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Motivational interviewing to treat overweight children: 24-month follow-up of a randomized controlled trial [with consumer summary] |
Broccoli S, Davoli AM, Bonvicini L, Fabbri A, Ferrari E, Montagna G, Panza C, Pinotti M, Storani S, Tamelli M, Candela S, Bellocchio E, Giorgi Rossi P |
Pediatrics 2016 Jan;137(1):e20151979 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; 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* |
BACKGROUND: Pediatrician-led motivational interviewing can be an effective way of controlling BMI in overweight children in the short term. Its long-term efficacy is unknown. The primary aim was to determine whether the short-term (12-month) impact of family pediatrician-led motivational interviews on the BMI of overweight children could be sustained in the long term (24 months), in the absence of any other intervention. METHODS: Children were recruited in 2011 by family pediatricians working in the province of Reggio Emilia, Italy, and randomly allocated to receive either 5 interviews delivered over a 12-month period or usual care. Eligible participants were all 4- to 7-year-old overweight children resident in the province of Reggio Emilia who had been receiving care from the pediatrician for >= 12 months. The primary outcome of this study was individual variation in BMI between the baseline visit and the 24-month follow-up, assessed by pediatricians not blinded to treatment group allocation. RESULTS: Of 419 eligible families, 372 (89%) participated; 187 children were randomized to receive intervention and 185 to usual care. Ninety-five percent of the children attended the 12-month follow-up, and 91% attended the 24-month follow-up. After the 12-month intervention period, BMI in the intervention group increased less than in the control group (0.46 and 0.78, respectively; difference -0.32; p = 0.005). At the 24-month follow-up, the difference had disappeared (1.52 and 1.56, respectively; difference -0.04; p = 0.986). CONCLUSIONS: The intervention lost its effectiveness within 1 year of cessation. Sustainable boosters are required for weight control and obesity prevention.
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