Brief Motivational Interviewing for Pediatric Obesity: BMI2 Trial

Background: 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 ages two through eight. Methods: Forty-two practices from the American Academy of Pediatrics, Pediatric Research in Office Settings Network were randomly assigned to one of three groups. Group 1 (Usual Care) measured BMI percentile at baseline, one-year, and two-year follow-up. Group 2 (Provider only) delivered four MI counseling sessions to parents of the index child over two years. Group 3 (Provider + RD) delivered four provider MI sessions plus six MI sessions from a RD. The primary outcome was child BMI percentile at two-year follow up. Results: At two-year follow-up, the adjusted BMI percentile was 90.3, 88.1, and 87.1 for Group 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. Conclusion: 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 effectively use MI and how best to train RDs and integrate them into primary care settings also merit future research. <br><br><br><br>