation in attitudes to obesity in children. Journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity. 1995, 19: 562-569. Wardle J, Volz C, Golding C: Social variation in attitudes to obesity in children. Journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity. 1995, 19: 562-569.
7.
go back to reference Jansen I, Craig W, Boyce W, Pickett W: Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004, 113: 1187-1194. 10.1542/peds.113.5.1187.CrossRef Jansen I, Craig W, Boyce W, Pickett W: Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004, 113: 1187-1194. 10.1542/peds.113.5.1187.CrossRef
8.
go back to reference Neumark-Sztainer D, Story M, French S, Hannan P, Resnick M, Blum R: Psychological concerns and health-compromising behaviors among overweight and nonoverweight adolescents. Obesity Research. 1997, 5: 237-249.CrossRefPubMed Neumark-Sztainer D, Story M, French S, Hannan P, Resnick M, Blum R: Psychological concerns and health-compromising behaviors among overweight and nonoverweight adolescents. Obesity Research. 1997, 5: 237-249.CrossRefPubMed
9.
go back to reference Zeller M, Avani M: Predictors of health-related quality of life in obese youth. Obesity. 2006, 14: 122-130. 10.1038/oby.2006.15.CrossRefPubMed Zeller M, Avani M: Predictors of health-related quality of life in obese youth. Obesity. 2006, 14: 122-130. 10.1038/oby.2006.15.CrossRefPubMed
10.
go back to reference Daley A, Copeland R, Wright N, Roalfe A, Wales J: Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized, controlled trial. Pediatrics. 2006, 118: 2126-2134. 10.1542/peds.2006-1285.CrossRefPubMed Daley A, Copeland R, Wright N, Roalfe A, Wales J: Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized, controlled trial. Pediatrics. 2006, 118: 2126-2134. 10.1542/peds.2006-1285.CrossRefPubMed
11.
go back to reference Tsiros M, Sinn N, Coates AM, Howe P, Buckley J: Treatment of adolescent overweight and obesity. European Journal of Pediatrics. 2008, 167: 9-16.CrossRefPubMed Tsiros M, Sinn N, Coates AM, Howe P, Buckley J: Treatment of adolescent overweight and obesity. European Journal of Pediatrics. 2008, 167: 9-16.CrossRefPubMed
12.
go back to reference Dansinger M, Gleason J, Griffith J, Selker H, Schaefer E: Comparison of the atkins, ornish, weight watchers, and zone diets for weight loss and heart disease risk reduction: A randomized trial. JAMA. 2005, 293: 43-53. 10.1001/jama.293.1.43.CrossRefPubMed Dansinger M, Gleason J, Griffith J, Selker H, Schaefer E: Comparison of the atkins, ornish, weight watchers, and zone diets for weight loss and heart disease risk reduction: A randomized trial. JAMA. 2005, 293: 43-53. 10.1001/jama.293.1.43.CrossRefPubMed
13.
go back to reference Grilo C: Cognitive behavioural therapy does not improve outcome in obese women with binge eating disorder receiving a comprehensive very low calorie diet programme. Evidence Based Mental Health. 2006, 9-12. Grilo C: Cognitive behavioural therapy does not improve outcome in obese women with binge eating disorder receiving a comprehensive very low calorie diet programme. Evidence Based Mental Health. 2006, 9-12.
14.
go back to reference Rogers C: Client-centered counseling. 1951, Boston: Houghton-Mifflin Rogers C: Client-centered counseling. 1951, Boston: Houghton-Mifflin
15.
go back to reference Miller W, Rollnick S: Motivational Interviewing: Preparing People for Change. 2002, New York: Guilford Press, 2 Miller W, Rollnick S: Motivational Interviewing: Preparing People for Change. 2002, New York: Guilford Press, 2
16.
go back to reference Angus L, Kagan F: Therapist empathy and client anxiety reduction in motivational interviewing: "She carries with me, the experience.". Journal of Clinical Psychology, In Session. 2009, 65: 1156-1167.CrossRefPubMed Angus L, Kagan F: Therapist empathy and client anxiety reduction in motivational interviewing: "She carries with me, the experience.". Journal of Clinical Psychology, In Session. 2009, 65: 1156-1167.CrossRefPubMed
17.
