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Motivational Interviewing and Caregiver Engagement in the Family Check-Up 4 Health

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Abstract

Motivational interviewing (MI) is a therapeutic style in which a provider elicits client motivation and helps strengthen commitment to change (Miller and Rollnick 2002). The original Family Check-Up (FCU; Dishion and Stormshak 2007)—and the adapted version for improving health behaviors in primary care, the Family Check-Up 4 Health (FCU4Health; Smith et al. 2018a)—are brief, assessment-driven, and family-centered preventive interventions that use MI to improve parent engagement in services to improve parenting and prevent negative child outcomes. This study examines the role of MI in the Raising Healthy Children project, a randomized trial to test the effectiveness of the FCU4Health for the prevention of obesity in pediatric primary care, with data from the 141 families assigned to receive the FCU4Health. Families were eligible for the study if the child was between 5.5 and 12 years of age at the time of identification and had a BMI ≥ 85th percentile for age and gender at the most recent visit to their primary care provider. MI skills at the first session predicted caregiver in-session active engagement, attendance at follow-up parenting sessions, and improvements in motivation to address child health and behavior goals. Baseline characteristics of the family (i.e., child health diagnosis, caregiver baseline depression, motivation, and Spanish language preference) had differential associations with responsiveness and MI skills. This study has implications for program development, provider training, and fidelity monitoring.

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Funding

This study was supported by the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (U18 DP006255; Berkel and Smith).

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Authors and Affiliations

  1. Department of Psychology, REACH Institute, Arizona State University, 900 S McAllister Ave, Tempe, AZ, USA

    Cady Berkel, Anne M. Mauricio & Thomas J. Dishion

  2. Phoenix Children’s Hospital, Phoenix, AZ, USA

    Cady Berkel & Jenna Rudo-Stern

  3. Center for Prevention Implementation Methodology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Justin D. Smith

Authors
  1. Cady Berkel
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  2. Anne M. Mauricio
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  3. Jenna Rudo-Stern
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  4. Thomas J. Dishion
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  5. Justin D. Smith
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Correspondence to Cady Berkel.

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Conflict of Interest

Berkel and Smith co-developed the Family Check-Up 4 Health program with Thomas Dishion, developer of the original Family Check-Up.

Ethical Approval

This trial was designed in accordance with the basic ethical principles of autonomy, beneficence, justice, and non-maleficence and conducted in accordance with the rules of Good Clinical Practice outlined in the most recent Declaration of Helsinki. The project was approved by the Institutional Review Boards of Arizona State University (Protocol 00004530) and Phoenix Children’s Hospital (Protocol 17-001). All other institutions participating in this research provided signed reliance agreements ceding to the IRB of Arizona State University.

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Informed consent was obtained from all individual participants included in the study.

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Berkel, C., Mauricio, A.M., Rudo-Stern, J. et al. Motivational Interviewing and Caregiver Engagement in the Family Check-Up 4 Health. Prev Sci 22, 737–746 (2021). https://doi.org/10.1007/s11121-020-01112-8

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