A Systematic Review of Psychometric Evaluation of Motivational Interviewing Integrity Measures

ERIC Educational Resources Information Center

Wallace, Lloyd; Turner, Fiona

2009-01-01

The Motivational Interviewing Skills Code (MISC) has been developed to measure motivational interviewing skill, but a need has been identified for more economical instruments. This study expands on a previous systematic review by Madson and Campbell (2006) and examines the extent to which motivational interviewing integrity measures other than the…

Evaluation of the effect of motivational interviewing counselling on hypertension care.

PubMed

Ma, Chunhua; Zhou, Ying; Zhou, Wei; Huang, Chunfeng

2014-05-01

This study tests the effectiveness of motivational interviewing compared with the usual care for Chinese hypertensive patients. A randomised controlled trial was used. One hundred and twenty eligible participants were randomly assigned to either the control group (usual care group) or the intervention group (motivational interviewing group). The results of this study demonstrated that the total scores and the mean scores for each dimension of the adherence questionnaire were increased in the intervention group (P<0.05), and the systolic blood pressure and diastolic blood pressure of the hypertensive patients greatly decreased in the intervention group during the six months of the motivational interviewing counselling (P<0.05). The application of motivational interviewing for hypertensive patients is a promising approach for sustaining the clinical benefits of adherence behaviour. Motivational interviewing should be provided to hypertensive patients at hospitals and community health centres to assist patients in controlling their BP and to enhance treatment adherence. A series of training courses on the motivational interviewing technique should be provided to nurses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

School Nurses' Experiences with Motivational Interviewing for Preventing Childhood Obesity

ERIC Educational Resources Information Center

Bonde, Ane Høstgaard; Bentsen, Peter; Hindhede, Anette Lykke

2014-01-01

Motivational interviewing is a counseling method used to bring about behavior change; its application by school nurses for preventing obesity in children is still new. This study, based on in-depth interviews with 12 school nurses, shows how school nurses adapted motivational interviewing and integrated it into their daily practice along with…

Using Motivational Interviewing to Help Your Students

ERIC Educational Resources Information Center

Sheldon, Lisa A.

2010-01-01

Motivational interviewing, which began as a counseling technique in addiction recovery, is a client-centered tool for making changes, increasing helpful behaviors and decreasing unhelpful behaviors. It relies on an individual's intrinsic motivation and interest in change, using a non-confrontational approach to frame goals in a practical,…

[The effect of motivational interviews on young drinkers' autonomous motivation].

PubMed

Flórez-Alarcón, Luis; Castellanos-Morales, Carol A

2012-06-01

Assessing changes in autonomous and controlled motivation in a group of young at risk consumers and excessive alcohol consumers receiving motivational interviewing-based (MI) Intervention. MI-based group intervention was put into practice to observe its effects on types of motivation. Two groups were formed (an experimental and a control group) using pretest-posttest design. 63 adolescents participated: 31 formed the experimental group (80 % male) and 32 the control group (68 % male). The treatment self-regulation questionnaire (TSRQ) was used to evaluate autonomous and controlled motivation. Analysis of variance revealed that autonomous motivation scores had no statistically significant change after the brief intervention, whereas this was so with controlled motivation (p<.05), suggesting that brief intervention had promoted this type of regulation towards moderate consumption expressed in terms of an external control, such as gaining social approval. The above results suggested that MI is a promising technique for intervention with Colombian adolescents as it had measurable positive effects on both types of motivation and motivational orientation toward control probably mediated the results. Individual motivational orientation and gender should be considered in the future.

A brief motivational interview with action and coping planning components enhances motivational autonomy among volunteer blood donors.

PubMed

France, Christopher R; France, Janis L; Carlson, Bruce W; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H; Madden, Katrala; Carey, Patricia M; Fox, Kristen R; Livitz, Irina E; Ankawi, Brett; Slepian, P Maxwell

2016-06-01

In contrast to standard donor retention strategies (e.g., mailings, phone calls, text messages), we developed a brief telephone interview, based on motivational interviewing principles, that encourages blood donors to reflect upon their unique motivators and barriers for giving. This study examined the effect of this motivational interview, combined with action and coping plan components, on blood donor motivations. The design was to randomly assign blood donors to receive either a telephone-delivered motivational interview with action and coping plan components or a control call approximately 6 weeks after their most recent donation. Participants completed a series of surveys related to donation motivation approximately 3 weeks before telephone contact (precall baseline) and then repeated these surveys approximately 1 week after telephone contact (postcall). The sample was 63% female, included a majority (52.6%) of first-time blood donors, and had a mean age of 30.0 years (SD, 11.7 years). A series of analyses of variance revealed that, relative to controls (n = 244), donors in the motivational interview group (n = 254) had significantly larger increases in motivational autonomy (p = 0.001), affective attitude (p = 0.004), self-efficacy (p = 0.03), anticipated regret (p = 0.001), and intention (p = < 0.001), as well as larger decreases in donation anxiety (p = 0.01), from precall baseline to postcall assessment. This study supports motivational interviewing with action and coping planning as a novel strategy to promote key contributors to donor motivation. © 2016 AABB.

A brief motivational interview promotes internal motivation to donate blood among young adults with and without a prior donation history.

PubMed

Livitz, Irina E; Fox, Kristen R; Himawan, Lina K; France, Christopher R

2017-06-01

Recruitment and retention of first-time and repeat donors is essential to maintain a stable blood supply. Recent evidence has shown that promoting internal motivation may be an effective strategy to enhance donation behavior. We tested the efficacy of an in-person motivational interview at increasing internal motivation and intention to donate. A sample of 219 donors and nondonors (69.4% female; mean ± SD age, 19.2 ± 1.1 years; 52.1% nondonors) were randomly assigned to either a motivational or a knowledge interview. Immediately before and after the interview participants completed a measure of donation intention and the Blood Donor Identity Survey, which is a multidimensional measure of donor motivation. A latent profile analysis revealed three distinct latent classes, which were identified as low internal motivation, mid internal motivation, and high internal motivation. Comparison of change in latent class from pre- to postinterview revealed that a higher proportion of participants in the motivational interview group moved to a more internally motivated class compared to the knowledge interview group (i.e., 34% vs. 4%, respectively). Further, relative to the knowledge interview group, participants in the motivational interview group reported greater increases in intention to donate. A brief motivational interview may enhance donation intention and intrinsic motivation among both experienced donors and nondonors alike. © 2017 AABB.

Do Motivational Interviewing Behaviors Predict Reductions in Partner Aggression for Men and Women?

PubMed Central

Woodin, Erica M.; Sotskova, Alina; O’Leary, K. Daniel

2011-01-01

Motivational interviewing is a directive, non-confrontational intervention to promote behavior change. The current study examined therapist behaviors during a successful brief motivational interviewing intervention for physically aggressive college dating couples (Woodin & O’Leary, 2010). Forty-five minute motivational interviews with each partner were videotaped and coded using the Motivational Interviewing Treatment Integrity scale (MITI; Moyers, Martin, Manuel, & Miller, 2003). Hierarchical modeling analyses demonstrated that therapist behaviors consistent with motivational interviewing competency predicted significantly greater reductions in physical aggression perpetration following the intervention. Specifically, greater reflection to question ratios by the therapists predicted reductions in aggression for both men and women, greater percentages of open versus closed questions predicted aggression reductions for women, and there was a trend for greater levels of global therapist empathy to predict aggression reductions for women. These findings provide evidence that motivational interviewing seems to have an effect on behavior change through therapist behaviors consistent with the theoretical underpinnings of motivational interviewing. PMID:22119133

Motivational Interviewing to Increase Postdischarge Antibiotic Adherence in Older Adults with Pneumonia.

PubMed

Eyler, Rachel; Shvets, Kristina; Blakely, Michelle L

2016-01-01

To evaluate the impact of a pharmacist-led, motivational interviewing on antibiotic adherence following discharge in older adults with pneumonia. Inpatient medical wards in a large tertiary academic medical center. Older adults diagnosed with pneumonia were enrolled from December 1, 2013, to August 1, 2014, at Yale-New Haven Hospital. Motivational interviewing-a patient-centered method of communication-has gained recognition as a tool that can aid pharmacists in addressing negative health behaviors (e.g., medication adherence, health screenings, substance abuse during counseling sessions). However, the potential role of motivational interviewing in older adults to improve medication adherence during transitions of care is not clear. In this study, in addition to standard discharge care, older adults hospitalized with pneumonia who were randomized to the intervention group received enhanced care: pharmacist-led motivational interviewing. Evaluation of adherence to prescribed antibiotic regimens and patient satisfaction with the motivational interviewing, enhanced-care session. Ultimately, 87% of patients in the intervention group (n = 16) compared with 64% of patients in the control group (n = 14) were adherent to their antibiotic regimens. Patient satisfaction with the motivational interviewing intervention was high. Pharmacist-led motivational interviewing sessions have the potential to positively influence antibiotic adherence rates and patient satisfaction.

Utilizing Motivational Interviewing to Address Resistant Behaviors in Clinical Supervision

ERIC Educational Resources Information Center

Wahesh, Edward

2016-01-01

Motivational interviewing is presented as an approach to address resistant behaviors in clinical supervision. A case example is used to illustrate the process in which the relational and technical elements of motivational interviewing can be applied to supervisee resistance. Implications for supervisors and researchers are discussed.

Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study

PubMed Central

Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna

2018-01-01

Background Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. Objective The aim of this study was to explore participants’ qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. Methods NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot’s head sensor. Evaluations were content-analyzed utilizing Boyatzis’ steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Results Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for

Cross-Cultural Training in Motivational Interviewing

ERIC Educational Resources Information Center

Miller, William R.; Hendrickson, Stacey M. L.; Venner, Kamilla; Bisono, Ani; Daugherty, Mikyta; Yahne, Carolina E.

2008-01-01

This study evaluated the cross-cultural transportability of motivational interviewing (MI), an evidence-based addiction treatment method. Free clinical training in MI was offered in separate targeted workshops for 86 African American, Native American, and Spanish-speaking addiction treatment providers. Audiotaped pre- and posttraining clinical…

The efficacy of motivational interviewing for disordered gambling: systematic review and meta-analysis.

PubMed

Yakovenko, Igor; Quigley, Leanne; Hemmelgarn, Brenda R; Hodgins, David C; Ronksley, Paul

2015-04-01

Motivational interviewing is a client-centered therapeutic intervention that aims to resolve ambivalence toward change. We conducted a systematic review and meta-analysis on the efficacy of motivational interviewing, compared to non-motivational interviewing controls, in the treatment of disordered gambling. Electronic databases were searched for randomized controlled trials that evaluated change in gambling behavior using motivational interviewing in adult disordered gamblers. The primary outcomes were the weighted mean difference (WMD) for change in average days gambled per month and average dollars lost per month. The search strategy yielded 447 articles, of which 20 met criteria for full text review. Overall, 8 studies (N=730) fulfilled the inclusion criteria for systematic review and 5 (N=477) were included in the meta-analysis. Motivational interviewing was associated with significant reduction in gambling frequency up to a year after treatment delivery. For gambling expenditure, motivational interviewing yielded significant reductions in dollars spent gambling compared to non-motivational controls at post-treatment only (1-3 months). Overall, the results of this review suggest that motivational interviewing is an efficacious style of therapy for disordered gambling in the short term. Whether treatment effects are maintained over time remains unclear. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study.

PubMed

Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna; Andrade, Jackie

2018-05-03

Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. The aim of this study was to explore participants' qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot's head sensor. Evaluations were content-analyzed utilizing Boyatzis' steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for change. Some participants felt that the

Motivational interviewing in general dental practice: A review of the evidence.

PubMed

Kay, E J; Vascott, D; Hocking, A; Nield, H

2016-12-16

Objectives The objective of this study was to systematically review the evidence regarding the use of motivational interviewing in the context of general dental practice, in order that practitioners can decide whether it might be an important skill to develop within their practices.Data sources The results reported in this study form part of a larger systematic review which sought to identify whether oral health promotion within dental practice is effective and how its effects can be optimised. Here, we focus on the papers describing motivational interviewing in dental practice published since 1994. The systematic review included searches of 20 online resources (including Ovid Medline and Embase).Data selection Papers which were not about oral health promotion and did not apply the behavioural and psychological theories, which underpin motivational interviewing, were excluded.Data synthesis This review included eight papers all of which were considered to be of robust quality, in terms of their research methods and seven of which were considered to offer externally valid findings. Five described randomised controlled trials and all of these RCTs demonstrated that interventions including motivational interviewing had a positive effect on oral health and health behaviour.Conclusions This review shows that the motivational interviewing technique, which is based on the concept of autonomy support, has potential for helping patients with poor oral health. Training in motivational interviewing for dental personnel could be a very useful addition to the skill set of practitioners and dental teams.

Teaching Motivational Interviewing Skills to Psychiatry Trainees: Findings of a National Survey.

PubMed

Abele, Misoo; Brown, Julie; Ibrahim, Hicham; Jha, Manish K

2016-02-01

The authors report on the current status of motivational interviewing education and training director attitudes about providing it to psychiatry residents. Training directors of general, child/adolescent and addiction psychiatry training programs were invited to participate in an anonymous online survey. Of the 333 training directors who were invited to participate, 66 of 168 (39.3%) general, 41 of 121 (33.9%) child/adolescent, and 19 of 44 (43.2%) addiction psychiatry training directors completed the survey. The authors found that 90.9% of general, 80.5% of child/adolescent, and 100% of addiction psychiatry training programs provided motivational interviewing education. Most programs used multiple educational opportunities; the three most common opportunities were didactics, clinical practice with formal supervision, and self-directed reading. Most training directors believed that motivational interviewing was an important skill for general psychiatrists. The authors also found that 83.3% of general, 87.8% of child/adolescent, and 94.7% of addiction psychiatry training directors reported that motivational interviewing should be taught during general psychiatry residency. Motivational interviewing skills are considered important for general psychiatrists and widely offered by training programs. Competency in motivational interviewing skills should be considered as a graduation requirement in general psychiatry training programs.

Group Motivational Interviewing in Schools: Development of a Health Promotion Intervention

ERIC Educational Resources Information Center

Hawkins, Jemma L.; Bravo, Paulina; Gobat, Nina; Rollnick, Stephen; Jerzembek, Gabrielle; Whitehead, Sarah; Chanon, Sue; Kelson, Mark; Adams, Orla; Murphy, Simon

2016-01-01

Objective: In the light of the shortcomings of curriculum-based health promotion in secondary schools, group motivational interviewing provides a potential alternative approach. This two-phase study set out to establish the key components, feasibility and acceptability of a group motivational interviewing intervention, focused on alcohol…

Using Student Interviews to Understand Theories of Motivation

ERIC Educational Resources Information Center

Hanich, Laurie B.

2009-01-01

This article describes the construction and development of a course assignment that uses student interviews as an instructional tool to bridge the gap between theory and practice in a graduate educational psychology course. The first part of the article describes the student interview assignment used to examine theories of motivation. The second…

Motivational interviewing in inflammatory bowel disease patients: a useful tool for outpatient counselling.

PubMed

Mocciaro, Filippo; Di Mitri, Roberto; Russo, Giuseppina; Leone, Salvo; Quercia, Valerio

2014-10-01

Most inflammatory bowel disease patients miss follow-up visits and are non-adherent to therapy due to the lack of an engaging patient-physician relationship. Motivational interviewing is a patient-centred counselling method used to elicit/strengthen motivation towards change. The aim of this study was to assess the role of motivational interviewing in patients affected by inflammatory bowel disease. The study included consecutive patients with inflammatory bowel disease presenting for the first consultation (June 2012-February 2013). All consultations were carried out applying the motivational interviewing approach. After each consultation, patients filled out a questionnaire asking demographic data, and their past and current experience. Overall, 23 males (51.1%) and 22 females (48.9%), mean age 36.1±15.2 years, were enrolled. Before and after experiencing the motivational interviewing approach (mean visit duration 41.5±8.7min) "overall satisfaction rate", "physician's communication skills", and "perceived empathy" were 60% vs 100%, 40% vs 95.6%, and 40% vs 100%, respectively. Satisfaction was lower in patients affected by indeterminate colitis (p=0.004), and of younger age (p=0.02). The motivational interview approach is appreciated by inflammatory bowel disease patients. Despite being time-consuming, the motivational interview appears considerably worthwhile at the first visit and in younger patients. Motivational interviewing can help physicians to deal with their patients, moving from "cure" to "care". Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

An Adapted Post-Donation Motivational Interview Enhances Blood Donor Retention

PubMed Central

Sinclair, Kadian S.; Campbell, Tavis S.; Carey, Patricia M.; Langevin, Eric; Bowser, Brent; France, Christopher R.

