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Motivational interviewing to prevent childhood obesity: a cluster RCT [with consumer summary]
Doring N, Ghaderi A, Bohman B, Heitmann BL, Larsson C, Berglind D, Hansson L, Sundblom E, Magnusson M, Blennow M, Tynelius P, Forsberg L, Rasmussen F
Pediatrics 2016 May;137(5):e20153104
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached age 4. METHODS: Child health care centers in 8 Swedish counties were randomized into intervention and control units and included 1,355 families with 1,369 infants. Over about 39 months, families in the intervention group participated in 1 group session and 8 individual sessions with a nurse trained in motivational interviewing, focusing on healthy food habits and physical activity. Families in the control group received care as usual. Primary outcomes were children's BMI, overweight prevalence, and waist circumference at age 4. Secondary outcomes were children's and mothers' food and physical activity habits and mothers' anthropometrics. Effects were assessed in linear and log-binominal regression models using generalized estimating equations. RESULTS: There were no statistically significant differences in children's BMI (beta -0.11, 95% confidence interval (CI) -0.31 to 0.08), waist circumference (beta -0.48, 95% CI -0.99 to 0.04), and prevalence of overweight (relative risk 0.95, 95% CI 0.69 to 1.32). No significant intervention effects were observed in mothers' anthropometric data or regarding mothers' and children's physical activity habits. There was a small intervention effect in terms of healthier food habits among children and mothers. CONCLUSIONS: There were no significant group differences in children's and mothers' anthropometric data and physical activity habits. There was, however, some evidence suggesting healthier food habits, but this should be interpreted with caution.
Reproduced with permission from Pediatrics. Copyright by the American Academy of Pediatrics.

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