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Child Obes. 2017 Oct 11. doi: 10.1089/chi.2017.0089. [Epub ahead of print]

Texting Motivational Interviewing: A Randomized Controlled Trial of Motivational Interviewing Text Messages Designed to Augment Childhood Obesity Treatment.

Author information

1
1 Department of Pediatrics, Duke University School of Medicine , Durham, NC.
2
2 Division of Developmental Pediatrics, Department of Pediatrics, New York University School of Medicine , New York, NY.
3
3 Department of Population Health, New York University School of Medicine , New York, NY.
4
4 Department of Psychology and Neuroscience, Duke Digital Health Science Center, Duke Global Health Institute, Duke University , Durham, NC.
5
5 Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children , Harvard Medical School, Boston, MA.
6
6 Division of General Pediatrics and Psychiatry, Mt. Sinai School of Medicine , New York, NY.
7
7 Division of Ambulatory Pediatrics, Nationwide Children's Hospital , Columbus, OH.

Abstract

BACKGROUND:

Text messages improve health outcomes for adults engaged in weight management. Little is known about whether text messaging parents of children enrolled in obesity treatment will improve child health.

METHODS:

We conducted a 2-group randomized controlled study among 101 children aged 5-12 and their parent/guardian enrolling in tertiary-care obesity treatment. Participants were randomized to standard care or standard care plus daily motivational interviewing-based text messages. The primary outcome was change in child BMI at 3 months. Secondary outcomes included feasibility, health behaviors, attrition, motivation, and parent BMI.

RESULTS:

We enrolled 101 parent-child dyads and retained 81% to 3-month follow-up. Child participants had a mean age of 9.9 years, and baseline BMI of 30.5 kg/m2. Half (48%) of participants were Black, and 64% of parent participants had a high school equivalent education or less. Ninety-nine percent of parents owned a mobile device with unlimited text messaging. Parents responded to 80% of texts, and 95% felt the texts "always" or "almost always" helped them make a good health decision. We observed no between-group difference in child zBMI from baseline to 3 months (0.0 vs. 0.2, p = 0.2). Intervention participants had significantly better adherence to clinic visits (3.3 visits vs. 2.1 visits/3 months, p < 0.001).

CONCLUSIONS:

Parent-directed text messages did not significantly change child BMI. However, texting significantly reduced attrition for treatment visits. Nearly all parents in this racially diverse, low-income sample engaged in daily text messaging, making this a feasible approach.

KEYWORDS:

body mass index; digital health; motivational interviewing; obesity treatment; text message

PMID:
29019418
DOI:
10.1089/chi.2017.0089
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