Childhood obesity is a serious public health issue with significant health risks and high medical costs. Using motivational interviewing (MI) around nutrition and physical activity in the context o an office visit has shown positive results in terms of health behavior change and weight lost in both the pediatric and adult populations. Despite studies demonstrating the efficacy of MI as a tool in the patient and physician encounter, most practicing clinicians lack training in MI. The American Academy of Pediatrics and Kognito are partnering to examine the following hypothesis that virtual reality technology is an effective tool to: 1) teach critical concepts and ) build skills and increase efficacy among healthcare professionals in motivational interviewing and cognitive behavioral coaching around childhood obesity prevention and treatment. Specifically the aims of this project are to:
AIM 1 : to ascertain the acceptability of utilizing vitual reality technology to educate clinicians on motivational interviewing and to build skills and self-efficacy in utilizing motivational interviewing and behavioral coaching as part of behavioral counseling at the point of care;
AIM 2 : to identify and isolate the key innovative technologies and features that will be most effective in improving clinician knowledge and skills on motivational interviewing and behavioral coaching;
AIM 3 : to identify, among a sample of target users, the most pertinent content to be included in a virtual reality- based educational module designed to improve clinician behavioral counseling and coaching through the use of motivational interviewing;
and AIM 4 : to ascertain potential ways that this technology can be used by the medical home and family/patient/practitioner team to monitor, assess, and progress on behavioral goals. Methods: To accomplish our aims, we propose conducting a blend of quantitative and qualitative research that allows clinicians to "test" the technology and provide both immediate feedback on an individual level and more reflective feedback in an interactive setting. A total of 35 pediatricians will be targeted for inclusion in Phase I research. The sample will reflect the current AAP member demographics for age and gender;within this context, we will oversample clinicians serving populations at higher risk for obesity. Pediatricians selected will be asked to complete two components of the study. First, all 35 will independently review a test module and provide quantitative feedback via pre and post surveys as well as pop-up questions throughout the module. In addition, qualitative data will be collected with participants through either a structured one on one interview over the phone or a small focus group. Commercial applications for this technology includes the capacity to be rapidly disseminated to practicing clinicians in a variety of settings, including for credit as Continuing Education activities, as well as to trainees through professional schools (medical, nursing, physician assistant, etc), and to conduct targeted outreach to those serving populations at the highest risk for obesity and obesity- related comorbities. The training and all its aforementioned components are available to any user with an internet- connected or CD/DVD capable computer and can, therefore, be delivered to large and geographically dispersed populations at low per-user costs when compared with in-person and group trainings.
The proposed joint research project between the American Academy of Pediatrics and Kognito will test whether virtual reality technology (VR) is an effective tool to teach clinicians motivational interviewing and behavioral coaching and its impact on the capacity of our clinician population to effectively address obesity and overweight in the office encounter thereby motivating patients and families to make positive health behavior changes. If proven acceptable and effective, the proposed VR module can serve as an non-threatening and accessible extended classroom for practicing clinicians and students to build skills in effective counseling and coaching of patients and families around nutrition and physical activity. Furthermore, there is the potential to target and build capacity among those clinicians serving populations at the highest risk for obesity and obesity- related comorbities as once developed this innovation can be rapidly disseminated at low cost to all clinicians treating children, adolescents and their families.