Motivational Interviewing in Pediatric Obesity: A Meta-analysis of the Effects on Behavioral Outcomes

BACKGROUND: Currently, the effects of motivational interviewing (MI) on children’s behavioral changes remain obscure. PURPOSE: This systematic review and meta-analysis examined the effects of MI on children’s lifestyle behavioral changes (fruits and vegetables [F/V], dairy, sugary beverages, calories, snacks, fat intake, moderate vigorous physical activity [MVPA], and screen time). METHODS: Six databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2022 were searched. Thirty-one intervention studies with a comparison group met the criteria. Random-effects models were performed to estimate the pooled effects; exploratory moderation analyses with mixed-effects models were used to explore potential intervention moderators. RESULTS: The pooled effect size was 0.10 (p = .334) on ↑F/V, 0.02 (p = .724) on ↑dairy, −0.29 (p < .001) on ↓calories, −0.16 (p = .054) on ↓sugary beverages, −0.22 (p = .002) on ↓snacks, −0.20 (p = .044) on ↓fat, 0.22 (p = .001) on ↑MVPA, and −0.06 (p = .176) on ↓screen time. The effects of MIs were moderated by ↑MI sessions regarding ↓snacks (B = −0.04, p = .010). Multicomponent and clinical programs had greater effects on dairy intake than their counterparts (0.09 vs. −0.21, p = .034; 0.12 vs. −0.14, p = .027, respectively). Similarly, interventions with a fidelity check resulted in greater dairy intake than those without a check (0.29 vs. −0.15, p = .014). A few long-term follow-up assessments revealed effects on ↓F/V (−0.18; p = .143, k = 2), ↓dairy (−0.13, p = .399, k = 4), ↓MVPA (−0.04; p = .611, k = 6), and ↑screen time (0.12; p = .242, k = 4). CONCLUSIONS: Our findings support the short-term effects of MI on improving children’s lifestyle behaviors. Additional investigations are needed to better sustain children’s long-term behavioral changes.