2010-01-01

Background Blood donors may hold conflicting thoughts about future donation. While they may perceive the direct benefit to themselves and others, they often report compelling reasons not to give again. As a result the standard encouragements to return may not be sufficient to motivate some donors. The present study examined the effects of a post-donation adapted motivational interview on blood donor attitudes and repeat donation behavior. Study Design and Methods Donors (n=215) were randomly assigned to either an adapted motivational interview (AMI) or a no-interview control group. Approximately one month after their index donation, donors in the AMI group completed a brief telephone interview to clarify individual-specific motivations and values concerning blood donation and address potential barriers. They were then asked to complete questionnaires regarding donation attitudes, anxiety, self-efficacy and intention to donate. Donors in the control group were also contacted one month post-donation and asked to complete the same series of questionnaires. Results Donors in the AMI group reported greater intention to provide a future donation, F = 8.13, p < 0.05, more positive donation attitudes, F = 4.59, p < 0.05, and greater confidence in their ability to avoid adverse reactions, F = 10.26, p < 0.01. Further, AMI was associated with higher rates of attempted donation at 12 months (OR, 2.48; 95% CI, 1.27–4.87). Conclusion Application of an adapted motivational interview may be an effective strategy to increase the donor pool by enhancing retention of existing donors. PMID:20456674

District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Kristofferzon, Marja-Leena

2014-08-01

To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use. Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. A cross-sectional survey study. A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing. Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing. © 2013 John Wiley & Sons Ltd.

A Randomized Trial of Motivational Interviewing: Cessation Induction Among Smokers With Low Desire to Quit.

PubMed

Catley, Delwyn; Goggin, Kathy; Harris, Kari Jo; Richter, Kimber P; Williams, Karen; Patten, Christi; Resnicow, Ken; Ellerbeck, Edward F; Bradley-Ewing, Andrea; Lee, Hyoung S; Moreno, Jose L; Grobe, James E

2016-05-01

Despite limitations in evidence, the current Clinical Practice Guideline advocates Motivational Interviewing for smokers not ready to quit. This study evaluated the efficacy of Motivational Interviewing for inducing cessation-related behaviors among smokers with low motivation to quit. Randomized clinical trial. Two-hundred fifty-five daily smokers reporting low desire to quit smoking were recruited from an urban community during 2010-2011 and randomly assigned to Motivational Interviewing, health education, or brief advice using a 2:2:1 allocation. Data were analyzed from 2012 to 2014. Four sessions of Motivational Interviewing utilized a patient-centered communication style that explored patients' own reasons for change. Four sessions of health education provided education related to smoking cessation while excluding elements characteristic of Motivational Interviewing. A single session of brief advice consisted of brief, personalized advice to quit. Self-reported quit attempts; smoking abstinence (biochemically verified); use of cessation pharmacotherapies; motivation; and confidence to quit were assessed at baseline and 3- and 6-month follow-ups. Unexpectedly, no significant differences emerged between groups in the proportion who made a quit attempt by 6-month follow-up (Motivational Interviewing, 52.0%; health education, 60.8%; brief advice, 45.1%; p=0.157). Health education had significantly higher biochemically verified abstinence rates at 6 months (7.8%) than brief advice (0.0%) (8% risk difference, 95% CI=3%, 13%, p=0.003), with the Motivational Interviewing group falling in between (2.9% abstinent, 3% risk difference, 95% CI=0%, 6%, p=0.079). Both Motivational Interviewing and health education groups showed greater increases in cessation medication use, motivation, and confidence to quit relative to brief advice (all p<0.05), and health education showed greater increases in motivation relative to Motivational Interviewing (Cohen's d=0.36, 95% CI=0.12, 0

Healthcare professionals experience with motivational interviewing in their encounter with obese pregnant women.

PubMed

Lindhardt, Christina Louise; Rubak, Sune; Mogensen, Ole; Hansen, Helle Ploug; Goldstein, Henri; Lamont, Ronald F; Joergensen, Jan Stener

2015-07-01

to explore and describe how healthcare professionals in the Southern Region of Denmark experienced motivational interviewing as a communication method when working with pregnant women with obesity. a qualitative, descriptive study based on face-to-face interviews with 11 obstetric healthcare professionals working in a perinatal setting. a thematic descriptive method was applied to semi-structured interviews. The healthcare professional's experiences were recorded verbatim during individual semi-structured qualitative interviews, transcribed, and analysed using a descriptive analysis methodology. motivational interviewing was found to be a useful method when communicating with obese pregnant women. The method made the healthcare professionals more aware of their own communication style both when encountering pregnant women and in their interaction with colleagues. However, most of the healthcare professionals emphasised that time was crucial and they had to be dedicated to the motivational interviewing method. The healthcare professionals further stated that it enabled them to become more professional in their daily work and made some of them feel less 'burned out', 'powerless' and 'stressed' as they felt they had a communication method in handling difficult workloads. healthcare professionals experienced motivational interviewing to be a useful method when working perinatally. The motivational interviewing method permitted heightened awareness of the healthcare professionals communication method with the patients and increased their ability to handle a difficult workload. Overall, lack of time restricted the use of the motivational interviewing method on a daily basis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Motivational interviewing in the health care setting

USDA-ARS?s Scientific Manuscript database

Alcohol use disorders are related to many negative health, emotional, societal, and economic consequences. These disorders are often difficult to treat because individuals suffering from them tend to be ambivalent about and resistant to change. Motivational interviewing (MI) provides healthcare prov...

Motivational interviewing with a depressed adolescent.

PubMed

Brody, Amanda E

2009-11-01

Motivational interviewing (MI) is a potentially useful tool for clinicians who are exploring ways to improve treatment outcomes with depressed clients. MI techniques may be particularly appropriate with depressed adolescents, for whom motivation to engage in therapy is often a problem and who often experience ambivalence about life choices. The present article presents a case description of MI with a depressed adolescent who was ambivalent about what life change to pursue. MI was used to help the client identify conflicts between her values, learn how they were contributing to her distress, and move toward resolving them. Advantages and limitations of these techniques are discussed.

Examining How Motivational Interviewing May Foster College Student Development

ERIC Educational Resources Information Center

Iarussi, Melanie M.

2013-01-01

Professional counselors practicing in higher education settings aspire to meet the developmental needs of college students in addition to addressing their mental health and substance use concerns. Motivational interviewing (MI) is an evidence-based counseling approach that focuses on enhancing motivation and commitment to change. This article…

Motivational interviewing interactions and the primary health care challenges presented by smokers with low motivation to stop smoking: a conversation analysis.

PubMed

Codern-Bové, Núria; Pujol-Ribera, Enriqueta; Pla, Margarida; González-Bonilla, Javier; Granollers, Silvia; Ballvé, José L; Fanlo, Gemma; Cabezas, Carmen

2014-11-26

Research indicates that one third of smokers have low motivation to stop smoking. The purpose of the study was to use Conversational Analysis to enhance understanding of the process in Motivational Interviewing sessions carried out by primary care doctors and nurses to motivate their patients to quit smoking. The present study is a substudy of the Systematic Intervention on Smoking Habits in Primary Health Care Project (Spanish acronym: ISTAPS). Motivational interviewing sessions with a subset of nine participants (two interview sessions were conducted with two of the nine) in the ISTAPS study who were current smokers and scored fewer than 5 points on the Richmond test that measures motivation to quit smoking were videotaped and transcribed. A total of 11 interviews conducted by five primary health care professionals in Barcelona, Spain, were analysed. Qualitative Content Analysis was used to develop an analytical guide for coding transcriptions. Conversation Analysis allowed detailed study of the exchange of words during the interaction. Motivational Interviewing sessions had three phases: assessment, reflection on readiness to change, and summary. The interaction was constructed during an office visit, where interactional dilemmas arise and can be resolved in various ways. Some actions by professionals (use of reiterations, declarations, open-ended questions) helped to construct a framework of shared relationship; others inhibited this relationship (focusing on risks of smoking, clinging to the protocol, and prematurely emphasizing change). Some professionals tended to resolve interactional dilemmas (e.g., resistance) through a confrontational or directive style. Interactions that did not follow Motivational Interviewing principles predominated in seven of the interviews analysed. Conversational analysis showed that the complexity of the intervention increases when a health professional encounters individuals with low motivation for change, and interactional

Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS).

PubMed

Campiñez Navarro, Manuel; Pérula de Torres, Luis Ángel; Bosch Fontcuberta, Josep M; Barragán Brun, Nieves; Arbonies Ortiz, Juan Carlos; Novo Rodríguez, Jesús Manuel; Bóveda Fontán, Julia; Martín Alvarez, Remedios; Prados Castillejo, Jose Antonio; Rivas Doutreleau, Gabriela Renée; Domingo Peña, Carmen; Castro Moreno, Jaime Jesús; Romero Rodríguez, Esperanza María

2016-09-01

Motivational interviewing (MI) is a collaborative, goal-oriented method to help patients change behaviour. Tools that are often used to measure MI are the motivational interviewing skills code' (MISC), the 'motivational interviewing treatment integrity' (MITI) and the 'behaviour change counselling index' (BECCI). The first two instruments have not been designed to be used in primary healthcare (PHC) settings. The BECCI actually is time-consuming. The motivational interviewing assessment scale (MIAS, 'EVEM' in Spanish) was developed to measure MI in PHC encounters as an alternative to the previous instruments. To validate MIAS as an instrument to assess the quality of MI in PHC settings. (a) Sixteen experts in MI participated in the design, face and consensus validity, using a Delphi-type methodology. (b) 27 PHC centres located in Spain. four experts in MI tested its psychometric properties with 332 video recordings coming from the Dislip-EM study (consultations provided by 37 practitioners). dimensionality, internal consistency, reliability (intra-class correlation coefficient-ICC), sensitivity to change and convergent validity with the BECCI scale. A 14-item scale was obtained after the validation process. Factor analysis: two factors explained 76.6% of the total variance. Internal consistency, α = 0.99. Reliability: intra-rater ICC = 0.96; inter-rater ICC = 0.97. Sensitivity to change: means before and after training were 23.63 versus 38.57 (P < 0.001). Spearman's coefficient between the MIAS and the BECCI scale was 0.98 (P < 0.001). The MIAS is a consistent and reliable instrument to assess the use of MI in PHC settings. [Box: see text].

A Behavior-Analytic Account of Motivational Interviewing

ERIC Educational Resources Information Center

Christopher, Paulette J.; Dougher, Michael J.

2009-01-01

Several published reports have now documented the clinical effectiveness of motivational interviewing (MI). Despite its effectiveness, there are no generally accepted or empirically supported theoretical accounts of its effects. The theoretical accounts that do exist are mentalistic, descriptive, and not based on empirically derived behavioral…

Primary care nurses' communication and its influence on patient talk during motivational interviewing.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Lindqvist, Helena; Kristofferzon, Marja-Leena

2016-11-01

The aim of this study was to describe what verbal behaviours/kinds of talk occur during recorded motivational interviewing sessions between nurses in primary care and their patients. The aim was also to examine what kinds of nurse talk predict patient change talk, neutral talk and/or sustain talk. Motivational interviewing is a collaborative conversational style. It has been shown to be effective, in addressing health behaviours such as diet, exercise, weight loss and chronic disease management. In Sweden, it is one of the approaches to disease prevention conversations with patients recommended in the National Guidelines for Disease Prevention. Research on the mechanisms underlying motivational interviewing is growing, but research on motivational interviewing and disease prevention has also been called for. A descriptive and predictive design was used. Data were collected during 2011-2014. Fifty audio-recorded motivational interviewing sessions between 23 primary care nurses and 50 patients were analysed using Motivational Interviewing Sequential Code for Observing Process Exchanges. The frequency of specific kinds of talk and sequential analysis (to predict patient talk from nurse talk) were computed using the software Generalized Sequential Querier 5. The primary care nurses and patients used neutral talk most frequently. Open and negative questions, complex and positive reflections were significantly more likely to be followed by change talk and motivational interviewing-inconsistent talk, positive questions and negative reflections by sustain talk. To increase patients' change talk, primary care nurses need to use more open questions, complex reflections and questions and reflections directed towards change. © 2016 John Wiley & Sons Ltd.

Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour.

PubMed

Frielink, Noud; Embregts, Petri

2013-12-01

Motivational interviewing is a promising method to increase treatment motivation for people with mild intellectual disability and challenging behaviour. The purpose of the present study was to identify how professionals could adapt motivational interviewing techniques for use with clients. We conducted semistructured qualitative interviews and focus groups with 26 clients, parents, and professionals. A general inductive approach led to the identification of multiple core themes. The authors recommend several modifications to accommodate motivational interviewing for use with clients: adapt to language level, adjust to cognitive abilities, and control for social desirability of responding. In addition, certain characteristics of professionals were also found to be critical for effective motivational interviewing: trustworthiness, engagement, acceptance, empathy, and honesty. Concrete recommendations for the adaptation of the motivational interviewing techniques for use with people with mild intellectual disability and challenging behaviour are identified. Certain characteristics of professionals are also critical for maximising the treatment motivation of clients.

Motivational Interviewing in the Prevention of Alcohol Abuse

DTIC Science & Technology

2007-08-01

4591 46 0 Kunsan 2549 93 0 Little Rock 4917 68 0 MacDill 3714 64 0 McChord 4024 108 0 Mildenhall 4424 123 0 Minot 4691 83 0 Whiteman 3548...Mikel Jon Wilson, Karen Wolf, Susi S Zoucha, Bill J Key Research Accomplishments - Developed a training manual for MI specific to AF ADAPT...motivational interviewing (MI) among highly motivated and skilled substance abuse counselors. Little is known, however, about the translational

Teaching health science students foundation motivational interviewing skills: use of motivational interviewing treatment integrity and self-reflection to approach transformative learning.

PubMed

M, Schoo A; S, Lawn; E, Rudnik; C, Litt J

2015-12-21

Many undergraduate and graduate-entry health science curricula have incorporated training in motivational interviewing (MI). However, to effectively teach skills that will remain with students after they graduate is challenging. The aims of this study were to find out self-assessed MI skills of health students and whether reflecting on the results can promote transformative learning. Thirty-six Australian occupational therapy and physiotherapy students were taught the principles of MI, asked to conduct a motivational interview, transcribe it, self-rate it using the Motivational Interviewing Treatment Integrity (MITI) tool and reflect on the experience. Student MI skills were measured using the reported MITI subscores. Student assignments and a focus group discussion were analysed to explore the student experience using the MITI tool and self-reflection to improve their understanding of MI principles. Students found MI challenging, although identified the MITI tool as useful for promoting self-reflection and to isolate MI skills. Students self-assessed their MI skills as competent and higher than scores expected from beginners. The results inform educational programs on how MI skills can be developed for health professional students and can result in transformative learning. Students may over-state their MI skills and strategies to reduce this, including peer review, are discussed. Structured self-reflection, using tools such as the MITI can promote awareness of MI skills and compliment didactic teaching methods.

What Can Motivational Interviewing Do for You?

ERIC Educational Resources Information Center

Burke, Brian L.

2011-01-01

Motivational Interviewing (MI) is a promising 25-year-old therapeutic approach that integrates relationship-building principles and more directive strategies to move clients toward behavioral change. A large and expanding number of controlled research studies of MI have demonstrated its efficacy for addictive behaviors ranging from use of alcohol,…

The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol.

PubMed

Ball, Geoff D C; Spence, Nicholas D; Browne, Nadia E; O'Connor, Kathleen; Srikameswaran, Suja; Zelichowska, Joanna; Ho, Josephine; Gokiert, Rebecca; Mâsse, Louise C; Carson, Valerie; Morrison, Katherine M; Kuk, Jennifer L; Holt, Nicholas L; Kebbe, Maryam; Gehring, Nicole D; Cesar, Melody; Virtanen, Heidi; Geller, Josie

2017-04-11

Experts recommend that clinicians assess motivational factors before initiating care for pediatric obesity. Currently, there are no well-established clinical tools available for assessing motivation in youth with obesity or their families. This represents an important gap in knowledge since motivation-related information may shed light on which patients might fail to complete treatment programs. Our study was designed to evaluate the measurement properties and utility of the Readiness and Motivational Interview for Families (RMI-Family), a structured interview that utilizes a motivational interviewing approach to (i) assess motivational factors in youth and their parents, and (ii) examine the degree to which motivation and motivation-related concordance between youth and parents are related to making changes to lifestyle habits for managing obesity in youth. From 2016 to 2020, this prospective study will include youth with obesity (body mass index [BMI] ≥97th percentile; 13-17 years old; n = 250) and their parents (n = 250). The study will be conducted at two primary-level, multidisciplinary obesity management clinics based at children's hospitals in Alberta, Canada. Participants will be recruited and enrolled after referral to these clinics, but prior to initiating clinical care. Each youth and their parent will complete the RMI-Family (~1.5 h) at baseline, and 6- and 12-months post-baseline. Individual (i.e., youth or parent) and family-level (i.e., across youth and parent) responses to interview questions will be scored, as will aspects of interview administration (e.g., fidelity to motivational interviewing tenets). The RMI-Family will also be examined for test-retest reliability. Youth data collected at each time point will include demography, anthropometry, lifestyle habits, psychosocial functioning, and health services utilization. Cross-sectional and longitudinal associations between individual and family-level interview scores on the RMI

Comparison of active-learning strategies for motivational interviewing skills, knowledge, and confidence in first-year pharmacy students.

