Education for lifestyle-based management of hyperlipidemia in children enhanced by a collaborative approach

BACKGROUND: Although therapeutic lifestyle changes are first-line measures in treating pediatric dyslipidemia, current didactic approaches for healthy lifestyle education are weakened by low adherence and poor sustainability. A collaborative education program including a clinician-led group education class with motivational counseling complemented by the addition of peer role models was implemented. OBJECTIVE: We sought to assess the effectiveness of motivational interviewing in collaboration with peers sharing their experience and its impact on serologic and lifestyle measures vs the conventional, didactic group education approach. METHOD: Changes in lipid profiles, anthropometric measurements, nutritional scores, physical activity levels, and daily screen time after 6 months were compared both within groups and between the collaborative and the didactic approach. RESULTS: We reviewed 75 children ages 11.1 +/- 3.5 years (n = 38 didactic/n = 37 collaborative). There were no group differences at baseline. Total cholesterol (5.79 +/- 1.65 mmol/L vs 5.52 +/- 1.39 mmol/L, P = .02) significantly decreased between the initial visit and the 6-month follow-up assessment with both approaches. Nutrition compliance scores significantly improved with both approaches (median. 5.3/10 vs 6.6/10, P = .004), with a marginally greater improvement for the collaborative (+1.7/10) vs the didactic approach (+1.0/10, P = .12). The collaborative approach was associated with greater reductions in weight percentile (-8.9% vs +1.8%, P = .03) and screen time (-7.0 h/wk vs +1.3 h/wk, P = .05) and a greater increase in physical activity (+4.0 h/wk vs +2.0 h/wk, P = .05). CONCLUSION: Although not associated with differences in lipid profiles, the collaborative educational approach was associated with a greater lifestyle improvement than was the didactic approach over a 6-month period. (C) 2014 National Lipid Association. All rights reserved.