Impact of a brief training on motivational interviewing and the 5A's approach on weight-related counseling practices of pediatricians

Jean A Welsh; Samantha J Lange; Janet Figueroa; Stephanie Walsh; Holly Gooding; Patricia Cheung

doi:10.1002/osp4.588

Impact of a brief training on motivational interviewing and the 5A's approach on weight-related counseling practices of pediatricians

Obes Sci Pract. 2022 Jan 19;8(4):466-473. doi: 10.1002/osp4.588. eCollection 2022 Aug.

Authors

Jean A Welsh^{1

2}, Samantha J Lange², Janet Figueroa^{1

2}, Stephanie Walsh^{1

2}, Holly Gooding¹, Patricia Cheung³

Affiliations

¹ Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA.
² Department of Child Advocacy Children's Healthcare of Atlanta Atlanta Georgia USA.
³ Rollins School of Public Health Emory University Atlanta Georgia USA.

Abstract

Background: Pediatric primary healthcare providers are well-positioned to provide healthy lifestyle and weight management related counseling but many lack training in evidence-based messages and methods.

Objectives: We assessed the impact of a brief, easy-to-access training for pediatric healthcare providers, (the Strong4Life Provider Training), designed to introduce/review current evidence-based messages and methods and improve healthy weight-related assessment and counseling practices.

Methods: Following their well-child visit, a convenience sample of children 12-17 years and parents of children 6-11 years (N = 121) of randomly selected Strong4Life trained (N = 15) and untrained (N = 15) pediatricians were administered a survey designed to assess the frequency, content, and patient satisfaction with weight management-related counseling provided. Results from parents and patients of trained pediatricians (N = 62) compared to those from parents and patients of untrained pediatricians (n = 59) were compared using chi-square tests. Generalized estimating equations were used to account for lack of independence among respondents from the same practice. P-values less than 0.05 were considered to be statistically significant.

Results: Parents/patients of trained pediatricians were more likely than those of an untrained pediatrician to report having been asked about child's consumption of fruit/vegetables, 57 (92%) versus 44 (75%), p = 0.04 and sugary drinks, 50 (81%) versus 29 (49%), p = 0.005, and their readiness for behavior change, 47 (76%) versus 29 (49%), p = 0.005, and to set a behavior change goal, 36 (59%) versus. 23 (40%), p = 0.005. Regardless of training status, physical activity, screen time, and weight status were assessed for most patients, and most were satisfied with the discussion. Few (21%) were asked about barriers to behavior change.

Keywords: 5As; counseling; motivational interviewing; obesity; pediatric.