PubMed

Lupu, Ana M; Stewart, Autumn L; O'Neil, Christine

2012-03-12

To compare 3 strategies for pharmacy student learning of motivational interviewing skills, knowledge of motivational interviewing principles, and confidence in and attitudes toward their application. Following a motivational interviewing lecture, first-year students were randomized to perform practice activities (written dialogue, peer role-play, or mock-patient counseling activities). Motivational interviewing skills, knowledge, confidence, and attitudes were measured. All students demonstrated improvement in skills, knowledge, and confidence. Students in the mock-patient counseling group demonstrated significantly better motivational interviewing skills during practice and trended toward higher scores on the summative evaluation. They also demonstrated a significant improvement in knowledge compared with that of the written dialogue group during practice. Feedback at the end was generally positive, with students expressing recognition for the value of motivational interviewing. Students demonstrated their best performance of motivational interviewing during assessments using interactions with mock or standardized patients.

Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians.

PubMed

Oshman, Lauren D; Combs, Gene N

2016-05-01

Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person's own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings. This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication. Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities. A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program. © The Author(s) 2016.

Dual Diagnosis Motivational Interviewing: a modification of Motivational Interviewing for substance-abusing patients with psychotic disorders

PubMed Central

Martino, Steve; Carroll, Kathleen; Kostas, Demetrios; Perkins, Jennifer; Rounsaville, Bruce

2013-01-01

Motivational Interviewing (MI) is a brief treatment approach for helping patients develop intrinsic motivation to change addictive behaviors. While initially developed to target primary substance using populations, professionals are increasingly recognizing the promise this approach has for addressing the motivational dilemmas faced by patients who have co-occurring psychiatric and psychoactive substance use disorders. Unfortunately, this recognition has not lead to a clear explication of how MI might be adopted for specific diagnostic populations of dually diagnosed patients. In this article we describe how we have applied the principles and practices of MI to patients who have psychotic disorders and co-occurring drug or alcohol use problems. Specifically, we provide two supplemental guidelines to augment basic MI principles (adopting an integrated dual diagnosis approach, accommodating cognitive impairments and disordered thinking). We present recommended modifications to primary MI skill sets (simplifying open-ended questions, refining reflective listening skills, heightening emphasis on affirmations, integrating psychiatric issues into personalized feedback and decisional balance matrices). Finally, we highlight other clinical considerations (handling psychotic exacerbation and crisis events, recommended professional qualifications) when using MI with psychotic disordered dually diagnosed patients. PMID:12495791

Teaching Motivational Interviewing Skills to Third-Year Psychiatry Clerkship Students

ERIC Educational Resources Information Center

Roman, Brenda; Borges, Nicole; Morrison, Ann K.

2011-01-01

Background: Despite a large percentage of health care costs being related to smoking, obesity, and substance abuse, most physicians are not confident in motivating patients to change health behaviors. Motivational interviewing (MI) is a directive, patient-centered approach for eliciting behavior change. The purpose of this study was to teach…

Effectiveness of motivational interviewing for improving physical activity self-management for adults with type 2 diabetes: A review.

PubMed

Soderlund, Patricia Davern

2018-03-01

Objectives This review examines the effectiveness of motivational interviewing for physical activity self-management for adults diagnosed with diabetes mellitus type 2. Motivational interviewing is a patient centered individually tailored counseling intervention that aims to elicit a patient's own motivation for health behavior change. Review questions include (a) How have motivational interviewing methods been applied to physical activity interventions for adults with diabetes mellitus type 2? (b) What motivational interviewing approaches are associated with successful physical activity outcomes with diabetes mellitus 2? Methods Database searches used PubMed, CINAHL, and PsycINFO for the years 2000 to 2016. Criteria for inclusion was motivational interviewing used as the principal intervention in the tradition of Miller and Rollnick, measurement of physical activity, statistical significance reported for physical activity outcomes, quantitative research, and articles written in English. Results A total of nine studies met review criteria and four included motivational interviewing interventions associated with significant physical activity outcomes. Discussion Findings suggest motivational interviewing sessions should target a minimal number of self-management behaviors, be delivered by counselors proficient in motivational interviewing, and use motivational interviewing protocols with an emphasis placed either on duration or frequency of sessions.

Motivational interviewing and colorectal cancer screening: a peek from the inside out.

PubMed

Wahab, Stéphanie; Menon, Usha; Szalacha, Laura

2008-08-01

This article focuses on design, training, and delivery of motivational interview (MI) in a longitudinal randomized controlled trial intended to assess the efficacy of two separate interventions designed to increase colorectal screening when compared to a usual care, control group. One intervention was a single-session, telephone-based MI, created to increase colorectal cancer screening within primary care populations. The other was tailored health counseling. We present the rationale, design, and process discussions of the one-time motivational interviewing telephone intervention. We discuss in this paper the training and supervision of study interventionists, in order to enhance practice and research knowledge concerned with fidelity issues in motivational interview interventions. To improve motivational interviewing proficiency and effectiveness, we developed a prescribed training program adapting MI to a telephone counseling session. The three interventionists trained in MI demonstrate some MI proficiency assessed by the motivational interviewing treatment integrity scale. In the post-intervention interview, 20.5% of the MI participants reported having had a CRC screening test, and another 19.75% (n=16) had scheduled a screening test. Almost half of the participants (43%) indicated that the phone conversation helped them to overcome the reasons why they had not had a screening test. Ongoing supervision and training (post-MI workshop) are crucial to supporting MI fidelity. The trajectory of learning MI demonstrated by the interventionists is consistent with the eight stages of learning MI. The MI road map created for the interventionists has shown to be more of a distraction than a facilitator in the delivery of the telephone intervention. MI can, however, be considered a useful tool for health education and warrants further study. MI training should include consistent training and process evaluation. MI can, however, be considered a useful tool for health

Teaching students behavior change skills: description and assessment of a new Motivational interviewing curriculum.

PubMed

White, Laura L; Gazewood, John D; Mounsey, Anne L

2007-05-01

One of the US government health goals outlined in the Healthy People 2010 document (2000) is to increase the number of physicians who counsel their patients regarding unhealthy behaviors. Studies have shown a low rate of physicians provide smoking cessation counseling. We introduced a motivational interviewing curriculum into our medical school for first and third year students and then evaluated the effect of this curriculum on third year students counseling skills. The motivational interviewing curriculum was comprised of a lecture series and small group teaching with practice in role plays. The effectiveness of the curriculum was evaluated by student performance in a videotaped interview with a standardized patient who portrayed a smoker. The interview was rated using the Motivational Interviewing Treatment Integrity scoring tool (MITI). The MITI assesses 6 criteria: empathy, MI spirit (autonomy, evocation and collaboration), MI adherence (asking permission, affirmation, emphasis of control and support), MI non adherence (advise, confront and direct), the types of questions (open or closed) and the number of reflections. Secondary outcomes included a knowledge exam related to motivational interviewing and students' evaluations of the effectiveness of the motivational interviewing curriculum. Analysis of the MITI scores showed that students reached a proficiency level on the rate of reflections, were just below proficiency in assessment of empathy and motivational interviewing spirit and substantially below proficiency in the percent of open ended questions. These proficiency scores were for professional counselors but nevertheless provided us with information on the effectiveness of the new curriculum and where the focus of our teaching should be. On the optional evaluation of the first-year MI curriculum by 112 students, 83% felt that the MI curriculum had helped them be more comfortable in discussing behavior change with patients and 98% felt it was an

Motivational Interviewing to prevent dropout from an education and employment program for young adults: A randomized controlled trial.

PubMed

Sayegh, Caitlin S; Huey, Stanley J; Barnett, Elizabeth; Spruijt-Metz, Donna

2017-07-01

This study tested the efficacy of Motivational Interviewing for improving retention at a "second chance" program in the United States for unemployed young adults who had not graduated high school (ages 18-24; 60% male). We investigated how Motivational Interviewing effects might be mediated by change talk (i.e., arguments for change) and moderated by preference for consistency (PFC). Participants (N = 100) were randomly assigned to (1) Motivational Interviewing designed to elicit change talk, (2) placebo counseling designed not to elicit change talk, or (3) no additional treatment. Motivational Interviewing sessions increased change talk, but did not increase program retention or diploma earning. PFC was a significant moderator of Motivational Interviewing's impact on program retention; Motivational Interviewing was most effective at increasing 8 week retention for high PFC participants, and least effective for low PFC participants. These results suggest that Motivational Interviewing could be a useful tool for improving retention in education and employment programs, but clinicians should be attentive to how participant characteristics might enhance or diminish Motivational Interviewing effects. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Motivational interviewing: helping patients move toward change.

PubMed

Richardson, Luann

2012-01-01

Motivational Interviewing (MI) is a valuable tool for nurses to help patients address behavior change. MI has been found effective for helping patients with multiple chronic conditions, adherence issues, and lifestyle issues change their health behaviors. For Christian nurses, MI is consistent with biblical principles and can be seen as a form of ministry. This article overviews the process of MI, stages of change, and offers direction for further learning.

Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF): study design and methods.

PubMed

Masterson Creber, Ruth; Patey, Megan; Dickson, Victoria Vaughan; DeCesaris, Marissa; Riegel, Barbara

2015-03-01

Lack of engagement in self-care is common among patients needing to follow a complex treatment regimen, especially patients with heart failure who are affected by comorbidity, disability and side effects of poly-pharmacy. The purpose of Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF) is to test the feasibility and comparative efficacy of an MI intervention on self-care, acute heart failure physical symptoms and quality of life. We are conducting a brief, nurse-led motivational interviewing randomized controlled trial to address behavioral and motivational issues related to heart failure self-care. Participants in the intervention group receive home and phone-based motivational interviewing sessions over 90-days and those in the control group receive care as usual. Participants in both groups receive patient education materials. The primary study outcome is change in self-care maintenance from baseline to 90-days. This article presents the study design, methods, plans for statistical analysis and descriptive characteristics of the study sample for MITI-HF. Study findings will contribute to the literature on the efficacy of motivational interviewing to promote heart failure self-care. We anticipate that using an MI approach can help patients with heart failure focus on their internal motivation to change in a non-confrontational, patient-centered and collaborative way. It also affirms their ability to practice competent self-care relevant to their personal health goals. Copyright © 2015 Elsevier Inc. All rights reserved.

Motivational Interviewing With Personalized Feedback: A Brief Intervention for Motivating Smokers With Schizophrenia to Seek Treatment for Tobacco Dependence

ERIC Educational Resources Information Center

Steinberg, Marc L.; Ziedonis, Douglas M.; Krejci, Jonathan A.; Brandon,Thomas H.

2004-01-01

Individuals with schizophrenia have a much higher prevalence of tobacco smoking, a lower cessation rate, and a higher incidence of tobacco-related diseases than the general population. The initial challenge has been to motivate these individuals to quit smoking. This study tested whether motivational interviewing is effective in motivating smokers…

An integrative review of the efficacy of motivational interviewing in HIV management.

PubMed

Dillard, Phillip K; Zuniga, Julie Ann; Holstad, Marcia M

2017-04-01

The purpose of this integrative review is to examine the use of motivational interviewing (MI) to improve health outcomes in persons living with HIV (PLWH). We reviewed the existing literature, using the PRISMA model. The PubMed, Web of Science, Embase, and CINAHL databases were searched for all relevant studies, using the terms HIV, AIDS, and motivational interviewing. Of 239 articles identified initially, 19 met our criteria for synthesis. These studies were conducted throughout the world, including the U.S., Thailand, and South Africa. In general, studies that used MI, either alone or in conjunction with other interventions, reported improved adherence, decreased depression, and decreased risky sexual behaviors. This review demonstrates a positive relationship between MI-based interventions and behavioral change, which may lead to improved health outcomes in PLWH. Motivational interviewing can be an effective method of therapeutic communication for PLWH, who struggle with adherence, depression, and risky sexual behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Motivational Interviewing to Increase Cognitive Rehabilitation Adherence in Schizophrenia.

PubMed

Fiszdon, Joanna M; Kurtz, Matthew M; Choi, Jimmy; Bell, Morris D; Martino, Steve

2016-03-01

Adherence to treatment in psychiatric populations is notoriously low. In this randomized, controlled, proof-of-concept study, we sought to examine whether motivational interviewing (MI) could be used to enhance motivation for, adherence to, and benefit obtained from cognitive rehabilitation. Dual diagnosis MI, developed specifically for individuals with psychotic symptoms and disorganization, was further adapted to focus on cognitive impairments and their impact. Sixty-four outpatients diagnosed with schizophrenia spectrum disorders completed baseline assessments and were randomized to receive either the 2-session MI focused on cognitive functioning or a 2-session sham control interview focused on assessment and feedback about preferred learning styles. Next, all participants were given 4 weeks during which they could attend up to 10 sessions of a computer-based math training program, which served as a brief analog for a full course of cognitive rehabilitation. As hypothesized, MI condition was associated with greater increases in task-specific motivation along with greater training program session attendance. Moreover, postinterview motivation level predicted session attendance. There were no significant differences in improvement on a measure of cognitive training content, which may have been due to the abbreviated nature of the training. While the literature on the efficacy of MI for individuals with psychosis has been mixed, we speculate that our positive findings may have been influenced by the adaptations made to MI as well as the focus on a nonpharmacological intervention. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2015.

Teaching Motivational Interviewing to Undergraduates: Evaluation of Three Approaches

ERIC Educational Resources Information Center

Madson, Michael B.; Schumacher, Julie A.; Noble, Jeremy J.; Bonnell, Melissa A.

2013-01-01

Many undergraduate psychology students assume positions as mental health paraprofessionals during or after college. The present study was a quasi-experimental evaluation of the effectiveness of teaching motivational interviewing (MI), a counseling approach that applies to many paraprofessional occupations. Results from 83 undergraduates indicated…

Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review.

PubMed

Spoelstra, Sandra L; Schueller, Monica; Hilton, Melissa; Ridenour, Kimberly

2015-05-01

This article presents an integrative review of the evidence for combined motivational interviewing and cognitive behavioural interventions that promote medication adherence. We undertook this review to establish a scientific foundation for development of interventions to promote medication adherence and to guide clinical practice. The World Health Organization has designated medication adherence as a global problem. Motivational interviewing and cognitive behaviour interventions have been found to individually promote medication adherence. However, there is a gap in the literature on the effect of combined motivational interviewing and cognitive behavioural approaches to promote medication adherence. Integrative review. COCHRANE, PubMed and CINAHL were searched to access relevant studies between 2004-2014. Inclusion criteria were interventions combining motivational interviewing and cognitive behavioural therapy with medication adherence as the outcome. Articles were assessed for measures of adherence and methodological rigour. Analysis was performed using an integrative review process. Six articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 5·58 and post-treatment of 0·92 and trended towards significance. Four cohort studies had effect sizes of 0·19-0·35 (p < 0·05). A case study had a pretreatment adherence rate of 25% and post-treatment 77% (p < 0·01). Although there were a limited number of studies on combined motivational interviewing and cognitive behavioural interventions, five out of six were effective at improving medication adherence. Future studies with large rigorous randomised trials are needed. This review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision

Parallel processes: using motivational interviewing as an implementation coaching strategy.

