The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol

Abstract

BackgroundExperts recommend that clinicians assess motivational factors before initiating care for pediatric obesity. Currently, there are no well-established clinical tools available for assessing motivation in youth with obesity or their families. This represents an important gap in knowledge since motivation-related information may shed light on which patients might fail to complete treatment programs. Our study was designed to evaluate the measurement properties and utility of the Readiness and Motivational Interview for Families (RMI-Family), a structured interview that utilizes a motivational interviewing approach to (i) assess motivational factors in youth and their parents, and (ii) examine the degree to which motivation and motivation-related concordance between youth and parents are related to making changes to lifestyle habits for managing obesity in youth.MethodsFrom 2016 to 2020, this prospective study will include youth with obesity (body mass index [BMI] ≥97th percentile; 13–17 years old; n = 250) and their parents (n = 250). The study will be conducted at two primary-level, multidisciplinary obesity management clinics based at children’s hospitals in Alberta, Canada. Participants will be recruited and enrolled after referral to these clinics, but prior to initiating clinical care. Each youth and their parent will complete the RMI-Family (~1.5 h) at baseline, and 6- and 12-months post-baseline. Individual (i.e., youth or parent) and family-level (i.e., across youth and parent) responses to interview questions will be scored, as will aspects of interview administration (e.g., fidelity to motivational interviewing tenets). The RMI-Family will also be examined for test-retest reliability. Youth data collected at each time point will include demography, anthropometry, lifestyle habits, psychosocial functioning, and health services utilization. Cross-sectional and longitudinal associations between individual and family-level interview scores on the RMI-Family and these clinical measures will be examined.DiscussionAs a measurement tool drawing on family-centered care and motivational interviewing, the RMI-Family was designed to increase understanding of the role of motivational factors in pediatric obesity management, allowing healthcare providers and policymakers to manage pediatric obesity more effectively and efficiently. Findings will help to create an innovative, tailored model of health care delivery that uses resources judiciously and is designed to best meet families’ needs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2201-8) contains supplementary material, which is available to authorized users.

Waitlist management in a pediatric weight management clinic: implementing an orientation session

“…Relatedly, pressure on the front desk staff to repeatedly describe why patients were referred, length of appointments, and how the clinic works was allayed. These outcomes represent notable improvements over traditional referral handling and scheduling where patients were given the next available appointment without first screening for interest [ 19 , 30 ].…”

“…Drawing on tenets of motivational interviewing, Ball and colleagues [ 19 ] created the Readiness and Motivation Interview for Families to aid healthcare providers in better understanding family-level motivational factors (e.g., perceived importance of lifestyle changes, perceived ability to implement lifestyle changes) that are so important to engagement and participation in treatment. Use of such measures may facilitate referral of patients and their families who are ready and willing to initiate and participate in pediatric weight management.…”

“…The unmet supply of comprehensive pediatric obesity programming is exacerbated by disinterest and amotivation in a subset of patients as well as waning motivation among patients and families who may have been ready to make changes at the time of initial referral [ 15 , 18 ]. As such, it is important to direct existing resources to those most ready to take advantage of pediatric weight management [ 19 ]. The purpose of this project was to evaluate the implementation of an orientation session within a pediatric weight management clinic.…”

Motivational Interviewing Screening Tool to Address Pediatric Obesity

“…However, many studies do not report these methods as being the most effective in establishing a long-term weight management option for the pediatric population. 4,5 A study by Gourlan et al 5 indicated implementing the technique of motivational interviewing (MI) in treating pediatric obesity resulted in improved physical activity and BMI. MI is a family-centered collaborative approach and focuses on the patient and provider to collaborate to determine a plan of care.…”

Motivational Interviewing as Group Therapy for Glycemic Control and Treatment Satisfaction of Patients with Type 2 Diabetes Mellitus

“…Its effect on better patient-doctor relationship and treatment adherence has been confirmed in a number of chronic medical conditions including diabetes [13]. In some pediatric chronic conditions not only the child's own motivation is important but also the parents' motivation is important for treatment engagement and success [14]. MI can be "blended with other evidence-based clinical skills and approaches" [11].…”