Health behaviour change in young children: the role of a parent-facilitated motivational interviewing prevention intervention program

Submission note: A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Health Psychology to the School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Bundoora.

Increasingly, children are being diagnosed with chronic conditions, such as obesity, due to a change in lifestyle behaviours including poor activity and eating habits. This change has increased children’s risk of developing adulthood diseases. Early prevention intervention programs are needed to deal with health behaviour change. Two studies explored this idea. Study 1 investigated whether an experimental program based on motivational interviewing (MEP) was more effective than an educational program (FWMP) in assisting 20 parents to support their children, aged between 7 and 12, to change unhelpful health behaviours that do not promote the maintenance of good health. It was predicted that, compared to the seven FWMP children, the 14 MEP children would demonstrate more helpful eating and activity habits post intervention that would be maintained at six months follow-up. It was also predicted that the MEP children would demonstrate greater improvement in self-esteem, mood, and body-image perception. Other variables examined included the children’s motivation orientation and other family members' health behaviours. Both programs targeted the parent as the change agent, and were matched in number of sessions, program length, and facilitator contact. On completion of MEP, a focus group assessed its utility. In contrast to the expected outcome, intervention effects were demonstrated in both groups. For example, children's activity levels were significantly increased and sedentary hours decreased. They also demonstrated a significant decrease in eating whilst watching T.V., and a decrease in calories and carbohydrates. These main effects suggest that the parents were an important influence in their children's health behaviour change. The focus group results suggest that, despite the quantitative findings, MEP helped parents address their ambivalence to support change. The feedback also highlighted barriers to HEALTH BEHAVIOUR CHANGE and MI 13 participation and retention, which were limitations of Study 1. Study 2 was conducted to explore impediments to problem recognition, help-seeking, and treatment adherence. Semi-structured, audio taped interviews were conducted with nine MEP parents and nine parents who withdrew from the interventions. Content and thematic analyses were used to identify major and category themes. The qualitative results suggest that minor differences may influence intervention participation. The quantitative results showed that the parents who withdrew were significantly more depressed than the intervention group. It is suggested that future studies assess parents for learned helplessness to identify whether this is a significant factor that impacts on parents’ active participation in interventions and in supporting their children to change their health behaviours.