PubMed

Hettema, Jennifer E; Ernst, Denise; Williams, Jessica Roberts; Miller, Kristin J

2014-07-01

In addition to its clinical efficacy as a communication style for strengthening motivation and commitment to change, motivational interviewing (MI) has been hypothesized to be a potential tool for facilitating evidence-based practice adoption decisions. This paper reports on the rationale and content of MI-based implementation coaching Webinars that, as part of a larger active dissemination strategy, were found to be more effective than passive dissemination strategies at promoting adoption decisions among behavioral health and health providers and administrators. The Motivational Interviewing Treatment Integrity scale (MITI 3.1.1) was used to rate coaching Webinars from 17 community behavioral health organizations and 17 community health centers. The MITI coding system was found to be applicable to the coaching Webinars, and raters achieved high levels of agreement on global and behavior count measurements of fidelity to MI. Results revealed that implementation coaches maintained fidelity to the MI model, exceeding competency benchmarks for almost all measures. Findings suggest that it is feasible to implement MI as a coaching tool.

Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

PubMed

Ingersoll, Karen S; Ceperich, Sherry D; Hettema, Jennifer E; Farrell-Carnahan, Leah; Penberthy, J Kim

2013-04-01

Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs. Participants at risk for AEP (N=217) were randomized to motivational interviewing+assessment feedback (EARLY), informational video, or informational brochure conditions. Outcomes were drinks per drinking day (DDD), ineffective contraception rate, and AEP risk at 3 and 6 months. All interventions were associated with decreased DDD, ineffective contraception rate, and AEP risk. Participants who received EARLY had larger absolute risk reductions in ineffective contraception and AEP risk, but not DDD. Effect sizes were compared to previous RCTs. The one-session EARLY intervention had less powerful effects than multi-session AEP prevention interventions among community women, but may provide a new option in a continuum of preventive care. Copyright © 2013 Elsevier Inc. All rights reserved.

Using Motivational Interviewing to Address College Client Alcohol Abuse

ERIC Educational Resources Information Center

Scholl, Mark B.; Schmitt, Dorothy M.

2009-01-01

Motivational Interviewing (MI; W. R. Miller & S. Rollnick, 2002) is presented as a potentially effective counseling strategy for assisting traditionally aged college students in reducing their problematic, heavy alcohol use. MI's congruence with two developmental theories--Self-Determination Theory (R. M. Ryan & E. L. Deci, 2000) and…

[Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus].

PubMed

Kang, Hye Yeon; Gu, Mee Ock

2015-08-01

This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus. A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0. For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group. The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

Randomized trial of intensive motivational interviewing for methamphetamine dependence.

PubMed

Polcin, Douglas L; Bond, Jason; Korcha, Rachael; Nayak, Madhabika B; Galloway, Gantt P; Evans, Kristy

2014-01-01

An intensive, 9-session motivational interviewing (IMI) intervention was assessed using a randomized clinical trial of 217 methamphetamine (MA) dependent individuals. Intensive motivational interviewing (IMI) was compared with a single standard session of MI (SMI) combined with eight nutrition education sessions. Interventions were delivered weekly over 2 months. All study participants also received standard outpatient group treatment three times per week. Both study groups showed significant decreases in MA use and Addiction Severity Index drug scores, but there were no significant differences between the two groups. However, reductions in Addiction Severity Index psychiatric severity scores and days of psychiatric problems during the past 30 days were found for clients in the IMI group but not the SMI group. SMI may be equally beneficial to IMI in reducing MA use and problem severity, but IMI may help alleviate co-occurring psychiatric problems that are unaffected by shorter MI interventions. Additional studies are needed to assess the problems, populations, and contexts for which IMI is effective.

Which Individual Therapist Behaviors Elicit Client Change Talk and Sustain Talk in Motivational Interviewing?

PubMed

Apodaca, Timothy R; Jackson, Kristina M; Borsari, Brian; Magill, Molly; Longabaugh, Richard; Mastroleo, Nadine R; Barnett, Nancy P

2016-02-01

To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (p<.001), simple reflection (p<.001), and complex reflection (p<.001)], but significantly less likely to immediately follow others (giving information (p<.001) and closed question (p<.001)]. Sustain talk was significantly more likely to follow therapist use of open questions (p<.001), simple reflections (p<.001), and complex reflections (p<.001), and significantly less likely to occur following therapist use of therapist affirm (p=.012), giving information (p<.001), and closed questions (p<.001). Certain individual therapist behaviors within motivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk. Copyright © 2015 Elsevier Inc. All rights reserved.

The Promise of Motivational Interviewing in School Mental Health

ERIC Educational Resources Information Center

Frey, Andy J.; Cloud, Richard N.; Lee, Jon; Small, Jason W.; Seeley, John R.; Feil, Edward G.; Walker, Hill M.; Golly, Annemieke

2011-01-01

In recent years, the science of developing and implementing interventions addressing school-related risk factors has produced many advances. This article addresses the promise of a cross-disciplinary practice approach known as motivational interviewing in school settings. Specifically, the supporting evidence as well as the process and principles…

Motivational Interviewing to Affect Behavioral Change in Older Adults

ERIC Educational Resources Information Center

Cummings, Sherry M.; Cooper, R. Lyle; Cassie, Kim McClure

2009-01-01

This article reviews and assesses the existing research literature on the efficacy of motivational interviewing (MI) to promote lifestyle changes and improve functioning among older adults confronting serious health challenges. A comprehensive literature review was conducted of intervention studies that tested the use of MI to achieve behavioral…

Motivation Coaching Training for Instructional Coaches: A Pilot Study of Motivational Interviewing Skills Training

ERIC Educational Resources Information Center

Lyons, Michael D.; Jones, Sara J.; Smith, Bradley H.; McQuillin, Samuel D.; Richardson, Georgette; Reid, Erin; McClellan, Anne

2017-01-01

In our paper we describe a newly developed teacher coaching model that provides training on motivational interviewing (MI) to improve instructional coaches' effectiveness with classroom teachers. Participants were 38 coaches who completed a three-day coaching training. At pre- and post-test, the participants completed role plays with an actor who…

Using motivational interviewing: through evidence-based health coaching.

PubMed

Huffman, Melinda

2014-10-01

To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short.

The effectiveness of consultation for clinicians learning to deliver motivational interviewing with fidelity.

PubMed

Barac, Raluca; Kimber, Melissa; Johnson, Sabine; Barwick, Melanie

2018-06-08

Despite the emerging literature documenting gains in clinician competence following consultation, little empirical work has examined consultation as an implementation strategy. To this end, the present study examined consultation in the context of implementing motivational interviewing in four community child and youth mental health organizations. We used qualitative methods with a dual goal: to describe the consultation process and to explore trainees' perspectives on consultation. Participants included 22 clinicians and 9 supervisors who received monthly, group, phone-based consultation for seven months following training in motivational interviewing. Analyses showed that consultation was perceived as effective because it helped to "keep motivational interviewing alive," fulfilled a profound learning function through collaboration and connection with others, and served as protected time for reflection on practice change. Our findings contribute to a body of knowledge about consultation elements that appear to be effective when implementing research-supported interventions in child and youth mental health.

Motivational Interviewing as an Intervention for At-Risk Couples.

ERIC Educational Resources Information Center

Cordova, James V.; Warren, Lisa Zepeda; Gee, Christina B.

2001-01-01

Thirty-one couples participated in the Marriage Checkup (MC), a pilot, motivational interviewing intervention for at-risk couples. Marital satisfaction improved significantly from pre- to post-checkup and remained improved at one month follow up. Although not addressing the efficacy of MC, this study supports its validity as an indicative…

How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations.

PubMed

Jelsma, Judith G M; Mertens, Vera-Christina; Forsberg, Lisa; Forsberg, Lars

2015-07-01

Many randomized controlled trials in which motivational interviewing (MI) is a key intervention make no provision for the assessment of treatment fidelity. This methodological shortcoming makes it impossible to distinguish between high- and low-quality MI interventions, and, consequently, to know whether MI provision has contributed to any intervention effects. This article makes some practical recommendations for the collection, selection, coding and reporting of MI fidelity data, as measured using the Motivational Interviewing Treatment Integrity Code. We hope that researchers will consider these recommendations and include MI fidelity measures in future studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Motivational Interviewing for Incarcerated Adolescents: Effects of Depressive Symptoms on Reducing Alcohol and Marijuana Use After Release*

PubMed Central

Stein, L. A. R.; Lebeau, Rebecca; Colby, Suzanne M.; Barnett, Nancy P.; Golembeske, Charles; Monti, Peter M.

2011-01-01

Objective: Motivational interviewing to reduce alcohol and marijuana use among incarcerated adolescents was evaluated. Method: Adolescents (N = 162, 84% male; M = 17.10 years old) were randomly assigned to receive motivational interviewing or relaxation training, with follow-up assessment 3 months after release. Results: Compared with those who received relaxation training, adolescents who received motivational interviewing had lower rates of alcohol and marijuana use at follow-up, with some evidence for moderating effects of depression. At low levels of depression, adolescents who received motivational interviewing had lower rates of use. Adolescents who received relaxation training and who had high levels of depressive symptoms early in incarceration showed less use at follow-up than those low in depressive symptoms who received relaxation training. Conclusions: This brief motivational interviewing intervention during incarceration reduces alcohol and marijuana use after release. In addition, depressive symptoms early in incarceration should be considered in treating these adolescents, but more work is needed to extend follow-up period and account for the impact of depression on outcomes. PMID:21513687

Effect of motivational interviewing on quality of life in patients with epilepsy.

PubMed

Hosseini, Nazafarin; Mokhtari, Somaye; Momeni, Ebrahim; Vossoughi, Mehrdad; Barekatian, Majid

2016-02-01

In this study, the effect of motivational interviewing on quality of life was evaluated in patients with epilepsy. Fifty-six patients with epilepsy in a clinical trial were randomly assigned to intervention and control groups. Motivational interviewing during 5 sessions was applied for the intervention group, and the control group received health-care services. Quality-of-life questionnaire in epilepsy (QOLIE-89) was applied as pre- and posttest for both groups. Before and two months after intervention, both groups were assessed. Data were analyzed by independent t-test, Chi-square test, and paired t-test. The data analysis showed that mean score of the QOLIE-89 was 38.94±8.55 and 70.90±7.99 in the intervention group before and after the intervention, respectfully, and 44.59±12.27 and 36.52±7.16 in the control group sequentially. The intervention group showed a significant score increase in their quality of life (p<0.001), whereas the control group had a score decrease (p<0.001). Motivational interviewing approach could be used as an effective intervention method for improving patients' quality of life. Copyright © 2015 Elsevier Inc. All rights reserved.

[Current evidence on the motivational interview in the approach to health care problems in primary care].

PubMed

Bóveda Fontán, Julia; Pérula de Torres, Luis Ángel; Campiñez Navarro, Manuel; Bosch Fontcuberta, Josep M; Barragán Brun, Nieves; Prados Castillejo, Jose Antonio

2013-11-01

The motivational interview has been widely used as a clinical method to promote behavioural changes in patients, helping them to resolve their ambivalence to obtain their own motivations. In the present article, a review is made of the main meta-analyses and systematic and narrative reviews on the efficacy of the motivational interview in the primary health care environment. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Motivational Interviewing to Promote Long-Acting Reversible Contraception in Postpartum Teenagers.

PubMed

Tomlin, Kristl; Bambulas, Tammalynn; Sutton, Maureen; Pazdernik, Vanessa; Coonrod, Dean V

2017-06-01

To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care. Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014. Motivational interviewing within the context of adolescent-focused prenatal care. Rates of uptake of LARC within 13 postpartum weeks. The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95% CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable contraceptive device. Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared with standard prenatal care. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Motivational Interviewing Skills are Positively Associated with Nutritionist Self-Efficacy

ERIC Educational Resources Information Center

Marley, Scott C.; Carbonneau, Kira; Lockner, Donna; Kibbe, Debra; Trowbridge, Frederick

2011-01-01

Objective: To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy. Design: Cross-sectional survey. Setting: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics. Participants: Sixty-five WIC…

Using motivational interviewing for weight feedback to parents of young children.

PubMed

Dawson, Anna M; Brown, Deirdre A; Cox, Adell; Williams, Sheila M; Treacy, Lee; Haszard, Jill; Meredith-Jones, Kim; Hargreaves, Elaine; Taylor, Barry J; Ross, Jim; Taylor, Rachael W

2014-06-01

To determine whether a single session of motivational interviewing (MI) for feedback of a child's overweight status promotes engagement in treatment following screening. One thousand ninety-three children aged 4-8 years were recruited through primary and secondary care to attend health screening, including assessment of parenting practices and motivation (questionnaire). Families with normal-weight children were informed about their child's weight but had no further involvement. Parents of overweight (body mass index ≥ 85th percentile) children (n = 271) were randomised to receive weight feedback via MI or best practice care (BPC) using a traffic light concept to indicate degree of health risk. Follow-up interviews were held 2 weeks later to examine intervention uptake, changes to motivation and behaviour, and parental response to feedback. Recruitment into the intervention was high (76%) and not altered by feedback condition (percentage difference 6.6 (95% confidence interval -2.9, 16.0). High scores on the Health Care Climate Questionnaire (rating of the interviewer) indicated satisfaction with how the information was provided to parents. No differences were observed in multiple indicators of harm. However, self-determined motivation for healthy life-styles was significantly higher in the MI condition at follow-up (0.18: 0.00, 0.35), after only a single session of MI. MI and BPC were both successful in encouraging parents to participate in a family-based intervention, with MI offering little significant benefit over BPC. A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Treatment fidelity of motivational interviewing delivered by a school nurse to increase girls' physical activity.

PubMed

Robbins, Lorraine B; Pfeiffer, Karin A; Maier, Kimberly S; Ladrig, Stacey M; Berg-Smith, Steven Malcolm

2012-02-01

Motivational interviewing, which involves the use of person-centered, directive counseling techniques, shows promise for changing adolescent behaviors. The purpose of this article was to describe the methodology and findings related to the treatment fidelity of three face-to-face motivational interviewing sessions involving middle school girls and a school nurse to help the girls increase their moderate-to-vigorous physical activity. The following four areas related to treatment fidelity were addressed: (a) study design, (b) training of interventionists, (c) intervention delivery, and (d) intervention receipt. Findings showed that 34 of 37 (91.9%) girls completed all three sessions. An initial motivational interviewing training workshop followed by evaluation of audiotaped sessions with constructive feedback can result in successful and consistent delivery by a school nurse.

Motivational Interviewing (MINT) Improves Continuous Positive Airway Pressure (CPAP) Acceptance and Adherence: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Olsen, Sara; Smith, Simon S.; Oei, Tian P. S.; Douglas, James

2012-01-01

Objective: Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) is poor. We assessed the effectiveness of a motivational interviewing intervention (motivational interview nurse therapy [MINT]) in addition to best practice standard care to improve acceptance and adherence to CPAP therapy in people with…

An interview guide for clinicians to identify a young disabled person's motivation to work.

PubMed

Faber, B J M; Wind, H; Frings-Dresen, M H W

2016-06-27

The percentage of young people with disabilities who are employed is relatively low. Motivation is considered to be an important factor in facilitating or hindering their ability to obtain employment. We aimed to develop a topic list that could serve as an interview guide for professionals in occupational health care which would aid them in their discussion of work motivation-related issues with this group. We systematically searched Pubmed, PsychInfo and Picarta. Studies were included if they described aspects of work motivation and/or instruments that assess work motivation. Based on the results of our literature survey, we developed a list of topics that had been shown to be related to work motivation. Our search resulted in 12 articles describing aspects of work motivation and 17 articles describing instruments that assess work motivation. The aspects that we found were intrinsic motivation, extrinsic motivation, goal setting, self-efficacy, expectancy, values and work readiness. Based on this information we developed an interview guide that includes seven topic areas: intrinsic motivation, extrinsic motivation, goal setting, expectancy, values, self- efficacy, and work readiness. The topics within the interview guide and the literature survey data that is presented will shed light on the role that motivation plays on the work participation among young people with disabilities.

Using Motivational Interviewing within the Early Stages of Group Development

ERIC Educational Resources Information Center

Young, Tabitha L.

2013-01-01

This article presents developmentally appropriate applications of Motivational Interviewing (MI; Miller & Rollnick, 2002) for use in preparing group members for the working stages of group. Practical strategies are offered for using MI to facilitate an atmosphere of trust, recognize member readiness for change, identify and resolve members'…

Using motivational interviewing to facilitate death talk in end-of-life care: an ethical analysis.

