A Meta-Analysis of Motivational Interviewing Interventions for Pediatric Health Behavior Change

Objective: Motivational interviewing (MI) is an empirically supported intervention that has shown effectiveness in moving people toward positive lifestyle choices. Although originally designed for adult substance users, MI has since expanded to other health concerns with a range of client age groups. The present study investigated the overall effectiveness of MI in the context of child and adolescent health behavior change and health outcomes. Method: A literature search using PsycINFO, PubMed, Google-Scholar, and Social Work Abstracts was performed. Thirty-seven empirical studies were included in this meta-analysis, encompassing 8 health domains. Results: The overall effect size (Hedges's g) of MI in this population as compared to both other active treatments and no treatment was g = 0.282 (95% CI [0.242, 0.323], SE = 0.021), slightly higher than a small effect size and also slightly higher than what has been typically found in the substance literature. Effect sizes varied by health condition such that the health domains with the largest overall effect sizes were Type 1 diabetes, asthma, and calcium intake. Conclusions: The effectiveness of MI in pediatric domains was moderated by factors such as practitioner background, health domain, and the family member who participated. Unexpectedly, number of MI sessions and follow-up length were not significant moderators. MI seems to be most effective when both parent and child participate in sessions and when the cultural background of the practitioner matches the family. Overall, these findings indicate that MI is an effective and appropriate intervention for targeting child health behavior changes.