STAGES OF CHANGE, PARENTING, ATYPICAL ANTIPSYCHOTIC MEDICATION, AND ADOLESCENT BODY MASS INDEX: AN EXPLORATORY STUDY
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Objective This retrospective longitudinal study investigated the relationship between readiness to change (The Transtheoretical Model of Stages of Change), parenting (e.g., parenting style, practices, and stress), and the use of atypical antipsychotic medication on body mass index (BMI) in adolescents with obesity, most of whom were Hispanic. Methods Data were obtained from an existing clinical database of 41 adolescents between 12-18 years of age (Mean age 14.35 years, 39% male, 4.9% White, 19.5% Black, 63.4% Hispanic, 12.2% Other) who participated in outpatient behavioral weight management group therapy, that included motivational interviewing, once a week for a period of seven weeks. Multilevel Regression Modeling analysis was employed to examine within and between participant differences in BMI. Readiness to change was measured with the use of baseline self-report ratings on the University of Rhode Island Change Assessment (URICA). Parent ratings on the Parenting Relationship Questionnaire-Child and Adolescent (PRQ-CA) were obtained as a measure of parenting style, practices, and stress. Medication status (e.g., the use of atypical antipsychotic medication) was collected for each individual. Results Although used by only two subjects atypical antipsychotic medication was significantly related to higher BMI at baseline. Parenting confidence was significantly related to lower BMI at baseline. From week to week, there was not a significant fixed effect for rate of change in BMI within or between individuals; however, random effects for rate of change between individuals were present. Mean baseline BMI was lower for individuals who presented in the action stage of change than those who presented in the precontempation/contemplation stages. Conclusion Understanding the influence of individual readiness to change, parenting confidence, and the use of atypical antipsychotic medication on adolescent weight status, may improve comprehensive assessment and interventions in the clinical treatment for adolescent obesity. Implications for professionals are discussed and directions for future research are highlighted. Furthermore, given the diverse demographic of the sample used in this study (63.4% Hispanic, 19.5% Black); multicultural considerations for adolescents with obesity are discussed.