PubMed

Black, Isra; Helgason, Ásgeir Rúnar

2018-03-21

Morbidity arising from unprepared bereavement is a problem that affects close personal relations of individuals at the end-of-life. The bereavement studies literature demonstrates that a lack of preparedness for a loved one's death is a risk factor for secondary psychological morbidity among survivors. Short awareness time of death negatively correlates to preparedness for bereavement. The absence of disclosure of end-of-life diagnosis and prognosis to close personal relations ('death talk') between patients and loved ones, or health professionals and loved ones, may contribute to short awareness time of death. To increase awareness time of death, we might attempt to increase patient first-personal disclosure of end-of-life diagnosis and prognosis to loved-ones, and/or patient consent to health professional disclosure of the same. Interventions based on motivational interviewing in end-of-life care whose aim is to facilitate death talk, either by the patient directly, or by a health professional with the patient's consent, may offer a part solution to the problem of unprepared bereavement. This paper evaluates the ethical permissibility of such interventions. We consider two ethical objections to using motivational interviewing in this way: first, that it is inappropriate for practitioners to seek disclosure as an outcome in this setting; second, that aiming at disclosure risks manipulating individuals into death talk. While it need not be impermissible to direct individuals toward disclosure of end-of-life diagnosis/prognosis, the objection from manipulation implies that it is pro tanto ethically preferable to use motivational interviewing in a non-directive mode in death talk conversations. However, insofar as non-directive motivational interviewing requires more advanced skills, and thus may be more difficult to learn and to practise, we advance that it may be ethically permissible, all things considered, to employ directional, or specific outcome

Complementary Tools to Empower and Sustain Behavior Change: Motivational Interviewing and Mindfulness.

PubMed

Sohl, Stephanie Jean; Birdee, Gurjeet; Elam, Roy

2016-11-01

Improving health behaviors is fundamental to preventing and controlling chronic disease. Healthcare providers who have a patient-centered communication style and appropriate behavioral change tools can empower patients to engage in and sustain healthy behaviors. This review highlights motivational interviewing and mindfulness along with other evidence-based strategies for enhancing patient-centered communication and the behavior change process. Motivational interviewing and mindfulness are especially useful for empowering patients to set self-determined, or autonomous, goals for behavior change. This is important because autonomously motivated behavioral change is more sustainable. Additional strategies such as self-monitoring are discussed as useful for supporting the implementation and maintenance of goals. Thus, there is a need for healthcare providers to develop such tools to empower sustained behavior change. The additional support of a new role, a health coach who specializes in facilitating the process of health-related behavior change, may be required to substantially impact public health.

Complementary Tools to Empower and Sustain Behavior Change: Motivational Interviewing and Mindfulness

PubMed Central

Sohl, Stephanie Jean; Birdee, Gurjeet; Elam, Roy

2015-01-01

Improving health behaviors is fundamental to preventing and controlling chronic disease. Healthcare providers who have a patient-centered communication style and appropriate behavioral change tools can empower patients to engage in and sustain healthy behaviors. This review highlights motivational interviewing and mindfulness along with other evidence-based strategies for enhancing patient-centered communication and the behavior change process. Motivational interviewing and mindfulness are especially useful for empowering patients to set self-determined, or autonomous, goals for behavior change. This is important because autonomously motivated behavioral change is more sustainable. Additional strategies such as self-monitoring are discussed as useful for supporting the implementation and maintenance of goals. Thus, there is a need for healthcare providers to develop such tools to empower sustained behavior change. The additional support of a new role, a health coach who specializes in facilitating the process of health-related behavior change, may be required to substantially impact public health. PMID:28239308

Effect of Motivational Interviewing on a Weight Loss Program Based on the Protection Motivation Theory.

PubMed

Mirkarimi, Kamal; Mostafavi, Firoozeh; Eshghinia, Samira; Vakili, Mohammad Ali; Ozouni-Davaji, Rahman Berdi; Aryaie, Mohammad

2015-06-01

The prevalence of overweight and obesity is on the increase the world over, which imposes an ever-increasing burden on societies and health care systems. This study sought to investigate the effect of motivational interviewing (MI) on a weight-loss program based on the protection motivation theory (PMT). This randomized clinical trial study, comprising pretest-posttest with a control group, was conducted on 150 overweight and obese women attending a private nutrition clinic for the first time. Samples were randomly selected using the clinic's records and then allocated to three groups (50 women in each group) receiving: 1) a standard weight-control program; 2) motivational interviewing; and 3) MI plus intention intervention. Data were collected using a researcher-made questionnaire through in-person interviews and were analyzed using SPSS (version 11) and statistical tests, including the Kruskal-Wallis test, one-way analysis of variance, paired t-test, and linear regression model. In the two intervention groups, the PMT construct scores, namely susceptibility (P = 0.001), severity (P = 0.001), rewards (P =0.004), self-efficacy (P = 0.001), response efficacy (P = 0.001), and costs (P = 0.014), were significantly increased compared to those in the control group. The anthropometric status was statistically significant in the MI group (P = 0.001) and the MI plus intention-intervention group (P = 0.001) at 2 months' follow-up, while in the control group, weight was meaningfully different after the intervention (P = 0.027). Weight was different between the groups after the intervention, with the Tukey test demonstrating that the differences were statistically significant between the control group and the MI group. Our results demonstrated that MI, combined with the implementation of intention intervention, increased weight loss and PMT construct scores in our study population.

Treatment Fidelity of Motivational Interviewing Delivered by a School Nurse to Increase Girls’ Physical Activity

PubMed Central

Robbins, Lorraine B.; Pfeiffer, Karin A.; Maier, Kimberly S.; LaDrig, Stacey M.; Berg-Smith, Steven Malcolm

2011-01-01

Motivational interviewing, which involves the use of person-centered, directive counseling techniques, shows promise for changing adolescent behaviors. The purpose of this paper was to describe the methodology and findings related to the treatment fidelity of three face-to-face motivational interviewing sessions involving middle school girls and a school nurse to help the girls increase their moderate to vigorous physical activity. The following four areas related to treatment fidelity were addressed: (a) study design, (b) training of interventionists, (c) intervention delivery, and (d) intervention receipt. Findings showed that 34 of 37 (91.9%) girls completed all three sessions. An initial motivational interviewing training workshop followed by evaluation of audio-taped sessions with constructive feedback can result in successful and consistent delivery by a school nurse. PMID:21970862

Motivational Interviewing: moving from why to how with autonomy support

PubMed Central

2012-01-01

Motivational Interviewing (MI), a counseling style initially used to treat addictions, increasingly has been used in health care and public health settings. This manuscript provides an overview of MI, including its theoretical origins and core clinical strategies. We also address similarities and differences with Self-Determination Theory. MI has been defined as person-centered method of guiding to elicit and strengthen personal motivation for change. Core clinical strategies include, e.g., reflective listening and eliciting change talk. MI encourages individuals to work through their ambivalence about behavior change and to explore discrepancy between their current behavior and broader life goals and values. A key challenge for MI practitioners is deciding when and how to transition from building motivation to the goal setting and planning phases of counseling. To address this, we present a new three-phase model that provides a framework for moving from WHY to HOW; from building motivation to more action oriented counseling, within a patient centered framework. PMID:22385702

Motivational interviewing to engage patients in chronic kidney disease management.

PubMed

Martino, Steve

2011-01-01

Patients with chronic kidney disease (CKD) must manage numerous medical treatments and lifestyle changes that strain their treatment adherence. An important strategy to improve adherence is to activate the patients' motivation to manage their CKD. This article describes an approach for enhancing patients' motivation for change, called motivational interviewing (MI), a treatment that is increasingly being used in health care settings to counsel patients with chronic diseases. Its basic principles, techniques, empirical support, published applications for improving CKD patients' self-management, and how to learn MI are presented. Research is needed to determine the efficacy and mechanisms of MI for CKD treatment as well as the development of innovative ways to deliver it to patients and train busy health care practitioners in the approach. Copyright © 2011 S. Karger AG, Basel.

Increasing Follow-up Outcomes of At-Risk Alcohol Patients Using Motivational Interviewing.

PubMed

Wagner, Andrew J; Garbers, Rachael; Lang, Ann; Borgert, Andrew J; Fisher, Mason

2016-01-01

Our trauma division implemented a screening, brief intervention, and referral to treatment (SBIRT) program in 2009 and has maintained more than 92% screening rate for all inpatient admissions since inception. Brief interventions are proven to be more likely to effect and reinforce change if a follow-up contact is made with patients. This led to discussion regarding whether identified patients were more likely to follow up with our SBIRT wellness specialist using motivational interviewing or with our partners, exercise physiology, who use traditional interviewing techniques. We retrospectively reviewed more than 3,000 inpatient admissions in which screening for at-risk alcohol use were positive. Fifty-one percent of identified patients were referred for wellness specialist consultation with a follow-up rate of 52% compared with a follow-up rate of only 21% in the exercise physiology group. Motivational interviewing is more effective in encouraging at-risk alcohol users to participate in follow-up care.

The impact of motivational interviewing on participation in childbirth preparation classes and having a natural delivery: a randomised trial.

PubMed

Rasouli, M; AtashSokhan, G; Keramat, A; Khosravi, A; Fooladi, E; Mousavi, S A

2017-03-01

This study aimed to determine the effectiveness of motivational interviewing on women's participation in childbirth classes and their subsequent natural vaginal delivery. Randomised controlled trial. Prenatal clinic of the Shohada Women's Hospital, Behshahr, Mazandaran, Iran. This study was conducted with 230 nulliparous women. Participants were randomised into three groups, including 76 women in the motivational interviewing group, and 77 women in both the lecture and the control groups. Participants were assessed at three time points, including at baseline (16-19 weeks of gestation) and then following the intervention (at 21 and 37 weeks of gestation). The motivational interviewing group received two focus interviews and two telephone follow-up sessions (at 3 and 6 weeks after the last session of motivational interviewing). The lecture group received a speech session. The control group received routine care service. Frequency of participation in childbirth preparation classes and mode of delivery. Over 90% of women in the motivational interviewing group participated in childbirth preparation classes, whereas the rate of participation in the lecture and the control groups was 59.7 and 27.3%, respectively. The probability of maternal participation in childbirth classes in the motivational interviewing and in the lecture groups was 3.3 (95% CI 2.1-4.5) and 2.2 (95% CI 1.4-3.0) times the probability of maternal participation in the control group, respectively. Moreover, the intervention groups had 1.4 (95% CI 1.1-1.8) and 1.1 (95% CI 0.9-1.4) times the probability of natural delivery, compared with the control group. The frequency of natural delivery in motivational interviewing, lecture, and control groups was 68.4, 54.5, and 48.1%, respectively. The results showed a statistically significant difference between the mean scores for the awareness and attitude scores between the three groups in different time periods. We found that motivational interviewing can be a

Integrating Motivational Interviewing and Brief Behavioral Activation Therapy: Theoretical and Practical Considerations

PubMed Central

Balán, Iván C.; Lejuez, C. W.; Hoffer, Marcela; Blanco, Carlos

2017-01-01

Behavioral Activation and specifically the Brief Behavioral Activation Therapy for Depression (BATD) has a strong record of empirical support but its focus on practical out of session activation-based assignments can lead to poor levels of adherence if efforts to enhance motivation are not prioritized. Towards this end, this manuscript describes the assimilative integration of Motivational Interviewing (MI) and BATD to improve clinical outcomes by integrating MI's focus on building and maintaining motivation to change into BATD. The manuscript provides an overview of MI and BATD, theoretical issue raised in integrating the two approaches, and examples of how this integration results in a nondirective and motivation-focused approach to conducting BATD. PMID:29151779

Using Solution-Focused Approaches in Motivational Interviewing with Young People

ERIC Educational Resources Information Center

Atkinson, Cathy; Amesu, Mawuli

2007-01-01

This article explores the theory and practice of using the solution-focused approach of motivational interviewing (MI) with young people. MI is based on the premise that people are not always at a stage of readiness to change behaviours, such as smoking, drinking or drug use, which are perceived by others to be problematic. The article explores…

Clinicians' Perspectives on Motivational Interviewing-Based Brief Interventions in College Health

ERIC Educational Resources Information Center

Rash, Elizabeth M.

2008-01-01

Brief interventions based on motivational interviewing (MI) are emerging as effective strategies for behavior change in college students. However, implementation of MI-based brief interventions may be challenging in the college health environment, and their practicality is controversial. The author explored college health clinicians' perspectives…

A test of the validity of the motivational interviewing treatment integrity code.

PubMed

Forsberg, Lars; Berman, Anne H; Kallmén, Håkan; Hermansson, Ulric; Helgason, Asgeir R

2008-01-01

To evaluate the Swedish version of the Motivational Interviewing Treatment Code (MITI), MITI coding was applied to tape-recorded counseling sessions. Construct validity was assessed using factor analysis on 120 MITI-coded sessions. Discriminant validity was assessed by comparing MITI coding of motivational interviewing (MI) sessions with information- and advice-giving sessions as well as by comparing MI-trained practitioners with untrained practitioners. A principal-axis factoring analysis yielded some evidence for MITI construct validity. MITI differentiated between practitioners with different levels of MI training as well as between MI practitioners and advice-giving counselors, thus supporting discriminant validity. MITI may be used as a training tool together with supervision to confirm and enhance MI practice in clinical settings. MITI can also serve as a tool for evaluating MI integrity in clinical research.

Perceived motivational factors for female football players during rehabilitation after sports injury - a qualitative interview study.

PubMed

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-04-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete's motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players' motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation.

Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol.

PubMed

Pérula, Luis Á; Campiñez, Manuel; Bosch, Josep M; Barragán Brun, Nieves; Arboniés, Juan C; Bóveda Fontán, Julia; Martín Alvarez, Remedios; Prados, Jose A; Martín-Rioboó, Enrique; Massons, Josep; Criado, Margarita; Fernández, José Á; Parras, Juan M; Ruiz-Moral, Roger; Novo, Jesús M

2012-11-22

Lifestyle is one of the main determinants of people's health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors' communication skills, and more specifically the Motivational Interviewing. The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire) is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. - Thirty-two primary care centers in Spain. -Sampling and Size: a) face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b) Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362). Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a) Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b) Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis), internal consistency (Cronbach alpha), intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology), generalizability, construct validity and sensitivity to change (Pearson product-moment correlation

Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol

PubMed Central

2012-01-01

Background Lifestyle is one of the main determinants of people’s health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors’ communication skills, and more specifically the Motivational Interviewing. Methods/Design The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire) is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. –Scope: Thirty-two primary care centers in Spain. -Sampling and Size: a) face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b) Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362). Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a) Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b) Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis), internal consistency (Cronbach alpha), intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology), generalizability, construct validity and sensitivity to change

Students' Views on the Effectiveness of Motivational Interviewing for Challenging Disaffection

ERIC Educational Resources Information Center

Snape, Laura; Atkinson, Cathy

2017-01-01

Emerging evidence suggests motivational interviewing (MI) is an effective intervention for supporting disaffected students. However, previous literature has failed to establish students' views on MI. In the present study, three students took part in an individual MI intervention, delivered by three educational psychologists (EPs). Self-report…

Integrating Motivational Interviewing into a Basic Counseling Skills Course to Enhance Counseling Self-Efficacy

ERIC Educational Resources Information Center

Iarussi, Melanie H.; Tyler, Jessica M.; Littlebear, Sarah; Hinkle, Michelle S.

2013-01-01

Motivational interviewing (MI), a humanistic counseling style used to help activate clients' motivation to change, was integrated into a basic counseling skills course. Nineteen graduate-level counseling students completed the Counselor Estimate of Self-Efficacy at the start and conclusion of the course. Significant differences were found between…

Therapist and Client Interactions in Motivational Interviewing for Social Anxiety Disorder.

PubMed

Romano, Mia; Arambasic, Jelena; Peters, Lorna

2017-07-01

The aim of the present study is to assess the bidirectional associations between therapist and client speech during a treatment based on motivational interviewing (MI) for social anxiety disorder. Participants were 85 adults diagnosed with social anxiety who received MI prior to entering cognitive behavioral therapy. MI sessions were sequentially coded using the Motivational Interviewing Skill Code 2.5. Therapist MI-consistent behaviors, including open questions as well as positive and negative reflections, were more likely to be followed by client change exploration (change talk and counter-change talk). Therapist MI-inconsistent behaviors were more likely to precede client neutral language. Client language was also found to influence therapist likelihood of responding in an MI-consistent manner. The findings support the first step of the MI causal model in the context of social anxiety and direct future research into the effect of therapist and client behaviors on MI treatment outcome. © 2016 Wiley Periodicals, Inc.

