title: Motivational interviewing and dietary counseling for obesity in primary care: an RCT.
abstract: OBJECTIVE
  Few studies have tested the impact of motivational interviewing (MI) delivered by primary care providers on pediatric obesity. This study tested the efficacy of MI delivered by providers and registered dietitians (RDs) to parents of overweight children aged 2 through 8.
  
  
  METHODS
  Forty-two practices from the Pediatric Research in Office Settings Network of the American Academy of Pediatrics were randomly assigned to 1 of 3 groups. Group 1 (usual care) measured BMI percentile at baseline and 1- and 2-year follow-up. Group 2 (provider only) delivered 4 MI counseling sessions to parents of the index child over 2 years. Group 3 (provider + RD) delivered 4 provider MI sessions plus 6 MI sessions from a RD. The primary outcome was child BMI percentile at 2-year follow up.
  
  
  RESULTS
  At 2-year follow-up, the adjusted BMI percentile was 90.3, 88.1, and 87.1 for groups 1, 2, and 3, respectively. The group 3 mean was significantly (P = .02) lower than group 1. Mean changes from baseline in BMI percentile were 1.8, 3.8, and 4.9 across groups 1, 2, and 3.
  
  
  CONCLUSIONS
  MI delivered by providers and RDs (group 3) resulted in statistically significant reductions in BMI percentile. Research is needed to determine the clinical significance and persistence of the BMI effects observed. How the intervention can be brought to scale (in particular, how to train physicians to use MI effectively and how best to train RDs and integrate them into primary care settings) also merits future research.
authors.affiliation: Department of Health Behavior & Health Education, School of Public Health, and kresnic@umich.edu.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Resnicow
authors.affiliation: Department of Health Behavior & Health Education, School of Public Health, and.
authors.forename: Fiona
authors.initials: F
authors.lastname: McMaster
authors.affiliation: Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois;
authors.forename: Alison
authors.initials: A
authors.lastname: Bocian
authors.affiliation: Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois;
authors.forename: Donna
authors.initials: D
authors.lastname: Harris
authors.affiliation: Department of Health Behavior & Health Education, School of Public Health, and.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: University of Iowa, College of Public Health, Iowa City, Iowa;
authors.forename: Linda
authors.initials: L
authors.lastname: Snetselaar
authors.affiliation: Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina;
authors.forename: Robert
authors.initials: R
authors.lastname: Schwartz
authors.affiliation: Academy of Nutrition and Dietetics, Chicago, Illinois; and.
authors.forename: Esther
authors.initials: E
authors.lastname: Myers
authors.affiliation: Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois;
authors.forename: Jaquelin
authors.initials: J
authors.lastname: Gotlieb
authors.affiliation: Academy of Nutrition and Dietetics, Chicago, Illinois; and.
authors.forename: Jan
authors.initials: J
authors.lastname: Foster
authors.affiliation: University of Iowa, College of Public Health, Iowa City, Iowa;
authors.forename: Donna
authors.initials: D
authors.lastname: Hollinger
authors.affiliation: University of Iowa, College of Public Health, Iowa City, Iowa;
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.affiliation: Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan;
authors.forename: Susan
authors.initials: S
authors.lastname: Woolford
authors.affiliation: University of Iowa, College of Public Health, Iowa City, Iowa;
authors.forename: Dru
authors.initials: D
authors.lastname: Mueller
authors.affiliation: University of Vermont College of Medicine, Burlington, Vermont.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Wasserman
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D003376:Counseling; D004038:Diet, Reducing / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D009042:Motivation; D062405:Motivational Interviewing; D064686:Nutritionists; D010290:Parents / Q000193:education / Q000523:psychology; D063766:Pediatric Obesity / Q000523:psychology / Q000628:therapy*; D011320:Primary Health Care; D014481:United States
keywords: obesity
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