Motivational Interviewing to Treat Adolescents With Obesity: A Meta-analysis.

CONTEXT: Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy lifestyle changes. OBJECTIVE: Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes. DATA SOURCES: We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, Web of Science, Cochrane Library, and Google Scholar from January 1997 to April 2018. STUDY SELECTION: Four authors reviewed titles, abstracts, and full-text articles. DATA EXTRACTION: Two authors abstracted data and assessed risk of bias and quality of evidence. RESULTS: Seventeen studies met inclusion criteria; 11 were included in the meta-analysis. There were nonsignificant effects on reducing BMI (mean difference [MD] -0.27; 95% confidence interval -0.98 to 0.44) and BMI percentile (MD -1.07; confidence interval -3.63 to 1.48) and no discernable effects on BMI z score, waist circumference, glucose, triglycerides, cholesterol, or fasting insulin. Optimal information size necessary for detecting statistically significant MDs was not met for any outcome. Qualitative synthesis suggests MI may improve health-related behaviors, especially when added to complementary interventions. LIMITATIONS: Small sample sizes, overall moderate risk of bias, and short follow-up periods. CONCLUSIONS: MI alone does not seem effective for treating overweight and obesity in adolescents, but sample size and study dose, delivery, and duration issues complicate interpretation of the results. Larger, longer duration studies may be needed to properly assess MI for weight management in adolescents.

A journal cancellation survey and resulting impact on interlibrary loan.

OBJECTIVE: The research describes an extensible method of evaluating and cancelling electronic journals during a budget shortfall and evaluates implications for interlibrary loan (ILL) and user satisfaction. METHODS: We calculated cost per use for cancellable electronic journal subscriptions (n=533) from the 2013 calendar year and the first half of 2014, cancelling titles with cost per use greater than $20 and less than 100 yearly uses. For remaining titles, we issued an online survey asking respondents to rank the importance of journals to their work. Finally, we gathered ILL requests and COUNTER JR2 turnaway reports for calendar year 2015. RESULTS: Three hundred fifty-four respondents completed the survey. Because of the level of heterogeneity of titles in the survey as well as respondents' backgrounds, most titles were reported to be never used. We developed criteria based on average response across journals to determine which to cancel. Based on this methodology, we cancelled eight journals. Examination of ILL data revealed that none of the cancelled titles were requested with any frequency. Free-text responses indicated, however, that many value free ILL as a suitable substitute for immediate full-text access to biomedical journal literature. CONCLUSIONS: Soliciting user feedback through an electronic survey can assist collections librarians to make electronic journal cancellation decisions during slim budgetary years. This methodology can be adapted and improved upon at other health sciences libraries.