Childhood obesity conversations: Motivational interviewing in the brief primary care visit

Abstract

Childhood obesity is a global epidemic that sets a child up for future health complications into adulthood. There’s no current consensus on approaching weight-related conversations with patients and families. Nurse practitioners (NPs) are in a unique position to recognize obesity and initiate weight-related conversations with patients and families. Unfortunately, formative educational programs under-educate practitioners in the conduction of obesity conversations, so there is a decreased confidence and resulting avoidance of weight-related conversations.

This practice improvement project (PIP) aimed to increase provider confidence and utilize motivational interviewing techniques to initiate and sustain weight-related conversations with children and families with overweight or obesity. The PIP consisted of an hour-long educational video sponsored by the American Academy of Pediatrics (AAP) electronically sent out to new family practice providers in a Nurse Practitioner Fellowship Program (NPFP) and experienced providers in the rural weight-management clinic. Pre- and post-surveys were employed to evaluate perceived confidence and utilization in clinical practice. Surveys also aided in understanding obesity education through formative and continuing education.

There were ten eligible participants, six from the NPFP and four from the weight management clinic. The PIP had a total of three participants who were all from the weight-management clinic. There were no participants from the NPFP. Through descriptive statistics, the co-investigator found that 2/3 of respondents had increased levels of perceived confidence regarding weight-related conversations with children and families with overweight or obesity. One participant indicated weight-related conversational training in formative schooling and all respondents reported weight-related conversational training through continuing education. One participant completed the one-month follow-up survey. The participant indicated he/she had implemented techniques presented in the video, but a larger population size is needed to make the results more meaningful. Although the results supported the purpose of the PIP, the co-investigator would recommend further research targeting primary care practitioners to determine the need for further education in the primary care setting. Although limitations existed, the education and delivery method met the needs of the participants. The co-investigator recommends implementing weight-related conversation education into primary care formative education and encourages practicing practitioners to seek out continuing education regarding weight-related conversations with patients and families.