Multicultural Orientation-Informed Focused Acceptance and Commitment Therapy in Adolescent Bariatric Surgery: A Pragmatic Trial

Abstract

Objective: The present paper details a pragmatic trial of a family-based Focused Acceptance and Commitment Therapy (FACT) intervention for adolescents seeking bariatric surgery and their caregivers. The intervention was developed within a multicultural orientation (MCO) framework to acknowledge families’ diverse sociocultural contexts and clinical needs. The study aimed to examine acceptability and feasibility of said intervention to increase adolescent and caregiver psychological flexibility, within the context of seeking bariatric surgery, by supporting values-consistent health behavior change. Method: Twelve adolescent-caregiver dyads consented/assented to participate in two intervention sessions (Session A focused on adolescents, Session B focused on caregivers) during routine pre-surgical visits. Eleven dyads consented to complete research measures including demographics and intervention acceptability measures (90% Black/African American; 90% girls). Results: 11/12 dyads completed Session A, 8/11 completed Session B, with average session completion of 82% across sessions, suggesting adequate intervention feasibility. Interventionists recorded post-session interviews discussing intervention implementation. The intervention was acceptable as rated by adolescents and caregivers and feasible to implement in an interdisciplinary clinic based on average session completion rate. Conclusion: This intervention was acceptable to adolescents and caregivers, and feasible to implement in an interdisciplinary clinic. Given initial promise, the intervention should be researched with larger samples of diverse families and within varied interdisciplinary pediatric settings.

Implications for Impact

A brief family-based clinical intervention was developed to increase health-related values engagement in youth seeking bariatric surgery and their caregiver. It was designed to be responsive to a family’s lived experiences and piloted in an interdisciplinary bariatric surgery clinic in the Mid-South with predominantly (90%) Black/African American families. Pilot data with a small sample size support acceptability and feasibility of this intervention, but further research in larger and varied groups is needed.

Keywords

pediatric obesity weight-loss surgery brief intervention Acceptance and Commitment Therapy diversity

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