A clinical intervention to address childhood obesity using self-determination theory

The constructs of the Self-Determination Theory were applied to the development, implementation, and evaluation of a weight management intervention in a clinical setting using motivational interviewing counseling techniques. The intervention was conducted with youth 9-11 years (mean age-10.3+/-0.8; n=31), who were patients at primary care clinics in rural Maine. A randomized wait-listed control test of the intervention was conducted using anthropometric measures and online survey instruments (measuring motivation, competence, relatedness, self-esteem, and body dissatisfaction) at pre- (baseline) and post- (12 weeks) assessment. During the twelve-week intervention the children and parent treatment participants met bi-weekly for a total of six 45-60 minute individualized nutrition counseling sessions; received telephone calls on the weeks between the individualized counseling sessions; and the parents attended three 75-90 minute group psychoeducational sessions. Key topics were covered over the twelve weeks and participants set goals for behavior change at the conclusion of each session. The wait-listed control group received only the pre- and post-assessment and was offered the intervention upon completion of the post-assessments. Analysis included dependent t-tests and non-parametric tests. Children in the treatment group reported significant improvements in anthropometrics (p<0.0001), autonomous motivation (p=0.048), and self-esteem (p=0.048) from pre- to post-assessment, as well as positive trends in nutritional intake, physical activity and reduction of TV viewing. Children in the wait-listed control group reported a significant decrease in body dissatisfaction (p=0.047) compared to no change in the treatment group from pre- to post-assessment. Parents in the treatment group reported significant improvements in autonomous motivation (p=0.030), controlled motivation (p=0.023), competence (p=0.001), relatedness (p=0.025), and self-esteem (p=0.031) from pre- to post-assessment. While there is strong evidence that study participants established the foundational skills required for long-term behavior change, it appears that a lengthier intervention may be necessary to impact diet and physical activity.;This project was supported by a Faculty Research Fund grant to Dr. Adrienne White from the University of Maine..