The patient-parent-provider alliance in childhood obesity treatment
Aamar, Rola O.
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Childhood obesity continues to be one of the most concerning public health crises in the US. Great strides have been made towards understanding the causes, risks, and consequences of childhood obesity, which have been used to guide the development of best practices for childhood obesity treatment. While expert best practice recommendations for treatment indicate the importance of the patient-provider relationship in treatment, the extant literature fails to capture how to use the patient-provider relationship as an alliance in treatment. The purpose of this dissertation study was to explore the role of patient-provider alliance and parent-provider alliance in a childhood obesity treatment setting, and to understand the relationship between the treatment alliance and treatment outcomes. Patients who presented for treatment at a childhood obesity treatment clinic in North Carolina were recruited on-site after completing an initial visit with the treatment team (physician, nutritionist, and medical family therapy intern). Validated measures were used in surveys to examine patient-provider alliance, parent-provider alliance, and patient motivation for treatment. Electronic medical record data was used to track patient return for a follow-up treatment visit. Two full structural models and one moderating model were tested. Both full structural models tested in the study had good model fit. The moderation model was not statistically significant. Results show that both the patients and the parents reported high treatment alliance with the treatment team. Findings also indicate a significant direct relationship from patient-provider alliance to both the patient’s motivation for treatment and the provider’s assessment of the patient’s readiness for change. The findings between treatment alliance and patient motivation for treatment and provider-assessment of readiness to change indicate that the alliance between the patient and provider maybe play an important role in how both the patient and provider engage in the treatment process.