Motivational Interviewing as a Lifestyle Management Strategy for Dyslipidemic Overweight and Obese Adolescents

Background: Dyslipidemia, overweight and obesity (OW/OB) in the pediatric population contributes to metabolic complications and future cardiovascular disease. The prevalence varies but the problem is a global issue. Adolescence is a challenging developmental stage with many factors influencing adolescent health. Lifestyle management is the preferred treatment. Motivational interviewing is a promising counselling approach; however, evidence is limited for this population. Objectives and Methods: The substantive focus involved exploring MI for dyslipidemic adolescents. Study A was a retrospective cohort comparison aimed to assess a collaborative educational approach with MI elements for pediatric patients (n=38) newly referred to a specialized lipid clinic, versus historical patients who had received a more didactic educational approach (n=31). Study B involved theoretical research to build and graphically represent a conceptual framework for MI, including special applications to adolescents. Study C was a mixed-methods, randomized controlled trial (N=32) to evaluate the outcomes of MI counselling, comparing adolescents together with a parent versus adolescents alone. A qualitative component occurred following the quantitative data collection to explore the perceptions of participants. Findings: Despite some limitations, sufficient promise was observed in the Study A findings to move forward with a detailed plan to rigorously explore MI. Significantly improved lifestyle and anthropometry outcomes were observed favouring the collaborative education approach with MI. The theoretical work in Study B defined four key elements for a MI framework: the Person, the Problem, the Process, and the MI Counsellor. The between group results for Study C were equivocal; however, with both groups combined in a secondary analysis, there were significant improvements in nearly all outcomes. The interviews enriched an understanding of the participantsâ lives, lifestyle change, and the counselling process. Conclusion: Motivational interviewing is an effective and desired counselling strategy for adolescents with dyslipidemia and overweight/obesity. Further research with a longer period of observation is needed to determine whether achieved lifestyle improvements can be sustained in the long-term.Ph.D.2018-12-01 00:00:0