title: Motivational interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: methodology and design.
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
  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.
  
  
  CONCLUSIONS
  Results from this study are expected to enhance our understanding of the efficacy of MI with children and adolescents who are overweight or obese.
authors.affiliation: Division of Endocrinology, Hospital for Sick Children, Toronto, Canada.
authors.forename: Beverly
authors.initials: B
authors.lastname: Walpole
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dettmer
authors.forename: Barbara
authors.initials: B
authors.lastname: Morrongiello
authors.forename: Brian
authors.initials: B
authors.lastname: McCrindle
authors.forename: Jill
authors.initials: J
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007406:Interview, Psychological; D009042:Motivation; D009864:Ontario; D011446:Prospective Studies; D012107:Research Design; D020377:Self Efficacy; D015431:Weight Loss