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Study design and baseline description of the BMI2 trial: reducing paediatric obesity in primary care practices
K Resnicow1, F McMaster, S Woolford
1Department of Health Behavior & Health Education, University of Michigan, Ann Arbor, MI 48109-2029, USA. kresnic@umich.edu
Insights
This study evaluated motivational interviewing (MI) for children with elevated BMI. Findings suggest volunteer clinicians can recruit participants for MI interventions, informing future childhood obesity prevention efforts.
Area of Science:
- Pediatric health
- Behavioral science
- Public health
Background:
- Childhood obesity is a growing concern, necessitating effective interventions.
- Early intervention in children aged 2-8 with elevated Body Mass Index (BMI) is crucial.
- Motivational Interviewing (MI) shows promise in behavior change, but its application by primary care providers needs further study.
Purpose of the Study:
- To test the efficacy of motivational interviewing (MI) delivered by primary care providers and dieticians for children aged 2-8 with BMI between the 85th and 97th percentiles.
- To assess the impact of MI on children's BMI percentile and related health behaviors.
- To evaluate the feasibility of implementing MI in pediatric primary care settings.
Main Methods:
- A randomized controlled trial involving 42 pediatric practices.
- Participants were assigned to usual care, MI by primary care providers, or MI by primary care providers plus dieticians.
- The primary outcome was BMI percentile at 2-year follow-up; secondary outcomes included screen time, physical activity, and dietary intake.
Main Results:
- 633 children were enrolled with a mean BMI percentile of 92.0 and mean age of 5.1 years.
- The cohort was diverse, with 57% female and varying socioeconomic and educational backgrounds.
- Parental confidence in achieving a healthy weight was high (average 8 out of 10).
Conclusions:
- Volunteer clinicians successfully recruited participants for the study.
- Clinicians demonstrated willingness to undergo training in MI, indicating feasibility for implementation.
- The study provides insights into the practical aspects of delivering MI interventions in primary care for childhood obesity.
Objectives:
This study will test the efficacy of motivational interviewing (MI) conducted by primary care providers and dieticians among children ages 2-8 years old with a body mass index (BMI) ≥ 85th and ≤ 97th percentile.
Methods:
Forty-two practices from the American Academy of Pediatrics, Pediatric Research in Office Settings Network were assigned to one of three groups. Group 1 (usual care) measures BMI percentile at baseline, and at 1- and 2-year follow-ups and receives standard health education materials. Group 2 providers deliver three proactive MI counselling sessions with a parent of the index child in Year 1 and one additional 'booster' visit in Year 2. Group 3 adds six MI counselling sessions from a trained dietician. The primary outcome is the child's BMI percentile at 2-year follow-up. Secondary outcomes include parent report of the child's screen time, physical activity, intake of fruits and vegetables, and sugar-sweetened beverages.
Results:
We enrolled 633 eligible children whose mean BMI percentile was 92.0 and mean age of 5.1. The cohort was 57% female. Almost 70% of parents reported a household income of ≥ $40,000 per year, and 39% had at least a college education. The cohort was 63% white, 23% Hispanic, 7% black and 7% Asian. Parent self-reported confidence that their child will achieve a healthy weight was on average an 8 (out of 10).
Conclusion:
To date, several aspects of the study can inform similar efforts including our ability to use volunteer clinicians to recruit participants and their willingness to dedicate their time, without pay, to receive training in MI.
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