Motivational interviewing to reduce anthropometrics among children: A meta-analysis, moderation analysis and Grading of Recommendations Assessment, Development and Evaluation assessment.

Background: Limited systematic reviews exist to evaluate the effects of motivational interviewing (MI) on children's anthropometric factors.

Objective: This review examined the effects of MI interventions for children and/or parents on children's anthropometric factors and included moderation analyses and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we searched Cochrane Library, PubMed, CINAHL, EMBASE, PsycINFO, Sociological Abstracts, SPORTDiscus, Education Resources Information Center, and Web of Science in December 2020. A two-step double screening approach was applied: (1) screening titles and abstracts, and (2) screening full-text articles obtained in step 1. At each step, discussion occurred until reaching consensus. The Cochrane risk-of-bias tool was used to evaluate risk of bias, and GRADE system was applied to assess overall quality of evidence. We performed meta-analyses using the Comprehensive Meta-Analysis software.

Results: A total of 2209 records were found, and 45 eligible articles were retained. MI interventions had a pooled effect of -0.15 on body mass index (BMI; 95% confidence interval [CI]: -0.24 to -0.06), -0.36 on waist circumference (WC; 95% CI: -0.71 to -0.01) and -0.22 on percent body fat (95% CI: -0.41 to -0.03). Child baseline weight status and percent low-income families were identified as significant intervention moderators. According to the GRADE assessment, the quality of evidence on BMI percentile, BMI z-score and percent body fat was moderate, while quality on BMI and WC was low.

Conclusions: In conclusion, culturally appropriate clinic- or home-based MI interventions with adequate duration, dose and active parental involvement are promising in reducing anthropometrics among children.