Exploring and Challenging Pupil Disaffection: An Evaluation of a Motivational Interviewing-Based Intervention Delivered by Paraprofessionals

ERIC Educational Resources Information Center

Snape, Laura; Atkinson, Cathy

2015-01-01

Research suggests motivational interviewing (MI) techniques can be useful in educational settings for improving motivation in disaffected pupils. This exploratory mixed methods study sought to investigate whether implementing an MI-based programme through school-based paraprofessionals would be effective in improving pupil motivation. Five pupils…

Self-Determination Theory and Motivational Interviewing: Complementary Models to Elicit Voluntary Engagement by Partner-Abusive Men

PubMed Central

NEIGHBORS, CLAYTON; WALKER, DENISE D.; ROFFMAN, ROGER A.; MBILINYI, LYUNGAI F.; EDLESON, JEFFREY L.

2012-01-01

Research examining intimate partner violence (IPV) has lacked a comprehensive theoretical framework for understanding and treating behavior. The authors propose two complementary models, a treatment approach (Motivational Interviewing, MI) informed by a theory (Self-Determination Theory; SDT), as a way of integrating existing knowledge and suggesting new directions in intervening early with IPV perpetrators. MI is a client-centered clinical intervention intended to assist in strengthening motivation to change and has been widely implemented in the substance abuse literature. SDT is a theory that focuses on internal versus external motivation and considers elements that impact optimal functioning and psychological well-being. These elements include psychological needs, integration of behavioral regulations, and contextual influences on motivation. Each of these aspects of SDT is described in detail and in the context of IPV etiology and intervention using motivational interviewing. PMID:22593609

Using Motivational Interviewing to Meet Core Competencies in Psychiatric Resident Training

ERIC Educational Resources Information Center

Kaplan, Sebastian; Elliott, Harold

2011-01-01

Objective: The authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. Methods: The authors provide a brief description of MI. In addition, based on a review of the literature the authors…

Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change.

PubMed

Poirier, Maria K; Clark, Matthew M; Cerhan, Jane H; Pruthi, Sandhya; Geda, Yonas E; Dale, Lowell C

2004-03-01

To examine the effectiveness of motivational interviewing training on improving medical students' knowledge of and confidence in their ability to counsel patients regarding health behavior change. In the spring of 2002, 42 first-year medical students participated in a counseling course on health behavior change. Three small groups focused on learning and practicing motivational interviewing techniques using brief lectures, interactive class activities, student role-plays, and simulated patients. Students completed an identical precourse and postcourse questionnaire that measured their confidence and knowledge regarding counseling skills in health behavior change. The medical students reported improved confidence in their understanding of motivational interviewing after participation in the course (very confident, 77%) compared with before the course (very confident, 2%). Each of the 8 confidence items were compared before and after the course using a signed rank test. All comparisons indicated a significant improvement (P < .001) in confidence. Regarding knowledge-based questions, students showed significant improvement; 31% of students answered all the questions correctly before the course, and 56% answered all the questions correctly after the course (P = .004). These results show that teaching motivational interviewing techniques to first-year medical students can enhance student confidence in and knowledge of providing counseling to patients regarding health behavior change.

[The use of motivational interviewing (MI) in patients with chronic renal failure].

PubMed

Zawadzka, Barbara; Kleja, Justyna

2014-01-01

Patients suffering from chronic kidney disease must submit to numerous medical procedures and burdensome changes in lifestyle that make it difficult to adapt to the disease. Therefore, an important issue is to stimulate the patients motivation to comply with medical recommendations. This article describes a therapy tool for developing patient's motivation to change, called therapy or motivational interview (MI), the type of approach that is increasingly being used inhealth care, as an aid to chronically ill patients. Characteristics of this approach generally relies on the assumption that the Motivation for a change should come from a patient, not the provider, and a patient should articulate arnd resolve ambivalence provider persuassion is not effective and enhance resistance from a change. Persuasion by a person healing can only strengthen and enhance the patient's resistance to unwanted habits.

Motivational Interviewing: An Evidence-Based Practice for Improving Student Practice Skills

ERIC Educational Resources Information Center

Hohman, Melinda; Pierce, Paloma; Barnett, Elizabeth

2015-01-01

Motivational interviewing (MI) is an evidence-based communication method to assist clients in resolving their ambivalence regarding change. With a school emphasis on evidence-based practice and learning outcomes, a social work department implemented a semester-long course on MI. The purpose of this study was to determine baseline skills and…

Rogers Redux: Relevance and Outcomes of Motivational Interviewing across Behavioral Problems

ERIC Educational Resources Information Center

Mason, Michael J.

2009-01-01

Very little work regarding C. Rogers's (1961) client-centered counseling has been published in the counseling discipline's journals over the last 20 years. However, during this time there has been an impressive output of empirical research using motivational interviewing (MI) in which C. Rogers's theory and approach are foundational. A review of…

Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review.

PubMed

Lee, Windy W M; Choi, K C; Yum, Royce W Y; Yu, Doris S F; Chair, S Y

2016-01-01

Clinically, there is an increasing trend in using motivational interviewing as a counseling method to help clients with cardiovascular diseases to modify their unhealthy lifestyle in order to decrease the risk of disease occurrence. As motivational interviewing has gained increased attention, research has been conducted to examine its effectiveness. This review attempts to identify the best available evidence related to the effectiveness of motivational interviewing on lifestyle modification, physiological and psychological outcomes for clients at risk of developing or with established cardiovascular diseases. Systematic review of studies incorporating motivational interviewing in modifying lifestyles, improving physiological and psychological outcomes for clients at risk of or diagnosed with cardiovascular diseases. Major English and Chinese electronic databases were searched to identify citations that reported the effectiveness of motivational interviewing. The searched databases included MEDLINE, British Nursing Index, CINAHL Plus, PsycINFO, SCOPUS, CJN, CBM, HyRead, WanFang Data, Digital Dissertation Consortium, and so on. Two reviewers independently assessed the relevance of citations based on the inclusion criteria. Full texts of potential citations were retrieved for more detailed review. Critical appraisal was conducted by using the standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute - Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStaRI). After eligibility screening, 14 articles describing 9 studies satisfied the inclusion criteria and were included in the analysis. Only certain outcomes in certain studies were pooled for meta-analysis because of the large variability of the studies included, other findings were presented in narrative form. For lifestyle modification, the review showed that motivational interviewing could be more effective than usual care on

Effect of Motivational Interviewing on Weight Efficacy Lifestyle among Women with Overweight and Obesity: A Randomized Controlled Trial.

PubMed

Mirkarimi, Kamal; Kabir, Mohammad Javad; Honarvar, Mohammad Reza; Ozouni-Davaji, Rahman Berdi; Eri, Maryam

2017-03-01

Obesity and overweight have become increasingly a major public health problem across the world. This study aimed at exploring the effects of motivational interviewing on weight efficacy lifestyle among women with obesity and overweight. A single-blind randomized clinical trial study was conducted on 100 overweight and obese women who attended a nutrition clinic. The samples were selected based on the clinical records and assigned into two groups, namely motivational interviewing arm (50 samples) and nutrition education arm (50 samples). Data were collected using a standard validated questionnaire entitled "weight efficacy lifestyle". The intervention was designed according to five motivation sessions and four nutrition education programs, such that the participants of the nutrition education arm were also provided with the nutrition pamphlets related to weight control. Data were finally analyzed using the SPSS statistical software by performing the independent t-test, chi-square, LSD and repeated measures ANOVA tests. P<0.05 were considered statistically significant. The mean age of women was 39.9±9.1 and 36.3±8.9 years in the control and motivational interviewing arms, respectively. Compared with the control group, the score of the motivational interviewing group was statistically significant in terms of weight efficacy lifestyle P=0.0001) and all subscales including social pressure (P=0.0001), physical discomfort (P=0.005), food accessibility (P=0.0001), positive and entertainment activities (P=0.0001), as well as negative emotions (P=0.003). Motivational interviewing appeared to be effective in increasing weight efficacy lifestyle among women with overweight and obesity. IRCT2014051817736N1.

Facilitating Behavioral Change in Voice Therapy: The Relevance of Motivational Interviewing

ERIC Educational Resources Information Center

Behrman, Alison

2006-01-01

Purpose: The purpose of this article is to present an exploration of some of the issues surrounding adherence to vocal behavioral change in voice therapy within the context of Motivational Interviewing (MI) and to explore MI's potential for integration into voice therapy (MI-adapted voice therapy). MI is a style of interpersonal communication in…

An Interview with Michael Horn: Blending Education for High-Octane Motivation

ERIC Educational Resources Information Center

Patterson, Gregory A.

2012-01-01

Blended learning holds the potential of improving the way we educate students and of making them more motivated. Blended education--the melding of information technology based distance learning with school attendance--is perhaps the best way to educate students for 21st century skills, says Michael Horn in a "Kappan" interview. Horn points out…

Motivational interviewing: a part of the weight loss program for overweight and obese women prior to fertility treatment.

PubMed

Karlsen, Kamilla; Humaidan, Peter; Sørensen, Lise H; Alsbjerg, Birgit; Ravn, Pernille

2013-09-01

This is a retrospective study to investigate whether motivational interviewing increases weight loss among obese or overweight women prior to fertility treatment. Women with body mass index (BMI) > 30 kg/m(2) approaching the Fertility Clinic, Regional Hospital Skive, were given advice about diet and physical activity with the purpose of weight loss. In addition, they were asked if they wanted to receive motivational interviewing. Among other data, age, height and weight were obtained. Main outcomes were weight loss measured in kg and decrease in BMI. We studied 187 women: 110 received sessions of motivational interviewing (intervention group, n = 110), 64 received motivational support by phone or e-mail only and 13 women did not wish any motivational support (control group, n = 77). The mean weight loss and decrease in BMI was greater in the intervention group compared with the control group (9.3 kg versus 7.3 kg, difference p = 0.01, 3.3 kg/m(2) versus 2.6 kg/m(2), difference p = 0.02). The mean period of intervention was comparable in the two groups, 7.9 month and 7.3 month, respectively, (difference non significant: NS). The study indicates that motivational interviewing may be a valuable tool in weight loss programs for obese and overweight women prior to fertility treatment.

Motivational interviewing in permanent supportive housing: the role of organizational culture.

PubMed

van den Berk-Clark, Carissa; Patterson Silver Wolf, David A; Ramsey, Alex

2015-07-01

This study evaluated motivational interviewing (MI) in a permanent supportive housing agency. The agency's contradictory social service and business missions resulted in an incompatible organizational culture theorized to diminish MI's effectiveness. A combination of observational, interview, and archival data collected over 3 years were used to examine MI implementation within an incompatible supportive housing agency. Two major themes arose: how MI is used to categorize and change clients in permanent supportive housing and how worker-worker relationships affect MI implementation. The results suggest that within incompatible organizational environments, key elements of effective MI implementation are greatly weakened.

Motivational Interviewing in permanent supportive housing: The role of organizational culture

PubMed Central

van den Berk-Clark, Carissa; Patterson Silver Wolf (Adelv unegv Waya), David A.; Ramsey, Alex

2014-01-01

This study evaluated motivational interviewing (MI) in a permanent supportive housing agency. The agency’s contradictory social service and business missions resulted in an incompatible organizational culture theorized to diminish MI’s effectiveness. A combination of observational, interview, and archival data collected over 3 years were used to examine MI implementation within an incompatible supportive housing agency. Two major themes arose: how MI is used to categorize and change clients in permanent supportive housing and how worker–worker relationships affect MI implementation. The results suggest that within incompatible organizational environments, key elements of effective MI implementation are greatly weakened. PMID:25129815

Impact of Student vs Faculty Facilitators on Motivational Interviewing Student Outcomes

PubMed Central

Widder-Prewett, Rebecca; Cameron, Ginger; Anderson, Douglas; Pinkerton, Mark; Chen, Aleda M. H.

2017-01-01

Objective. To determine the impact of student or faculty facilitation on student self-assessed attitudes, confidence, and competence in motivational interviewing (MI) skills; actual competence; and evaluation of facilitator performance. Methods. Second-year pharmacy (P2) students were randomly assigned to a student or faculty facilitator for a four-hour, small-group practice of MI skills. MI skills were assessed in a simulated patient encounter with the mMITI (modified Motivational Interviewing Treatment Integrity) tool. Students completed a pre-post, 6-point, Likert-type assessment addressing the research objectives. Differences were assessed using a Mann-Whitney U test. Results. Student (N=44) post-test attitudes, confidence, perceived or actual competence, and evaluations of facilitator performance were not different for faculty- and student-facilitated groups. Conclusion. Using pharmacy students as small-group facilitators did not affect student performance and were viewed as equally favorable. Using pharmacy students as facilitators can lessen faculty workload and provide an outlet for students to develop communication and facilitation skills that will be needed in future practice. PMID:28970608

Impact of Student vs Faculty Facilitators on Motivational Interviewing Student Outcomes.

PubMed

Widder-Prewett, Rebecca; Draime, Juanita A; Cameron, Ginger; Anderson, Douglas; Pinkerton, Mark; Chen, Aleda M H

2017-08-01

Objective. To determine the impact of student or faculty facilitation on student self-assessed attitudes, confidence, and competence in motivational interviewing (MI) skills; actual competence; and evaluation of facilitator performance. Methods. Second-year pharmacy (P2) students were randomly assigned to a student or faculty facilitator for a four-hour, small-group practice of MI skills. MI skills were assessed in a simulated patient encounter with the mMITI (modified Motivational Interviewing Treatment Integrity) tool. Students completed a pre-post, 6-point, Likert-type assessment addressing the research objectives. Differences were assessed using a Mann-Whitney U test. Results. Student (N=44) post-test attitudes, confidence, perceived or actual competence, and evaluations of facilitator performance were not different for faculty- and student-facilitated groups. Conclusion. Using pharmacy students as small-group facilitators did not affect student performance and were viewed as equally favorable. Using pharmacy students as facilitators can lessen faculty workload and provide an outlet for students to develop communication and facilitation skills that will be needed in future practice.

Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: study design and methodology.

PubMed

Brennan, Leah; Walkley, Jeff; Fraser, Steve F; Greenway, Kate; Wilks, Ray

2008-05-01

Despite the high prevalence and negative physical and psychosocial consequences of overweight and obesity in adolescents, very little research has evaluated treatment in this population. Consequently, clinicians working with overweight and obese adolescents have little empirical research on which to base their practise. Cognitive behavioural therapy has demonstrated efficacy in promoting behaviour change in many treatment resistant disorders. Motivational interviewing has been used to increase motivation for change and improve treatment outcomes. In this paper we describe the rationale and design of a randomised controlled trial testing the efficacy of motivational interviewing and cognitive behaviour therapy in the treatment of overweight and obese adolescents. Participants took part in a motivational interview or a standard semi-structured assessment interview and were then randomly allocated to a cognitive behavioural intervention or a wait-list control condition. The cognitive behavioural intervention, the CHOOSE HEALTH Program, consisted of 13 individual treatment sessions (12 face-to-face, 1 phone call) followed by 9 maintenance sessions (7 phone calls, 2 face-to-face). Assessments were conducted prior to participation, after the treatment phase and after the maintenance phase of intervention. Improvement in body composition was the primary outcome; secondary outcomes included improved cardiovascular fitness, eating and physical activity habits, family and psychosocial functioning. Despite the demonstrated effectiveness of motivational interviewing and cognitive behavioural therapy in the long-term management of many treatment resistant disorders, these approaches have been under-utilised in adolescent overweight and obesity treatment. This study provides baseline data and a thorough review of the study design and treatment approach to allow for the assessment of the efficacy of motivational interviewing and cognitive behavioural therapy in the treatment of

The Straight Path to Healing: Using Motivational Interviewing to Address Spiritual Bypass

ERIC Educational Resources Information Center

Clarke, Philip B.; Giordano, Amanda L.; Cashwell, Craig S.; Lewis, Todd F.

2013-01-01

Spiritual bypass is the avoidance of underlying emotional issues by focusing solely on spiritual beliefs, practices, and experiences. Motivational interviewing (MI) is a client-centered, compassionate approach to effectively addressing resistance among those who present with spiritual bypass. In this article, the authors provide background…

Training Substance Abuse Clinicians in Motivational Interviewing Using Live Supervision via Teleconferencing

ERIC Educational Resources Information Center

Smith, Jennifer L.; Carpenter, Kenneth M.; Amrhein, Paul C.; Brooks, Adam C.; Levin, Deborah; Schreiber, Elizabeth A.; Travaglini, Laura A.; Hu, Mei-Chen; Nunes, Edward V.

2012-01-01

Objective: Training through traditional workshops is relatively ineffective for changing counseling practices. Teleconferencing supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method: Ninety-seven drug treatment counselors completed a 2-day MI workshop and were randomized to live…

Dyslipidemia management in overweight or obese adolescents: A mixed-methods clinical trial of motivational interviewing.

