Motivational interviewing in low socioeconomic adolescents with overweight or obesity

Abstract

Background: The PRALIMAP-INÈS trial aimed to investigate whether a strengthened care management strategy (SCMS) in low socioeconomic adolescents could have an equivalent effect in preventing and reducing overweight than standard care management in high socioeconomic adolescents. The SCMS includes 5 sessions of motivational interviewing (MI) aiming to develop motivation and to mobilize teenagers resources. This study focuses on effect of MI on change talk, stages of change, autonomy, self-efficacy, self-esteem. Methods: PRALIMAP-INÈS was a mixed, prospective and multicentre trial including 36 state-run schools in the North-Eastern France. It included overweight or obese adolescents, aged 13-17 years old. The SCMS was proposed to 414 adolescents in low socioeconomic status, among which 44,2% accepted to participate to MI. The five sessions of MI were distributed every two weeks and had addressed resolving ambivalence, diet, physical activity, social relationships and emotions. All interviewers were psychologists. Change in talk, resources, stages of change were rated by discourse analyses and questionnaires. Findings: The five sessions of MI gradually show a significant evolution in the stages of change, with a majority of teenagers who belonged to the action phase or maintenance. Moreover, during the sessions, the speech was significantly less focused on desires, needs and reasons to change, but more about the ability, commitment and the first steps. Finally, autonomy, self-efficacy and self-esteem were significantly higher at the end of the sessions. Discussion: MI is an effective strategy to help adolescents with low internal resources to consider change in their eating behaviors and physical activity.