Motivation in adolescents and caretakers undergoing a weight management program – longitudinal data from the cluster-randomized, motivation-focused STARKIDS trial

@article{herschbach2026motivation,
  title = {{Motivation in adolescents and caretakers undergoing a weight management program – longitudinal data from the cluster-randomized, motivation-focused STARKIDS trial}},
  author = {Anne Herschbach and Florian Junne and Rebecca Erschens and Stefan Ehehalt and Johann Jacoby and Peter Martus and Isabelle Mack and Alisa Weiland and Inga Krauß and Constanze Greule and Gorden Sudeck and Guido Zurstiege and Annalena Wels and Sophia Helen Adam and Andreas Hoell and Wolfgang Bethge and Monika Ums and Torben Sammet and Maren Reyer and Olaf Schliesing and Stephan Zipfel and Caterina Gawrilow and Katrin Elisabeth Giel and Katrin Ziser},
  journal = {BMC Medicine},
  year = {2026},
  month = nov,
  doi = {10.1186/s12916-026-05332-7},
  url = {https://link.springer.com/article/10.1186/s12916-026-05332-7},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Motivation in adolescents and caretakers undergoing a weight management program – longitudinal data from the cluster-randomized, motivation-focused STARKIDS trial
AU  - Anne Herschbach
AU  - Florian Junne
AU  - Rebecca Erschens
AU  - Stefan Ehehalt
AU  - Johann Jacoby
AU  - Peter Martus
AU  - Isabelle Mack
AU  - Alisa Weiland
AU  - Inga Krauß
AU  - Constanze Greule
AU  - Gorden Sudeck
AU  - Guido Zurstiege
AU  - Annalena Wels
AU  - Sophia Helen Adam
AU  - Andreas Hoell
AU  - Wolfgang Bethge
AU  - Monika Ums
AU  - Torben Sammet
AU  - Maren Reyer
AU  - Olaf Schliesing
AU  - Stephan Zipfel
AU  - Caterina Gawrilow
AU  - Katrin Elisabeth Giel
AU  - Katrin Ziser
PY  - 2026
DA  - 2026/11/04
JO  - BMC Medicine
DO  - 10.1186/s12916-026-05332-7
UR  - https://link.springer.com/article/10.1186/s12916-026-05332-7
AB  - Background: Motivation towards behavior change is an important determinant of long-term weight management. Previous research demonstrates that children’s and adolescents’ motivation can be increased through participation in weight management programs. However, little is known about motivational changes in caretakers of children and adolescents with overweight and obesity despite their recognized role as “agents of change” in pediatric weight management. The study aims to compare motivational changes in caretakers and adolescents between a group receiving a motivation-focused weight management program and a control group. Furthermore, predictors for motivational changes are unknown.  Methods: This study is a secondary analysis of the cluster-randomized STARKIDS trial. The intervention group received an 18-month motivation-focused weight management program, the control group received optimized treatment-as-usual. Motivation was assessed based on Transtheoretical Model, using the University of Rhode Island Change Assessment-Short, as well as the related parent-perspective version. Each of these instruments contains four subscales: Precontemplation, Contemplation, Action, and Maintenance. Linear mixed models with multiply imputed data were employed to evaluate changes within the subscales between pre- to post-intervention measurements and to compare these changes between the intervention and control group. A multiple linear regression was subsequently used to identify predictors of motivational change.  Results: Caretakers in the intervention group showed significantly greater changes on Maintenance subscale compared to caretakers in the control group at both T0-T1 and T0-T2 and trends for these changes on Action subscale. No group differences were found in adolescents. Among caregivers in the intervention group, multiple regression analysis for T0-T1 changes on Action subscale identified parent-reported adolescents’ obesity-related quality of life as significant negative predictor for an increase on Action stage.  Conclusions: This motivation-focused weight management program produced motivational gains at the Maintenance stage, supporting sustained behavioral change. Baseline obesity-related quality of life predicted motivational change, suggesting its value as a clinical marker for tailoring interventional approaches. Future research should explore distinct motivational trajectories to inform more individualized pediatric weight management strategies.  Trial registration: Preregistered in the German Clinical Trials Register (DRKS) DRKS000228 13 (acknowledged primary register of the World Health Organization) on 27 November 2020 (Universal Trial Number U111112549536).
SN  - 1741-7015
ER  -