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eferences

1] Bryner RW, Ullrich IH, Sauers J, Donley D, Hornsby G, KolarM, et al. Effects of resistance vs aerobic training combinedwith an 800 calorie liquid diet on lean body mass and restingmetabolic rate. J Am Coll Nutr 1999;18:115—21.

2] Shang E, Hasenberg T. Aerobic training improves weightloss, body composition and co-morbidities in patientsafter laparoscopic Roux-en-Y bypass. Surg Obes Relat Dis2010;6:260—6.

ttp://dx.doi.org/10.1016/j.orcp.2012.08.017

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ong-term outcomes of bariatric surgery

ary Wittert

Discipline of Medicine, University of Adelaide,delaide 5000

When severe obesity is present weight loss, suf-cient to improve or reverse comorbidities and

mprove quality of life, is only rarely achieved andaintained by diet and exercise alone. Bariatric

urgery, using a restrictive (laparoscopic adjustableastric band, sleeve gastrectomy) or combinationf restrictive and malabsorptive (Roux-en-Y gastricypass) procedure can produce substantial long-erm weight loss, resolution of comorbidities, andmprovements in longevity. However, the magni-ude of weight loss achieved and improvement inomorbidities varies markedly between the differ-nt procedures as do quality of life outcomes, andhe nature, frequency, and timing of complications.n order to optimise long-term outcomes patientsust be provided with objective information as

o the benefits and risks of each procedure withue consideration to their age, sex, expectations,ifestyle, degree of obesity, and co-morbidities andigorous follow-up. This best done in the contextf a multidisciplinary service, where the requi-ite surgical skills exist, and appropriate, lifelongollow-up can be ensured.

ttp://dx.doi.org/10.1016/j.orcp.2012.08.018

017

pdate of bariatric surgery in adolescents

ouise A. Baur

University of Sydney, The Children’s Hospital atestmead; NSW, Australia

Bariatric surgery is a well-recognized form of

herapy for adults with severe obesity. What roleoes it play in adolescents? There is evidencef its effectiveness from several case series andne randomised controlled trial (Melbourne-based).

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uidelines for bariatric surgery in adolescents inustralia and New Zealand, developed by a workingroup comprised of members from the Paediatrics

Child Health Division of the RACP, the Obesityurgery Society of ANZ, and the ANZ Association ofaediatric Surgeons, were first published in 20101,2]. The recommendations highlight its use ineverely obese adolescents (BMI > 40, or BMI > 35ith severe co-morbidities) who are usually aged5 years or more, with consideration of the ado-escent’s decisional capacity and attainment ofhysical maturity, as well as a supportive fam-ly environment. They also emphasise the needor management in centres with multidisciplinaryeight management teams, for the surgery toe performed in tertiary institutions experiencedn bariatric surgery, and for long-term multidisci-linary follow-up. There are major challenges in themplementation of these recommendations acrossoth countries. There remains a general paucity ofultidisciplinary clinics for severely obese youngeople, poor referral pathways, and in Australia ateast, very few publicly funded bariatric surgeryervices, with almost none available for adoles-ents.

eferences

1] Baur LA, Fitzgerald DA. Recommendations for bariatricsurgery in adolescents in Australia and New Zealand. J Pae-diatr Child Health 2010;46:704—7.

2] Dixon JB, Fitzgerald D, Kow L, Bailey D, Baur LA. Adolescentbariatric surgery: ANZ guidance and recommendations. ANZJ Surg 2011;81:854—5.

ttp://dx.doi.org/10.1016/j.orcp.2012.08.019

018

raining non-clinicians to deliver adapted Motiva-ional Interviewing for feedback to parents aboutheir child’s weight status

eirdre Brown 1, Anna Dawson 2, Rachael Taylor 2

Victoria University of Wellington, New ZealandUniversity of Otago, New Zealand

Motivational Interviewing (MI) is regarded as aotentially useful approach to engaging parents innterventions to reduce child overweight. A sig-ificant evidence base supports the use of MI inomplementing interventions targeted at substancese problems. Its efficacy in addressing obesity is

ess clear. Our research program utilized an adaptedersion of MI for providing feedback to parentsbout their child’s weight status, with the aim ofncreasing acceptance and understanding of the

