title: A randomized clinical trial comparing delivery of behavioral pediatric obesity treatment using standard and enhanced motivational approaches.
abstract: OBJECTIVE
  To examine the efficacy of an adjunct motivational and autonomy-enhancing intervention (self-directed) for behavioral family-based pediatric obesity relative to the standard prescription of uniform behavioral skills use and interventionist goal assignment (prescribed).
  
  
  METHODS
  In this randomized clinical trial, 72 overweight/obese children and their parents/caregivers were assigned to either self-directed or prescribed intervention for 20 weeks, with approaches diverging after week 5. Anthropometric measurements from child and participating parent at baseline, posttreatment, and 3-month, 6-month, 1-year, and 2-year follow-ups were evaluated for change (n = 59 in follow-up analyses).
  
  
  RESULTS
  The approaches demonstrated similar child body mass index (BMI) z-score and parent BMI change from baseline to posttreatment and throughout follow-up, with child and parent weight status lower than baseline at 2 years after treatment cessation.
  
  
  CONCLUSIONS
  An adjunct motivational and autonomy-enhancing approach to behavioral family-based pediatric obesity treatment is a viable alternative to the standard intervention approach.
authors.affiliation: Seattle Children's Research Institute, P.O. Box 5371, M/S: CW8-6, Seattle, WA 98145-5005, USA. brian.saelens@seattlechildrens.org.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Saelens
authors.forename: Paula
authors.initials: P
authors.lastname: Lozano
authors.forename: Kelley
authors.initials: K
authors.lastname: Scholz
mesh_terms: D001521:Behavior Therapy; D002648:Child; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D010290:Parents / Q000523:psychology; D020377:Self Efficacy
keywords: health promotion and prevention; obesity; weight management
references.citation: Pediatr Obes. 2012 Feb;7(1):3-15
references.pmid: 22434735
references.citation: Health Psychol. 2007 Jul;26(4):381-91
references.pmid: 17605557
references.citation: Pediatrics. 2010 Feb;125(2):e396-418
references.pmid: 20083531
references.citation: Arch Dis Child. 2010 Apr;95(4):256-61
references.pmid: 19966092
references.citation: Pediatrics. 2004 Dec;114(6):1569-73
references.pmid: 15574616
references.citation: J Am Diet Assoc. 2010 Jun;110(6):879-91
references.pmid: 20497777
references.citation: N Engl J Med. 1997 Sep 25;337(13):869-73
references.pmid: 9302300
references.citation: Adv Data. 2000 Jun 8;(314):1-27
references.pmid: 11183293
references.citation: Obes Rev. 2011 Sep;12(9):709-23
references.pmid: 21692966
references.citation: J Adolesc Health. 2012 Feb;50(2):201-3
references.pmid: 22265118
references.citation: Pediatrics. 2010 Feb;125(2):361-7
references.pmid: 20083515
references.citation: Arch Pediatr Adolesc Med. 2007 May;161(5):495-501
references.pmid: 17485627
references.citation: J Eval Clin Pract. 2007 Jun;13(3):364-8
references.pmid: 17518800
references.citation: J Pediatr Psychol. 1999 Jun;24(3):223-48
references.pmid: 10379137
references.citation: Clin Psychol Rev. 2009 Jun;29(4):283-93
references.pmid: 19328605
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S254-88
references.pmid: 18055654
references.citation: BMC Public Health. 2010 May 24;10:271
references.pmid: 20497522
references.citation: JAMA. 2002 Nov 20;288(19):2469-75
references.pmid: 12435261
references.citation: J Pediatr. 2012 Aug;161(2):320-7.e1
references.pmid: 22381024
references.citation: Health Psychol. 2007 Sep;26(5):521-32
references.pmid: 17845100
references.citation: Arch Pediatr Adolesc Med. 2000 Mar;154(3):220-6
references.pmid: 10710017
references.citation: Pediatrics. 2001 Sep;108(3):712-8
references.pmid: 11533341
references.citation: J Am Diet Assoc. 2006 Dec;106(12):2024-33
references.pmid: 17126634
references.citation: Int J Pediatr Obes. 2011 Aug;6(3-4):197-205
references.pmid: 21722068
references.citation: Obes Res. 1998 Sep;6 Suppl 2:51S-209S
references.pmid: 9813653
references.citation: Arch Pediatr Adolesc Med. 2005 Dec;159(12):1173-80
references.pmid: 16330743