title: Pairing motivational interviewing with a nutrition and physical activity assessment and counseling tool in pediatric clinical practice: a pilot study.
abstract: BACKGROUND
  Recommendations to screen and counsel for lifestyle behaviors can be challenging to implement during well-child visits in the primary care setting. A practice intervention was piloted using the Family Nutrition and Physical Activity (FNPA) Screening Tool paired with a motivational interviewing (MI)-based counseling tool during well-child visits. Acceptability and feasibility of this intervention were assessed. Its impact on parent-reported obesigenic behavior change and provider efficacy in lifestyle counseling were also examined.
  
  
  METHODS
  This was an observational study in a pediatric primary care office. During well-child visits of 100 patients (ages 4-16 years), the FNPA tool was implemented and providers counseled patients in an MI-consistent manner based on its results. Duration of implementation, patient satisfaction of the intervention, and success of stated lifestyle goals were measured. Provider self-efficacy and acceptability were also surveyed.
  
  
  RESULTS
  The FNPA assessment was efficient to administer, requiring minutes to complete and score. Patient acceptability was high, ranging from 4.0 to 4.8 on a 5-point scale. Provider acceptability was good, with the exception of duration of counseling; self-efficacy in assessing patient "readiness for change" was improved. Parent-reported success of primary lifestyle goal was 68% at 1 month and 46% at 6 months.
  
  
  CONCLUSIONS
  The FNPA assessment with an MI-based counseling tool shows promise as an approach to identify and address obesigenic behaviors during pediatric well-child visits. It has the potential to improve provider efficacy in obesity prevention and also influence patient health behaviors, which can possibly impact childhood excessive weight gain. After refinement, this practice intervention will be used in a larger trial.
authors.affiliation: 1 Department of Pediatrics, University of Illinois College of Medicine at Peoria , Peoria, IL.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Christison
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Daley
authors.forename: Carl V
authors.initials: CV
authors.lastname: Asche
authors.forename: Jinma
authors.initials: J
authors.lastname: Ren
authors.forename: Jean C
authors.initials: JC
authors.lastname: Aldag
authors.forename: Adolfo J
authors.initials: AJ
authors.lastname: Ariza
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Lowry
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D037001:Directive Counseling; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D009752:Nutritional Status; D009819:Office Visits; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D010865:Pilot Projects