title: Building Motivation in African American Caregivers of Adolescents With Obesity: Application of Sequential Analysis.
abstract: We sought to examine communication between counselors and caregivers of adolescents with obesity to determine what types of counselor behaviors increased caregivers' motivational statements regarding supporting their child's weight loss.
  
  
  
  We coded 20-min Motivational Interviewing sessions with 37 caregivers of African American 12-16-year-olds using the Minority Youth Sequential Coding for Observing Process Exchanges. We used sequential analysis to determine which counselor communication codes predicted caregiver motivational statements.
  
  
  
  Counselors' questions to elicit motivational statements and emphasis on autonomy increased the likelihood of both caregiver change talk and commitment language statements. Counselors' reflections of change talk predicted further change talk, and reflections of commitment language predicted more commitment language.
  
  
  
  When working to increase motivation among caregivers of adolescents with overweight or obesity, providers should strive to reflect motivational statements, ask questions to elicit motivational statements, and emphasize caregivers' autonomy.
authors.affiliation: Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, MI, USA.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Jacques-Tiura
authors.affiliation: Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, MI, USA.
authors.forename: April Idalski
authors.initials: AI
authors.lastname: Carcone
authors.affiliation: Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, MI, USA.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naar
authors.affiliation: Department of Dietetics and Nutrition, Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Brogan Hartlieb
authors.affiliation: Karmanos Cancer Institute, School of Medicine, Wayne State University, MI, USA.
authors.forename: Terrance L
authors.initials: TL
authors.lastname: Albrecht
authors.affiliation: Linguistics Program, Department of English, Wayne State University, MI, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Barton
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003376:Counseling / Q000379:methods*; D005260:Female; D058015:Health Communication / Q000379:methods; D006801:Humans; D008297:Male; D062405:Motivational Interviewing / Q000379:methods*; D063766:Pediatric Obesity / Q000523:psychology / Q000628:therapy*
keywords: African Americans; adolescents; obesity; patient-provider communication