go back to reference Resnicow K, Davis R, Rollnick S: Motivational Interviewing for pediatric obesity: Conceptual Issues and Evidence Review. Journal of the American Dietetic Association. 2006, 106: 2024-2033. 10.1016/j.jada.2006.09.015.CrossRefPubMed Resnicow K, Davis R, Rollnick S: Motivational Interviewing for pediatric obesity: Conceptual Issues and Evidence Review. Journal of the American Dietetic Association. 2006, 106: 2024-2033. 10.1016/j.jada.2006.09.015.CrossRefPubMed
18.
go back to reference Suarez M, Mullins S: Motivational interviewing and pediatric health behavior interventions. Journal of Developmental Behavior and Pediatrics. 2008, 29: 417-428. 10.1097/DBP.0b013e31818888b4.CrossRef Suarez M, Mullins S: Motivational interviewing and pediatric health behavior interventions. Journal of Developmental Behavior and Pediatrics. 2008, 29: 417-428. 10.1097/DBP.0b013e31818888b4.CrossRef
19.
go back to reference Prochaska J, Redding C, Evers K: The Transtheoretical Model and Stages of Change. 2002, In K Glanz, B K Prochaska J, Redding C, Evers K: The Transtheoretical Model and Stages of Change. 2002, In K Glanz, B K
20.
go back to reference Littell J, Girvin H: Stages of change: A critique. Behavior Modification. 2002, 26: 223-273. 10.1177/0145445502026002006.CrossRefPubMed Littell J, Girvin H: Stages of change: A critique. Behavior Modification. 2002, 26: 223-273. 10.1177/0145445502026002006.CrossRefPubMed
21.
go back to reference Treasure J: Motivational interviewing. Advances in Psychiatric Treatment. 2004, 10: 331-337. 10.1192/apt.10.5.331.CrossRef Treasure J: Motivational interviewing. Advances in Psychiatric Treatment. 2004, 10: 331-337. 10.1192/apt.10.5.331.CrossRef
22.
go back to reference Rollnick S, Miller W, Butler : Motivational interviewing in Health Care. 2008, Sage Publications Rollnick S, Miller W, Butler : Motivational interviewing in Health Care. 2008, Sage Publications
23.
go back to reference Dunn E, Neighbors C, Larimers M: Motivational enhancement therapy and self-help treatment for binge eaters. Psychology of Addictive Behaviors. 2006, 44-52. Dunn E, Neighbors C, Larimers M: Motivational enhancement therapy and self-help treatment for binge eaters. Psychology of Addictive Behaviors. 2006, 44-52.
24.
go back to reference Warzieski M, Sereika S, Styn M, Music E, Burke L: Changes in self-efficacy and dietary adherence: The impact on weight loss in the PREFER study. Journal of Behavioral Medicine. 2008, 31: 81-92. 10.1007/s10865-007-9135-2.CrossRef Warzieski M, Sereika S, Styn M, Music E, Burke L: Changes in self-efficacy and dietary adherence: The impact on weight loss in the PREFER study. Journal of Behavioral Medicine. 2008, 31: 81-92. 10.1007/s10865-007-9135-2.CrossRef
25.
go back to reference Erikson S, Gerstle M, Feldstein S: Brief interventions in pediatric health care settings: A review. Archives of Pediatrics and Adolescent Medicine. 2005, 159: 1173-1180. 10.1001/archpedi.159.12.1173.CrossRef Erikson S, Gerstle M, Feldstein S: Brief interventions in pediatric health care settings: A review. Archives of Pediatrics and Adolescent Medicine. 2005, 159: 1173-1180. 10.1001/archpedi.159.12.1173.CrossRef
26.
