Teen and caregiver perspectives on success, clinician role, and family involvement in ACTION PAC, a weight management intervention trial

Describe perspectives of teens and caregivers regarding motivations, successes, and challenges related to participation in ACTION PAC (ClinicalTrials.gov: NCT02502383), a two-year weight management trial. Intervention group participants received 16 short motivational interviewing (MI) sessions with school-based health center (SBHC) primary care clinicians over two years. Post-study, we conducted semi-structured interviews with purposefully sampled intervention group teens and their caregivers. Interviews were audio recorded, transcribed, and managed in NVivo 11. Three independent coders analyzed the data, developed a coding tree, examined how codes intersected and clarified relationships through memo writing. The clinician’s role and use of motivational interviewing and family involvement in behavior changes were cited as critical to success. Some adolescents noted difficulty in sustaining behavior changes post-intervention and social and systemic barriers to behavior change. Future studies should identify strategies to sustain teen motivation, better involve families, and address systemic barriers. In this study, which simulated real-world SBHC conditions, adolescents appreciated the use of an MI approach and felt that was key to their success, indicating the potential to continue use of this approach to motivating behavior changes in SBHC settings.