A Meta-Analysis of Motivational Interviewing Interventions for Pediatric Health Behavior Change

Motivational interviewing (MI) is an empirically supported intervention that has shown effectiveness in moving people towards positive lifestyle choices. Although originally designed for adult substance users, MI has since expanded to other health concerns with a range of clients age groups. The following meta-analysis analyzed MI's effectiveness in eliciting behavior change in pediatric health domains. Thirty-seven empirical studies were included in this meta-analysis, encompassing eight health domains. The overall effect size (Hedge's g) in this population as compared to both other active treatments and no treatment was 0.282 (95% CI [0.242-0.323]), slightly higher than a "small" effect size, and also slightly higher than what has been typically found in the substance literature. The effectiveness of MI in pediatric domains was moderated by factors such as practitioner background, health domain, and the family member who participated. Effect sizes varied by health condition such that the health domains with the largest overall effect sizes were Type 1 Diabetes, asthma, and calcium intake. MI seems to be most effective when both parent and child participate in sessions and when the cultural background of the practitioner matches the family. Unexpectedly, number of MI sessions and follow-up length were not significant moderators. Overall, these findings indicate that MI is an effective and appropriate intervention for targeting child health behavior changes

Influence of Best Friends on Children’s Athletic Competence and Physical Activity Engagement: A Longitudinal Analysis

Pediatric obesity is a significant public health concern, associated with systemic physical health repercussions and impairing social and emotional consequences. Physical activity is an important protective factor against development of obesity, and childhood represents a critical time for forming lifelong physical activity habits. Weight status has been shown in the adult and adolescent literature to move through social systems as a “social contagion”, yet the social systems on development of physical activity and athletic competence in childhood has been less studied, especially within a longitudinal frame. This study aimed to examine the influence of perceived and self-reported best friend factors on child physical activity and athletic competence over a school year. Methods included in-school administration of questionnaires related to athletic competence and perceived best friend athletic competence, as well as objective measurement of physical activity. Findings suggested friends were similar on these constructs at Time 1, but not Time 2. The novel measurement of perceived best friend athletic competence was revealed to be a unique and influential construct. This variable was distinct from both child self-reported athletic competence and best friend self-reported athletic competence, and significantly influenced child engagement in physical activity over time. Implications for this study include the importance of measuring the child’s perception of the best friend when examining dyads in the context of physical activity

Change in health-related quality of life in the context of pediatric obesity interventions: A meta-analytic review.

Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n = 16), surgical (n = 5), and pharmacological (n = 1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in body mass index (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined. Method: Data were gathered from studies reporting on weight change and ΔHRQoL over the course of obesity interventions (N = 22) in youths (N = 1,332) with average ages between 7.4 and 16.5 years (M = 12.2). An overall effect size was calculated for ΔHRQoL. Moderation analyses were conducted using analysis of variance and weighted regression. MCID analyses were conducted by converting HRQoL data to standard error of measurement units. Results: The overall effect size for ΔHRQoL in the context of pediatric obesity interventions was medium (g = 0.51). A significant linear relationship was detected between ΔBMI and ΔHRQoL (R2 = 0.87). This relationship was moderated by treatment type, with medical (i.e., surgical) interventions demonstrating a stronger relationship. Results indicated that it takes a change of 0.998 BMI units to detect true change in HRQoL. Conclusion: This study provides the first known quantitative examination of changes in HRQoL associated with weight loss in pediatric interventions. Medical interventions appear to offer a more substantial increase in HRQoL per unit of BMI change. These results offer a concrete weight loss goal for noticing positive effects in daily life activities. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Change in Health-Related Quality of Life in the Context of Pediatric Obesity Interventions: A Meta-Analytic Review

Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n = 16), surgical (n = 5), and pharmacological (n = 1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in body mass index (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined. Method: Data were gathered from studies reporting on weight change and ΔHRQoL over the course of obesity interventions (N = 22) in youths (N = 1,332) with average ages between 7.4 and 16.5 years (M = 12.2). An overall effect size was calculated for ΔHRQoL. Moderation analyses were conducted using analysis of variance and weighted regression. MCID analyses were conducted by converting HRQoL data to standard error of measurement units. Results: The overall effect size for ΔHRQoL in the context of pediatric obesity interventions was medium (g = 0.51). A significant linear relationship was detected between ΔBMI and ΔHRQoL (R2 = 0.87). This relationship was moderated by treatment type, with medical (i.e., surgical) interventions demonstrating a stronger relationship. Results indicated that it takes a change of 0.998 BMI units to detect true change in HRQoL. Conclusion: This study provides the first known quantitative examination of changes in HRQoL associated with weight loss in pediatric interventions. Medical interventions appear to offer a more substantial increase in HRQoL per unit of BMI change. These results offer a concrete weight loss goal for noticing positive effects in daily life activities