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information presented, and enhancing uptake intoan intervention. One of the fundamental principlesof MI is a collaborative, client-centred approach,which is tailored to the client’s thoughts, beliefs,skills and resources. It requires a significant amountof autonomy from practitioners. As such, MI doesnot fit well with a manualised approach to its imple-mentation. Published studies of MI often do notreport training and fidelity details, meaning it isdifficult to evaluate how well the MI was delivered.This talk will focus on our experiences of trainingresearch personnel to use MI, approaches to ensur-ing fidelity throughout the research project, anddata evaluating fidelity. Our data illustrate the chal-lenges associated with developing and retaining MIskills. They underscore the importance of includingfeedback, supervision and objective, data-drivenmethods to evaluate fidelity as part of the method-ology of research studies using MI. The implicationsfor assessing research using MI and the potentialbarriers to its use in health settings will be dis-cussed.

http://dx.doi.org/10.1016/j.orcp.2012.08.020

S019

Training interviewers to deliver a telephone-based behavioural family intervention encourag-ing fruit and vegetable consumption

Rebecca Wyse 1, Luke Wolfenden 2, Leah Brennan 3

1 School of Medicine and Public Health, The Univer-sity of Newcastle, Newcastle, Australia2 Hunter New England Population Health, Newcas-tle, Australia3 Centre for Obesity Research and Education,Monash University, Melbourne, Australia

Background: There is limited capacity forpsychologists and allied health professionals todeliver population-based primary preventioninterventions. Supporting non-professionals toprovide behavioural intervention may enhancethe reach of such initiatives. This presentationdescribes the selection, training and supportgiven to interviewers delivering a behaviouraltelephone-based parent intervention to increasechild fruit and vegetable (F&V) intake (HealthyHabits), and discusses the implications for futureinterventions.

Method: Five interviewers were trained todeliver a four-contact telephone-based interven-tion to 181 parents of preschool-aged children as

part of an RCT. The intervention was scripted anddelivered via CATI by interviewers with no formaltertiary health qualifications. The intervention sup-

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Symposia Abstracts

orted parents to change aspects of their homeood environment associated with high child F&Vntake, and utilised a range of behaviour changeechniques including; goal setting and review,rompting intention formation and prompting iden-ification as a role model. Eligible interviewerseceived 2 days of training and were selected basedn competency in role plays and group activities.nterviewers received fortnightly group supervisiony a psychologist.

Results: The intervention was effective in engag-ng parents and enhancing child F&V intake. Datauggest parents perceived interviewers as support-ve and competent and perceived the interventions acceptable. Process data suggest interviewersonsidered extended practice and supervision to bemportant components facilitating proficient inter-ention delivery.

Conclusion: Based on the Healthy Habits expe-ience, trained interviewers have the capacity toeliver effective behavioural telephone-based pre-ention interventions to parents. These findingsave considerable public health implications forelivery of telephone-based community nutritionervices.

ttp://dx.doi.org/10.1016/j.orcp.2012.08.021

020

raining non-psychologists to deliver Lifestyleriple P — A behavioural family interventionncouraging a healthy lifestyle

nna Malone

Triple P New Zealand Ltd

This presentation will highlight the Lifestyleriple P intervention, which is a variant of theriple P-Positive Parenting Program. Triple P is auite of multi-level programs designed to reducehe prevalence of behavioural and emotional prob-ems in children by enhancing the knowledge, skills,nd confidence of parents. Lifestyle Triple P, inarticular, is an evidence-based, parent-centredntervention that specifically targets the risk androtective factors underlying childhood obesity.his program provides different levels of interven-ion that vary in intensity according to the needs ofndividual families. This presentation will exploreow the Lifestyle intervention seeks to prevent andanage childhood obesity by encouraging children

o develop healthy eating and activity habits. Theethods and mechanics of how the intervention

eeks to achieve these goals by focussing on increas-ng the self-efficacy and self-sufficiency of parents