African-American Adolescents’ Weight Loss Skills Utilization: Effects on Weight Change in a Sequential Multiple Assignment Randomized Trial

Abstract

Objective: Successful weight loss interventions for African-Americans adolescents are lacking. Cognitive-behavioral interventions seek to develop weight loss skills (e.g., counting calories, goal setting, managing one's environment). Little is known about how well adolescents implement such skills in their daily lives. Study aims were to (1) examine weight loss skills utilization at midpoint and end of a 6-month cognitive-behavioral/motivational interviewing weight loss sequential multiple assignment randomized trial (SMART), and (2) determine if greater skill utilization predicted weight loss at treatment end and 3 months post-treatment.Method: One hundred and eighty six African-Americans adolescents with obesity and their caregiver were first randomly assigned to complete 3 months of cognitive-behavioral and motivational interviewing family-based weight loss treatment in their home or in the research office (Phase 1). Nonresponders (i.e., those who lost < 3% of initial weight, n = 161) were rerandomized to 3 months of continued skills training (n = 83) or contingency management (n = 78) for Phase 2; responders were allocated to 3 months of relapse prevention (n = 20). Adolescents' frequency of weight loss skills utilization was assessed via questionnaire at treatment midpoint and end.Results: Higher treatment attendance was associated with better skill utilization. Higher skill utilization was associated with more weight loss at treatment end, whereas higher baseline confidence was associated with more weight loss at follow-up.

Motivational interviewing to reduce anthropometrics among children: A meta‐analysis, moderation analysis and Grading of Recommendations Assessment, Development and Evaluation assessment

“…Of the 38 interventions, 19 were clinic‐based, 8 were school‐based, 6 were home‐based, 3 were community‐based and 2 compared a home‐based intervention with a clinic‐based intervention 31,32 . The intervention duration ranged from 5 weeks to 39 months, with an average duration of 8.29 months.…”

Resource mobilization combined with motivational interviewing to promote healthy behaviors and healthy weight in low-income families: An intervention feasibility study

“…48 MI has been used with parents, [48][49][50] adolescents, 51 and children as young as third grade, 52 though the use of MI in a family setting (including parent and child) for obesity prevention has received limited study. [51][52][53][54] However, family-focused goal-setting and MI are used to treat child obesity, 23,55,56 alcohol use, and family functioning. 53,57 Only five studies have included children in MI sessions resulting in behavior changes, 58,59 and weight loss.…”