title: Provider communication behaviors that predict motivation to change in black adolescents with obesity.
abstract: OBJECTIVE
  The goal of this research was to identify communication behaviors used by weight loss counselors that mostly strongly predicted black adolescents' motivational statements. Three types of motivational statements were of interest: change talk (CT; statements describing their own desires, abilities, reasons, and need for adhering to weight loss recommendations), commitment language (CML; statements about their intentions or plans for adhering), and counterchange talk (CCT; amotivational statements against change and commitment).
  
  
  METHODS
  Thirty-seven black adolescents with obesity received a single motivational interviewing session targeting weight-related behaviors. The video-recorded transcribed sessions were coded using the Minority Youth Sequential Coding for Observing Process Exchanges generating a sequential chain of communication. Data were then subjected to sequential analysis to determine causal relationships between counselor and adolescent communication.
  
  
  RESULTS
  Asking open-ended questions to elicit adolescent CT and emphasizing adolescents' autonomy most often led to CT. Open-ended questions to elicit CML, reflecting adolescent CML, and emphasizing autonomy most often led to CML. In contrast, open-ended questions to elicit CCT, reflecting CCT, reflecting ambivalence, and neutral open-ended questions about the target behavior led to CCT.
  
  
  CONCLUSIONS
  This study provides clinicians with insight into the most effective way to communicate with black adolescents with obesity about weight loss. Specifically, reflective statements and open questions focusing on their own desires, abilities, reasons, need, and commitment to weight loss recommendations are more likely to increase motivational statements, whereas other types of reflections and questions may be counterproductive. Finally, because adolescents have a strong need for autonomous decision making, emphasizing their autonomy may be particularly effective in evoking motivational statements.
authors.affiliation: *Pediatric Prevention Research Center, Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI; †Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI; ‡Department of English, Wayne State University, Detroit, MI; §Department of Psychology, Kennesaw State University, Kennesaw, GA; ‖Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
authors.forename: April Idalski
authors.initials: AI
authors.lastname: Carcone
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naar-King
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Brogan
authors.forename: Terrance
authors.initials: T
authors.lastname: Albrecht
authors.forename: Ellen
authors.initials: E
authors.lastname: Barton
authors.forename: Tanina
authors.initials: T
authors.lastname: Foster
authors.forename: Tim
authors.initials: T
authors.lastname: Martin
authors.forename: Sharon
authors.initials: S
authors.lastname: Marshall
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000523:psychology; D001741:Black or African American / Q000208:ethnology / Q000523:psychology*; D017028:Caregivers; D002648:Child; D003142:Communication; D003376:Counseling / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan / Q000208:ethnology; D062405:Motivational Interviewing / Q000379:methods / Q000592:standards*; D063766:Pediatric Obesity / Q000208:ethnology / Q000523:psychology*; D011369:Professional-Patient Relations; D061217:Weight Reduction Programs / Q000379:methods / Q000592:standards; D000078329:Workforce