go back to reference Resnicow K, Taylor R, Baskin M, McCarty F: Results of Go Girls: A weight control program for overweight African-American adolescent females. Obesity Research. 2005, 13: 1739-1748. 10.1038/oby.2005.212.CrossRefPubMed Resnicow K, Taylor R, Baskin M, McCarty F: Results of Go Girls: A weight control program for overweight African-American adolescent females. Obesity Research. 2005, 13: 1739-1748. 10.1038/oby.2005.212.CrossRefPubMed
27.
go back to reference Schwartz R, Hamre R, Weal Dietz: Office-based motivational interviewing to prevent childhood obesity. Archives of Pediatrics and Adolescent Medicine. 2007, 161: 495-501. 10.1001/archpedi.161.5.495.CrossRefPubMed Schwartz R, Hamre R, Weal Dietz: Office-based motivational interviewing to prevent childhood obesity. Archives of Pediatrics and Adolescent Medicine. 2007, 161: 495-501. 10.1001/archpedi.161.5.495.CrossRefPubMed
28.
go back to reference Kuczmarski R, Ogden C, Grummer-Strawn L, Flegal K, Guo S, Wei R, et al: CDC growth charts: United States. Advanced Data. 2000, 314: 1-27. Kuczmarski R, Ogden C, Grummer-Strawn L, Flegal K, Guo S, Wei R, et al: CDC growth charts: United States. Advanced Data. 2000, 314: 1-27.
29.
go back to reference Channon S, Huws-Thomas M, Rollnick S, Hood K, Cannings-John R, Rogers C, et al: A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes. Diabetes Care. 2007, 30: 1390-1395. 10.2337/dc06-2260.CrossRefPubMed Channon S, Huws-Thomas M, Rollnick S, Hood K, Cannings-John R, Rogers C, et al: A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes. Diabetes Care. 2007, 30: 1390-1395. 10.2337/dc06-2260.CrossRefPubMed
30.
go back to reference Parcel GS, Edmundson E, Perry C, Feldman HA, O'Hara Tompkins N, Nader P, et al: Measurement of self-efficacy for diet-related behaviors among elementary school children. J-Sch-Health. 1995, 65: 23-27. 10.1111/j.1746-1561.1995.tb03335.x.CrossRefPubMed Parcel GS, Edmundson E, Perry C, Feldman HA, O'Hara Tompkins N, Nader P, et al: Measurement of self-efficacy for diet-related behaviors among elementary school children. J-Sch-Health. 1995, 65: 23-27. 10.1111/j.1746-1561.1995.tb03335.x.CrossRefPubMed
31.
go back to reference Clark M, Abrams D, Niaura R, Eaton C, Rossi J: Self-efficacy in weight management. J Consult Clin Psychol. 1991, 59: 739-744. Clark M, Abrams D, Niaura R, Eaton C, Rossi J: Self-efficacy in weight management. J Consult Clin Psychol. 1991, 59: 739-744.
32.
go back to reference Smith C, Williamson D, Womble L, Johnson J, Burke L: Psychometric development of a multidemensional measure of weight-related attitudes and behaviors. Eat Weight Disord. 2000, 5: 73-86.CrossRefPubMed Smith C, Williamson D, Womble L, Johnson J, Burke L: Psychometric development of a multidemensional measure of weight-related attitudes and behaviors. Eat Weight Disord. 2000, 5: 73-86.CrossRefPubMed
33.
go back to reference van Strien T, Frijters J, Bergers G, Defatres P: The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional and external eating behaviour. International Journal of Eating Disorders. 1986, 2: 295-315.CrossRef van Strien T, Frijters J, Bergers G, Defatres P: The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional and external eating behaviour. International Journal of Eating Disorders. 1986, 2: 295-315.CrossRef
34.
go back to reference Varni J, Burwinkle T, Seid M, Skarr D: The PedsQL as a pediatric population health measure: Feasibility, reliability and validity. Academic Pediatrics. 2003, 3: 329-341. Varni J, Burwinkle T, Seid M, Skarr D: The PedsQL as a pediatric population health measure: Feasibility, reliability and validity. Academic Pediatrics. 2003, 3: 329-341.