PubMed

Chahal, Nita; Rush, Janet; Manlhiot, Cedric; Boydell, Katherine M; Jelen, Ahlexxi; McCrindle, Brian W

2017-01-01

Lifestyle management for dyslipidemic adolescents often occurs in the context of family-centered care, which necessitates adaptation of counseling strategies. To determine the effectiveness of motivational interviewing for lifestyle behavior change for dyslipidemic adolescents in a dyad with a parent versus alone. A total number of 32 adolescents were randomized 1:1 to receive a series of motivational interviewing sessions either together with a parent or alone for a 6-month intervention, with both quantitative and qualitative assessment of outcomes. Both groups were similar at baseline. Following the intervention, there were no significant differences between groups in physical, laboratory, lifestyle or psychosocial measures, except for a reduction in dietary fats/sugars (p = 0.02) and in screen time (p = 0.02) in the alone group. When both groups were combined, significant reductions at 6 months were noted for body mass index (p < 0.001), waist circumference (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein cholesterol (p < 0.001), triglycerides (p = 0.01), non-high-density lipoprotein cholesterol (p < 0.001), fasting insulin (p = 0.01), and homeostatic model (p = 0.02). Reduced screen time and increased fruit and vegetable intake were also noted for both groups combined. These changes were also reflected in self-efficacy (p = 0.004), self-esteem (p = 0.03), and improvement in quality of life measures. Interview data provided insights into the utility and acceptability of the motivational interviewing intervention. Motivational interviewing was an efficient strategy for inspiring healthy lifestyle and physiological changes among adolescents in both groups. Family centered pediatric approaches should consider the autonomy and individual preferences of the adolescent prior to counseling.

Dyslipidemia management in overweight or obese adolescents: A mixed-methods clinical trial of motivational interviewing

PubMed Central

Chahal, Nita; Rush, Janet; Manlhiot, Cedric; Boydell, Katherine M; Jelen, Ahlexxi; McCrindle, Brian W

2017-01-01

Background: Lifestyle management for dyslipidemic adolescents often occurs in the context of family-centered care, which necessitates adaptation of counseling strategies. Objective: To determine the effectiveness of motivational interviewing for lifestyle behavior change for dyslipidemic adolescents in a dyad with a parent versus alone. Methods: A total number of 32 adolescents were randomized 1:1 to receive a series of motivational interviewing sessions either together with a parent or alone for a 6-month intervention, with both quantitative and qualitative assessment of outcomes. Results: Both groups were similar at baseline. Following the intervention, there were no significant differences between groups in physical, laboratory, lifestyle or psychosocial measures, except for a reduction in dietary fats/sugars (p = 0.02) and in screen time (p = 0.02) in the alone group. When both groups were combined, significant reductions at 6 months were noted for body mass index (p < 0.001), waist circumference (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein cholesterol (p < 0.001), triglycerides (p = 0.01), non–high-density lipoprotein cholesterol (p < 0.001), fasting insulin (p = 0.01), and homeostatic model (p = 0.02). Reduced screen time and increased fruit and vegetable intake were also noted for both groups combined. These changes were also reflected in self-efficacy (p = 0.004), self-esteem (p = 0.03), and improvement in quality of life measures. Interview data provided insights into the utility and acceptability of the motivational interviewing intervention. Conclusion: Motivational interviewing was an efficient strategy for inspiring healthy lifestyle and physiological changes among adolescents in both groups. Family centered pediatric approaches should consider the autonomy and individual preferences of the adolescent prior to counseling. PMID:28567283

Motives and activities for continuing professional development: An exploration of their relationships by integrating literature and interview data.

PubMed

Pool, Inge A; Poell, Rob F; Berings, Marjolein G M C; Ten Cate, Olle

2016-03-01

To effectively enhance professional development, it is important to understand the motivational factors behind nurses' engagement in particular types of learning activities. Nurses have various motives for professional development and utilise different learning activities. Not much is known about how these relate. The aim of this study was to explore the relationship between nurses' motives and activities for continuing professional development, by examining in which types of learning activities nurses engage, with which motives, and whether certain motives are associated with certain learning activities. A qualitative study using semi-structured interviews. Twenty-one nurses in academic and general Dutch hospitals participated. Interview data on nurses' learning biographies were analysed using a literature-based framework on motives and learning activities for continuing professional development. As recent classifications of nurses' motives for professional development were absent, the literature was reviewed for motives, using three databases. The interview transcripts were analysed for motives, learning activities and their relationships. Nine motives and four categories of learning activities for continuing professional development were delineated. Increasing competence was the primary motive that stimulated nurses to engage in self-directed learning during work, and in formal learning activities. To comply with requirements, they engaged in mandatory courses. To deepen knowledge, they registered for conferences. To develop their careers, they enrolled in postgraduate education. Five other motives were not mentioned as frequently. Specific motives were found to be related to engagement in particular learning activities. Nurses could use these findings to increase their awareness of why and how they develop professionally, and managers and human resource development professionals could develop approaches that would better suit nurses' needs. Copyright © 2016

Evaluating the Validity of the Client Evaluation of Motivational Interviewing Scale in a Brief Motivational Intervention for College Student Drinkers.

PubMed

Madson, Michael B; Villarosa, Margo C; Schumacher, Julie A; Mohn, Richard S

2016-06-01

The Client Evaluation of Motivational Interviewing scale (CEMI) is a measure for assessing client perceptions of clinicians' use of motivational interviewing (MI). This study explored the factorial, convergent and predictive validity of the CEMI with a sample of 137 college students who completed a brief motivational intervention for alcohol harm reduction. A two factor structure was confirmed, supporting previous findings of relational and technical subscales. The CEMI technical subscale partially mediated an increase in readiness to change drinking, while the relational subscale did not. Higher scores on CEMI technical subscale predicted higher scores on the tasks, bond and goals subscales of the Working Alliance Inventory while higher scores on the CEMI relationship subscale predicted an increase in the goals subscale. Finally, the correlations between the CEMI subscales and observer-rated MI spirit score and MI adherent and non-adherent behavioral counts were in the expected directions but did not reach statistical significance. Further revision and evaluation of the CEMI is recommended. Clinical, training and research implications are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Validation of the one pass measure for motivational interviewing competence.

PubMed

McMaster, Fiona; Resnicow, Ken

2015-04-01

This paper examines the psychometric properties of the OnePass coding system: a new, user-friendly tool for evaluating practitioner competence in motivational interviewing (MI). We provide data on reliability and validity with the current gold-standard: Motivational Interviewing Treatment Integrity tool (MITI). We compared scores from 27 videotaped MI sessions performed by student counselors trained in MI and simulated patients using both OnePass and MITI, with three different raters for each tool. Reliability was estimated using intra-class coefficients (ICCs), and validity was assessed using Pearson's r. OnePass had high levels of inter-rater reliability with 19/23 items found from substantial to almost perfect agreement. Taking the pair of scores with the highest inter-rater reliability on the MITI, the concurrent validity between the two measures ranged from moderate to high. Validity was highest for evocation, autonomy, direction and empathy. OnePass appears to have good inter-rater reliability while capturing similar dimensions of MI as the MITI. Despite the moderate concurrent validity with the MITI, the OnePass shows promise in evaluating both traditional and novel interpretations of MI. OnePass may be a useful tool for developing and improving practitioner competence in MI where access to MITI coders is limited. Copyright © 2015. Published by Elsevier Ireland Ltd.

Experts: despite time constraints, motivational interviewing techniques can have lasting impact on drinkers, drug abusers.

PubMed

2013-04-01

Researchers have found that the Brief Negotiation Interview (BNI), a tool developed at Yale School of Medicine in New Haven, CT, can curb harmful drinking in patients when the tool is used with these patients in the emergency setting. Further, by using the same motivational interviewing techniques employed in the tool, experts say providers can help patients curb other harmful behaviors as well. The BNI consists of a series of questions that take about seven minutes to discuss with patients. The tool prompts patients to come up with their own reasons for changing harmful behaviors. To implement the BNI, emergency providers need training and constant reinforcement. Ideally, experts say the motivational interviewing techniques employed in the BNI need to become routine to have a lasting impact on patient care.

Effect of a Significant Other on Client Change Talk in Motivational Interviewing

ERIC Educational Resources Information Center

Apodaca, Timothy R.; Magill, Molly; Longabaugh, Richard; Jackson, Kristina M.; Monti, Peter M.

2013-01-01

Objective:To examine significant-other (SO) and therapist behaviors as predictors of client change language within motivational interviewing (MI) sessions. Method: Participants from an emergency department received a single session of MI that included SO participation (N = 157). Sessions were coded using therapy process coding systems. Sessions…

A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies

ERIC Educational Resources Information Center

Lundahl, Brad W.; Kunz, Chelsea; Brownell, Cynthia; Tollefson, Derrik; Burke, Brian L.

2010-01-01

Objective: The authors investigated the unique contribution motivational interviewing (MI) has on counseling outcomes and how MI compares with other interventions. Method: A total of 119 studies were subjected to a meta-analysis. Targeted outcomes included substance use (tobacco, alcohol, drugs, marijuana), health-related behaviors (diet,…

Exploring the use of Motivational Interviewing with a disengaged primary-aged child

PubMed Central

Cryer, Sarah; Atkinson, Cathy

2015-01-01

Research suggests motivational interviewing (MI) techniques are both widely-used by educational psychologists (EPs) and effective in supporting young people of secondary age. To date, there has been no published research investigating the use of MI with primary-aged children. This study details the use of a short MI-based intervention with a primary-aged pupil identified as disengaged. A case-based approach was employed, using pupil and teacher interviews and observational fieldnotes to assess the usefulness of the intervention. Data were analysed using thematic analysis and the intervention checked for adherence to the MI spirit and principles. Here the process, structure and outcomes of the intervention are exemplified through an illustrative case study with a nine-year-old boy. Results indicate that the adapted intervention had a significant impact on learning motivation and classroom behaviour. The implications of the findings are discussed in relation to the use of school-based therapeutic interventions by EPs. PMID:26339113

Motivational interviewing: relevance in the treatment of rheumatoid arthritis?

PubMed Central

Prothero, Louise; Lempp, Heidi; Galloway, James; Sturt, Jackie

2016-01-01

Abstract Advances in pharmacological treatment options in RA have led to a dramatic potential for improvement in patients’ physical and psychological status. Despite advances, poor outcomes, including fatigue, pain, reduced physical activity and quality of life, are still observed. Reasons include non-adherence to medication, insufficient knowledge about the disease and lack of support in coping and effectively self-managing their condition. Motivational interviewing (MI) is a person-centred approach that relies on collaboration and empathy aiming to elicit a person’s own motivation for behaviour change. It has been implemented in a variety of long-term conditions, addressing issues such as lifestyle changes with beneficial effects, but it is yet to be widely recognized and adopted in the field of rheumatology. This review will explain the techniques underpinning MI and the rationale for adopting this approach in rheumatology with the aim to increase medication adherence and physical activity and improve patients’ coping strategies for pain and fatigue. PMID:26515960

The Effect of Brief Training in Motivational Interviewing on Client Outcomes and Trainee Skill Development

ERIC Educational Resources Information Center

Young, Tabitha L.

2010-01-01

Motivational Interviewing (MI) is an evidence-based practice that focuses on working through client ambivalence and increasing clients' motivation to change. The purposes of this study were to investigate the effect that a unique student-based training in MI had on counselor trainees' ability to perform MI, and on client outcomes. This training…

Perceived motivational factors for female football players during rehabilitation after sports injury – a qualitative interview study

PubMed Central

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-01-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete’s motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players’ motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation. PMID:29740552

Group motivational interviewing for adolescents: Change talk and alcohol and marijuana outcomes

PubMed Central

D’Amico, Elizabeth J.; Houck, Jon M.; Hunter, Sarah B.; Miles, Jeremy N.V.; Osilla, Karen Chan; Ewing, Brett A.

2014-01-01

Objective Little is known about what may distinguish effective and ineffective group interventions. Group motivational interviewing (MI) is a promising intervention for adolescent alcohol and other drug (AOD) use; however, the mechanisms of change for group MI are unknown. One potential mechanism is change talk, which is client speech arguing for change. The present study describes the group process in adolescent group MI and effects of group-level change talk on individual alcohol and marijuana outcomes. Method We analyzed 129 group session audio recordings from a randomized clinical trial of adolescent group MI. Sequential coding was performed using the Motivational Interviewing Skill Code (MISC) and the CASAA Application for Coding Treatment Interactions (CACTI) software application. Outcomes included past-month intentions, frequency, and consequences of alcohol and marijuana use, motivation to change, and positive expectancies. Results Sequential analysis indicated that facilitator open-ended questions and reflections of change talk (CT) increased group CT. Group CT was then followed by more CT. Multilevel models accounting for rolling group enrollment revealed group CT was associated with decreased alcohol intentions, alcohol use and heavy drinking three months later; group sustain talk was associated with decreased motivation to change, increased intentions to use marijuana, and increased positive alcohol and marijuana expectancies. Conclusions Facilitator speech and peer responses each had effects on change and sustain talk in the group setting, which was then associated with individual changes. Selective reflection of CT in adolescent group MI is suggested as a strategy to manage group dynamics and increase behavioral change. PMID:25365779

Motivational Interviewing as a Supervision Strategy in Probation: A Randomized Effectiveness Trial

ERIC Educational Resources Information Center

Walters, Scott T.; Vader, Amanda M.; Nguyen, Norma; Harris, T. Robert; Eells, Jennifer

2010-01-01

Motivational interviewing (MI) has been recommended as a supervision style in probation. This project examined the effectiveness of an MI training curriculum on probation officer MI skill and subsequent probationer outcome. Twenty probation officers were randomized to receive MI training, or to a waiting list control, while an additional group of…

Toward an Emerging Role for Motivational Interviewing in Primary Care.

PubMed

Keeley, Robert; Engel, Matthew; Reed, Alex; Brody, David; Burke, Brian L

2018-05-18

Implementing Motivational Interviewing (MI) in primary care settings has been problematic due in part to persistent gaps in knowledge. Examples include poor understanding of how to effectively train persons to conduct MI, or of which aspects of MI-related communication are associated with better outcomes for patients. This review describes how recent research findings addressing the knowledge gaps support a growing role for MI in primary care. Two trials of MI training combined classroom time with ongoing coaching and feedback, resulting in enhanced MI ability relative to a control arm where PCPs received minimal or no MI training. A third MI training trial excluded coaching and feedback, failing to increase use of MI. Adding to a growing list of behavioral health-related problems for which MI training has shown some effectiveness, a trial of training PCPs to use MI with depressed patients was associated with significantly improved depressive symptoms. Moreover, aspects of the PCPs' MI-related language and patients' arguments for positive behavior changes, "change talk," appeared to explain the positive effects of MI training on depression outcome. MI-training approaches have improved such that PCPs and possibly other clinic staff may want to consider MI training as a way to more effectively support their patients as they address behavioral health-related problems (e.g., tobacco use). MI training should focus on eliciting "change talk" from patients. Researchers and funding agencies might collaborate to continue closing knowledge gaps in the MI literature.

Depression Symptoms Among Homeless Smokers: Effect of Motivational Interviewing.

PubMed

Robinson, Cendrine D; Rogers, Charles R; Okuyemi, Kolawole S

2016-08-23

Tobacco use is higher among homeless individuals than the general population. Homeless individuals are also more likely to have symptoms of depression. Depression symptoms may add to the burden of homelessness by increasing psychological distress and serve as a barrier to quitting smoking. The primary goal of this study is to assess the impact of depression symptoms on psychological distress in homeless smokers. The effect of depression symptoms on abstinence and the effect of Motivational Interviewing (MI) on cessation among smokers is also explored. Homeless smokers (N = 430) enrolled in a smoking cessation study were randomized to Motivational Interviewing (MI) or standard care (SC). Participants received nicotine replacement therapy and were followed for 26 weeks. Participants were categorized into a depression symptoms (DS) group or control group using the Patient Health Questionnaire-9. Between group differences of perceived stress, hopelessness, confidence, craving and abstinence were assessed at weeks 8 and 26. The interaction between depression symptoms (levels: DS and control) and the intervention (levels: MI and SC) was also assessed. Homeless smokers in the DS group reported higher levels of hopelessness, perceived stress, and craving. There was no effect of DS status on abstinence at week 8 or week 26. There was no significant interaction between depression symptoms (DS vs. Control) and the intervention (MI vs. SC). Despite reporting greater psychological distress, homeless smokers with depression symptoms in this sample had abstinence levels similar to the control group. Future research should explore protective factors among depressed smokers.

