4. Discussion
obesity
OBESITY, REGRESSION, PACS
The objective of this study was to explore the preliminary effects of PAC-focused RDMI on outcomes among dyads in a multicomponent obesity prevention intervention. Addressing PACs in this context is critical [A primary advantage of using MI is its focus on the psychological and/or cognitive predictors of behavior change (e.g., ambivalence) versus an emphasis on passive education/knowledge, or more paternalistic approaches. Such an appreciation for the varying predictors of, and/or contributors to health behavior and its related outcomes (e.g., psychological factors, mental health), is essential for prevention strategies. This characteristic of MI may contribute to its potentially positive effect on health outcomes among underserved populations, including diverse populations [African American participants were more likely to be classified as This study documents that RDMI use was associated with improvements in PAC health behavior. Specifically, for every one-unit increase in Further, RDMI in this study was one component of a multicomponent intervention, and interest remains in understanding the unique contributions of RDMI as an “active ingredient.” Attendance/participation in other study components did contribute to diet-related outcomes, though to varying degrees, and in some instances, RDMI demonstrated a greater contribution. Results of logistic regression indicate that PAC BMI was the strongest predictor of RDMI completion. The literature indicates that confronting weight status may negatively impact treatment engagement and outcomes; thus, the lack of focus on these issues in this study highlights a strength [Despite MI’s role in addressing ambivalence [This study had numerous strengths, including a detailed examination of MI from a RD, including in a diverse cohort, as well as for the purposes of modifying PAC behavior in the context of a child-focused pediatric obesity prevention intervention. However, this study is not without limitations. As data for one year of the overarching five-year trial are presented, the sample size is small, limiting interpretation and potentially explaining the absence of statistical significance. In addition, in this study, the short-term follow up may be insufficient to observe sustained changes in health or behavior, and limit the interpretation of long-term or sustained implications. In conclusion, results indicate MI from a RD delivered to PACs can improve ambivalence regarding diet quality, as well as measures of diet, in both PACs and youth, including among PACs with high ambivalence.