35.
go back to reference Kovacs M: Children's Depression Inventory. 1991 Kovacs M: Children's Depression Inventory. 1991
36.
go back to reference Rosenberg M: Society and the adolescent self-image. 1965, Princeton, NJ: Princeton University PressCrossRef Rosenberg M: Society and the adolescent self-image. 1965, Princeton, NJ: Princeton University PressCrossRef
37.
go back to reference Gratz K, Roemer L: Multidemensional assessment of emotion regulation and dysregulation: Development, factor structure and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment. 2004, 26: 41-54.CrossRef Gratz K, Roemer L: Multidemensional assessment of emotion regulation and dysregulation: Development, factor structure and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment. 2004, 26: 41-54.CrossRef
38.
go back to reference Wilfrey D, Stein R, Saelens B, Mockus D, Hayden-Wade H, Real Welch: Efficacy of maintenance treatment approaches for childhood overweight. A randomized controlled trial. JAMA. 2007, 298: 1661-1673. 10.1001/jama.298.14.1661.CrossRef Wilfrey D, Stein R, Saelens B, Mockus D, Hayden-Wade H, Real Welch: Efficacy of maintenance treatment approaches for childhood overweight. A randomized controlled trial. JAMA. 2007, 298: 1661-1673. 10.1001/jama.298.14.1661.CrossRef
39.
go back to reference Friedlander S, Larkin E, Rosen C, Palermo T, Reline S: Decreased quality of life associated with obesity in school-aged children. Archives of Pediatrics and Adolescent Medicine. 2003, 157: 1206-1211. 10.1001/archpedi.157.12.1206.CrossRefPubMed Friedlander S, Larkin E, Rosen C, Palermo T, Reline S: Decreased quality of life associated with obesity in school-aged children. Archives of Pediatrics and Adolescent Medicine. 2003, 157: 1206-1211. 10.1001/archpedi.157.12.1206.CrossRefPubMed
40.
go back to reference Tanner: Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. British Medical Journal. 1976, 51: 170- Tanner: Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. British Medical Journal. 1976, 51: 170-
41.
go back to reference Dufour S, Teal Burgert: Validation of insulin sensitivity indices from oral glucose tolerance test parameters in obese children and adolescents. J Clin Endocrinol Metab. 2004, 89: 1096-1101. 10.1210/jc.2003-031503.CrossRefPubMed Dufour S, Teal Burgert: Validation of insulin sensitivity indices from oral glucose tolerance test parameters in obese children and adolescents. J Clin Endocrinol Metab. 2004, 89: 1096-1101. 10.1210/jc.2003-031503.CrossRefPubMed
42.
go back to reference Hay J, Caimey J: Development of the Habitual Activity Estimation Scale for clinical research: A systematic approach. Ped Ex Sci. 2006, 18: 193-202. Hay J, Caimey J: Development of the Habitual Activity Estimation Scale for clinical research: A systematic approach. Ped Ex Sci. 2006, 18: 193-202.
43.
go back to reference Godfrey S, Davies C, Wozniak E, Barnes C: Cardio-respiratory response to exercise in normal children. Clinical Science. 1971, 40: 419-431.CrossRefPubMed Godfrey S, Davies C, Wozniak E, Barnes C: Cardio-respiratory response to exercise in normal children. Clinical Science. 1971, 40: 419-431.CrossRefPubMed
44.
go back to reference Schneiderman-Walker J, Wilkes D, Strug L, Lands L, Pollock S, Selvadurai H, et al: Sex differences in habitual physical activity and lung function decline inchildren with cystic fibrosis. Journal of Pediatrics. 2005, 147: 321-326. 10.1016/j.jpeds.2005.03.043.CrossRefPubMed Schneiderman-Walker J, Wilkes D, Strug L, Lands L, Pollock S, Selvadurai H, et al: Sex differences in habitual physical activity and lung function decline inchildren with cystic fibrosis. Journal of Pediatrics. 2005, 147: 321-326. 10.1016/j.jpeds.2005.03.043.CrossRefPubMed
Metadata
Title
Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design
Authors
Beverly Walpole
Elizabeth Dettmer
Barbara Morrongiello
Brian McCrindle
Jill Hamilton
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-459

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