Impact of Dietitian-Delivered Motivational Interviewing Within a Food is Medicine Intervention Targeting Adults Living With and Beyond Cancer.

Abstract

Food is medicine (FIM) interventions are a strategy for preventing and managing chronic disease via diet. These interventions often combine the provision of food with access to behavior change support (e.g., from registered dietitians (RDs)), though the ideal approach for the latter is not fully elucidated. The objective of this study is to evaluate integrated motivational interviewing (MI) from an RD (RDMI) on outcomes among adults living with and beyond cancer (LWBC) with overweight and obesity enrolled in a FIM intervention (Clinicaltrials.gov: NCT03489213 (02/09/2018)). Specifically, RDMI with autonomy in the mode of delivery (i.e., phone, email, text, video) and dose (frequency) was offered within a 6-month intensive FIM intervention followed by a 6-month step-down maintenance phase. Dose and engagement with RDMI were measured. There were 52 and 33 participants who requested RDMI during the intensive and maintenance phases, respectively. Completion of ≥ 1 RDMI telephonic encounter significantly predicted weight loss post-intervention (R² = 0.07, p = 0.03); there were no differences in dose, engagement, or weight loss based on the mode of delivery. The dose during the intensive intervention was moderately and significantly correlated with weight loss post-intervention and maintenance (r = 0.43, p < 0.01; r = 0.33, p = 0.02, respectively); there was a weak correlation for engagement at the same follow-up points (r = 0.28 and r = 0.15). In conclusion, higher doses of RDMI improved weight loss for adults LWBC with overweight or obesity. Careful consideration of the implementation of MI from providers, including RDs, in the context of cancer-focused FIM interventions should be further examined.