Exploring the Use of Motivational Interviewing with a Disengaged Primary-Aged Child

ERIC Educational Resources Information Center

Cryer, Sarah; Atkinson, Cathy

2015-01-01

Research suggests motivational interviewing (MI) techniques are both widely-used by educational psychologists (EPs) and effective in supporting young people of secondary age. To date, there has been no published research investigating the use of MI with primary-aged children. This study details the use of a short MI-based intervention with a…

Mechanisms of motivational interviewing in health promotion: a Bayesian mediation analysis

PubMed Central

2012-01-01

Background Counselor behaviors that mediate the efficacy of motivational interviewing (MI) are not well understood, especially when applied to health behavior promotion. We hypothesized that client change talk mediates the relationship between counselor variables and subsequent client behavior change. Methods Purposeful sampling identified individuals from a prospective randomized worksite trial using an MI intervention to promote firefighters’ healthy diet and regular exercise that increased dietary intake of fruits and vegetables (n = 21) or did not increase intake of fruits and vegetables (n = 22). MI interactions were coded using the Motivational Interviewing Skill Code (MISC 2.1) to categorize counselor and firefighter verbal utterances. Both Bayesian and frequentist mediation analyses were used to investigate whether client change talk mediated the relationship between counselor skills and behavior change. Results Counselors’ global spirit, empathy, and direction and MI-consistent behavioral counts (e.g., reflections, open questions, affirmations, emphasize control) significantly correlated with firefighters’ total client change talk utterances (rs = 0.42, 0.40, 0.30, and 0.61, respectively), which correlated significantly with their fruit and vegetable intake increase (r = 0.33). Both Bayesian and frequentist mediation analyses demonstrated that findings were consistent with hypotheses, such that total client change talk mediated the relationship between counselor’s skills—MI-consistent behaviors [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .02, .12] and MI spirit [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .01, .13]—and increased fruit and vegetable consumption. Conclusion Motivational interviewing is a resource- and time-intensive intervention, and is currently being applied in many arenas. Previous research has identified the importance of counselor behaviors and client change talk in the

The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review

PubMed Central

Christie, D; Channon, S

2014-01-01

Having good intentions to engage in healthy behaviours, to change our lives in a positive direction and make substantial, lasting changes may not always translate into actions or behaviour that is maintained. Motivational Interviewing is a directive person-centred approach designed to explore ambivalence and activate motivation for change [Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behaviour. London: Guilford Press, 1991]. A key component of a motivational interviewing conversation is to acknowledge that clients have every right to make no change. It uses a guiding communication style which invites people to consider their own situation and find their own solutions to situations that they identify as problematic that are preventing change. Motivational Interviewing was first introduced in adult health addiction services in the early 1980s. It has developed in the physical health specialties, and in the last 20 years or so attention has turned to the potential of Motivational Interviewing in the paediatric setting and the challenges of using it in families with children at differing ages and developmental stages. This article summarizes studies published from 2006 to 2011 of Motivational Interviewing in individuals across the lifespan with type 1 and type 2 diabetes and obesity. PMID:23927612

The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review.

PubMed

Christie, D; Channon, S

2014-05-01

Having good intentions to engage in healthy behaviours, to change our lives in a positive direction and make substantial, lasting changes may not always translate into actions or behaviour that is maintained. Motivational Interviewing is a directive person-centred approach designed to explore ambivalence and activate motivation for change [Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behaviour. London: Guilford Press, 1991]. A key component of a motivational interviewing conversation is to acknowledge that clients have every right to make no change. It uses a guiding communication style which invites people to consider their own situation and find their own solutions to situations that they identify as problematic that are preventing change. Motivational Interviewing was first introduced in adult health addiction services in the early 1980s. It has developed in the physical health specialties, and in the last 20 years or so attention has turned to the potential of Motivational Interviewing in the paediatric setting and the challenges of using it in families with children at differing ages and developmental stages. This article summarizes studies published from 2006 to 2011 of Motivational Interviewing in individuals across the lifespan with type 1 and type 2 diabetes and obesity. ©2013 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

An Interview Study of Learner Motivation and Learner Involvement in Mandatory College-Level Academic Writing Classes

ERIC Educational Resources Information Center

Vanniarajan, Swathi M.

2011-01-01

Scholarship in applied linguistics has not sufficiently addressed learner motivation in mandatory writing classes in postsecondary settings. The data collected through short interviews from 20 students enrolled in a mandatory academic writing program at the junior/senior level in a California State University indicated that learner motivation in…

Motivational interviewing as a smoking cessation strategy with nurses: an exploratory randomised controlled trial.

PubMed

Mujika, Agurtzane; Forbes, Angus; Canga, Navidad; de Irala, Jokin; Serrano, Inmaculada; Gascó, Plácido; Edwards, Margaret

2014-08-01

Despite the important role that health professionals have in reducing tobacco use, many have a smoking habit themselves. The prevalence of smoking is particularly high among nurses. To test the efficacy, acceptability and feasibility of a motivational interviewing (MI) based smoking cessation intervention with nurses. Two group parallel experimental design with random allocation to groups. A large teaching hospital in the North of Spain. Nurses who smoked (n=30) were randomised into two groups: motivational interviewing based intervention (n=15) and usual care (n=15). Motivational interviewing based intervention consisted of four individual MI sessions. Usual care consisted of brief advice. Variables considered to assess efficacy were biochemically verified smoking cessation, mean cigarettes smoked, stages of change, self-efficacy and depression score. Variables to assess acceptability and feasibility included participant satisfaction, adherence to MI, and duration of sessions. Data were collected at: baseline, end of intervention and three months after the end of the intervention. At three month follow up, compared with the control group, more nurses in the intervention group had quit (absolute difference 33.3%; 95% confidence interval [CI] 2.6-58.2). In the nurses who did not quit, there was no significant difference between the intervention and control groups in the number of cigarettes smoked per day, although progress in the stages of change was greater in the intervention group compared to the control group. Measures of acceptability and feasibility indicated good satisfaction with the intervention, with high levels of attendance and completion. This study found a beneficial effect of motivational interviewing on nurses' smoking cessation. The intervention was acceptable for nurses and a number of aspects were identified that need to be considered prior to conducting a larger scale in order to optimise the intervention. Using MI might be a novel approach to

A randomized trail using motivational interviewing for maintenance of blood pressure improvements in a community-engaged lifestyle intervention: HUB City Steps

USDA-ARS?s Scientific Manuscript database

Background: Little is known about the effective dose of motivational interviewing for maintaining intervention-induced health outcome improvements. Purpose: To compare effects of two doses of motivational interviewing for maintaining blood pressure improvements in a community-engaged lifestyle int...

The Motivational Interviewing Navigation Guide: A Process for Enhancing Teachers' Motivation to Adopt and Implement School-Based Interventions

ERIC Educational Resources Information Center

Frey, Andy J.; Lee, Jon; Small, Jason W.; Seeley, John R.; Walker, Hill M.; Feil, Edward G.

2013-01-01

There is a critical need to engage theory-driven research related to the deployment of mental health promotion initiatives and student outcomes. A growing body of research supporting the use of motivational interviewing and engagement strategies in education suggests that this approach may be promising to better understand mechanisms through which…

Dismantling Motivational Interviewing and Feedback for College Drinkers: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Walters, Scott T.; Vader, Amanda M.; Harris, T. Robert; Field, Craig A.; Jouriles, Ernest N.

2009-01-01

Motivational interviewing (MI) is a counseling style that has been shown to reduce heavy drinking among college students. To date, all studies of MI among college students have used a format that includes a feedback profile delivered in an MI style. This study was a dismantling trial of MI and feedback among heavy-drinking college students. After…

The Effect of a Brief Training in Motivational Interviewing on Trainee Skill Development

ERIC Educational Resources Information Center

Young, Tabitha L.; Hagedorn, W. Bryce

2012-01-01

Motivational interviewing (MI) is an empirically based practice that provides counselors with methods for working with resistant and ambivalent clients. Whereas previous research has demonstrated the effectiveness of training current clinicians in this evidenced-based practice, no research has investigated the efficacy of teaching MI to…

Motivations for contributing to health-related articles on Wikipedia: an interview study.

PubMed

Farič, Nuša; Potts, Henry W W

2014-12-03

Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. The aim was to characterize individuals' motivations for contributing to health content on the English-language Wikipedia. A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and rewarding activity), and positive attitude to

Motivations for Contributing to Health-Related Articles on Wikipedia: An Interview Study

PubMed Central

2014-01-01

Background Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. Objective The aim was to characterize individuals’ motivations for contributing to health content on the English-language Wikipedia. Methods A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. Results A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and

Motivational interviewing competencies among UK family nurse partnership nurses: a process evaluation component of the building blocks trial.

PubMed

Channon, Sue; Bekkers, Marie-Jet; Sanders, Julia; Cannings-John, Rebecca; Robertson, Laura; Bennert, Kristina; Butler, Christopher; Hood, Kerenza; Robling, Michael

2016-01-01

Motivational Interviewing (MI) is a person-centred counselling approach to behaviour change which is increasingly being used in public health settings, either as a stand-alone approach or in combination with other structured programmes of health promotion. One example of this is the Family Nurse Partnership (FNP) a licensed, preventative programme for first time mothers under the age of 20, delivered by specialist family nurses who are additionally trained in MI. The Building Blocks trial was an individually randomised controlled trial comparing effectiveness of Family Nurse Partnership when added to usual care compared to usual care alone within 18 sites in England. The aim of this process evaluation component of the trial is to determine the extent to which Motivational Interviewing skills taught to Family Nurse Partnership nurses were used in their home visits with clients. Between July 2010 and November 2011, 92 audio-recordings of nurse-client consultations were collected during the 'pregnancy' and 'infancy' phases of the FNP programme. They were analysed using The Motivational Interviewing Treatment Integrity (MITI) coding system. A competent level of overall MI adherent practice according to the MITI criteria for 'global clinician ratings' was apparent in over 70 % of the consultations. However, on specific behaviours and the MITI-derived practitioner competency variables, there was a large variation in the percentage of recordings in which "beginner proficiency" levels in MI (as defined by the MITI criteria) was achieved, ranging from 73.9 % for the 'MI adherent behaviour' variable in the pregnancy phase to 6.7 % for 'percentage of questions coded as open' in the infancy phase. The results suggest that it is possible to deliver a structured programme in an MI-consistent way. However, some of the behaviours regarded as key to MI practice such as the percentage of questions coded as open can be more difficult to achieve in such a context. This is an

A Randomized Trial Using Motivational Interviewing for Maintenance of Blood Pressure Improvements in a Community-Engaged Lifestyle Intervention: HUB City Steps

ERIC Educational Resources Information Center

Landry, Alicia; Madson, Michael; Thomson, Jessica; Zoellner, Jamie; Connell, Carol; Yadrick, Kathleen

2015-01-01

Little is known about the effective dose of motivational interviewing for maintaining intervention-induced health outcome improvements. The purpose of this study was to compare effects of two doses of motivational interviewing for maintaining blood pressure improvements in a community-engaged lifestyle intervention conducted with…

The effect of education through motivational interviewing compared with conventional education on self-care behaviors in heart failure patients with depression.

PubMed

Navidian, Ali; Mobaraki, Hajar; Shakiba, Mansour

2017-08-01

To determine the effect of education based on motivational interviewing on self-care behaviors in heart failure patients with depression. In this study, 82 patients suffering from heart failure whose depression had been confirmed were selected and divided into two groups. The Self-Care Heart Failure Index was utilized to evaluate self-care behavior. The intervention group received four sessions of self-care behavior education based on the principles of motivational interviewing, and the control group received four sessions of conventional education on self-care behavior. At 8 weeks after finishing the interventions, the self-care behaviors of both groups were evaluated. Data were analyzed using paired and independent t-tests, Chi-square, and analysis of covariance, as appropriate. The average increase in the overall scores and the scores on the three sub-scales of self-care behavior (maintenance, management, and confidence) of the heart failure patients with depression were significantly higher after education based on motivational interviewing than after conventional self-care education (p<0.05). Motivational interviewing had a significant positive effect on self-care behaviors in patients with heart failure and depression. Due to the effectiveness of the MI, using motivational interviewing for education in depressed HF patients is recommended. Copyright © 2017 Elsevier B.V. All rights reserved.

[Development and Evaluation of a Motivational Interviewing Program for Exercise Improvement in Persons with Physical Disabilities].

PubMed

Jeong, Jeong Hee; Jeong, Ihn Sook

2017-06-01

The aims of this study were to develop a motivational interviewing program for exercise improvement in persons with physical disabilities and to examine the effect of this motivational interviewing intervention. The study employed a nonequivalent control group pretest and posttest design. A total of 62 persons with physical disabilities (30 in the experimental group, 32 in the control group) were recruited from 2 community rehabilitation centers. The experimental group received 8 sessions of a group motivational interviewing program, scheduled once a week, with each session lasting 60 minutes. Test measures were completed before the intervention, immediately after the end of the intervention, 2 weeks later, and 6 weeks after the end of the intervention. Measures included self-efficacy for exercise, decisional balance for exercise, stage of change for exercise, regularity of exercise, exercise maintenance, and independent living ability. Data were analyzed using the χ²-test, Fisher's exact test, Independent samples t-test, and repeated measures ANOVA, conducted using IBM SPSS Statistics version 18. The experimental group showed a significant increase in self-efficacy for exercise (F=50.98, p<.001), benefit (pros) of exercise (F=24.16, p<.001), and independent living ability (F=50.94, p<.001), and a significant decrease in loss (cons) of exercise (F=26.50, p<.001). There were significant differences between the two groups in stages of change for exercise (p<.001), regularity of exercise (p<.001), and exercise maintenance (χ²=26.61, p<.001). The motivational interviewing program has the potential to improve exercise levels in persons with physical disabilities. © 2017 Korean Society of Nursing Science

Reliability and validity of a treatment fidelity assessment for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

PubMed

Seng, Elizabeth K; Lovejoy, Travis I

2013-12-01

This study psychometrically evaluates the Motivational Interviewing Treatment Integrity Code (MITI) to assess fidelity to motivational interviewing to reduce sexual risk behaviors in people living with HIV/AIDS. 74 sessions from a pilot randomized controlled trial of motivational interviewing to reduce sexual risk behaviors in people living with HIV were coded with the MITI. Participants reported sexual behavior at baseline, 3-month, and 6-months. Regarding reliability, excellent inter-rater reliability was achieved for measures of behavior frequency across the 12 sessions coded by both coders; global scales demonstrated poor intraclass correlations, but adequate percent agreement. Regarding validity, principle components analyses indicated that a two-factor model accounted for an adequate amount of variance in the data. These factors were associated with decreases in sexual risk behaviors after treatment. The MITI is a reliable and valid measurement of treatment fidelity for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

A randomized trial using motivational interviewing for maintenance of blood pressure improvements in a community-engaged lifestyle intervention: HUB city steps

PubMed Central

Landry, Alicia; Madson, Michael; Thomson, Jessica; Zoellner, Jamie; Connell, Carol; Yadrick, Kathleen

2015-01-01

Little is known about the effective dose of motivational interviewing for maintaining intervention-induced health outcome improvements. The purpose of this study was to compare effects of two doses of motivational interviewing for maintaining blood pressure improvements in a community-engaged lifestyle intervention conducted with African-Americans. Participants were tracked through a 12-month maintenance phase following a 6-month intervention targeting physical activity and diet. For the maintenance phase, participants were randomized to receive a low (4) or high (10) dose of motivational interviewing delivered via telephone by trained research staff. Generalized linear models were used to test for group differences in blood pressure. Blood pressure significantly increased during the maintenance phase. No differences were apparent between randomized groups. Results suggest that 10 or fewer motivational interviewing calls over a 12-month period may be insufficient to maintain post-intervention improvements in blood pressure. Further research is needed to determine optimal strategies for maintaining changes. PMID:26590242

Motivational interviews to improve contraceptive use in populations at high risk of unintended pregnancy: a systematic review and meta-analysis.

PubMed

Wilson, Amie; Nirantharakumar, Krishnarajah; Truchanowicz, Ewa G; Surenthirakumaran, Rajendra; MacArthur, Christine; Coomarasamy, Arri

2015-08-01

Effective contraceptive use has the potential to prevent around 230 million births each year. An estimated 222 million women want to delay pregnancy or cease childbearing, but are not actively using contraception. Lack of education is a known barrier for effective contraceptive use. Motivational interviews are presumed to improve effective contraceptive use, but studies to date report varied findings. Some studies demonstrate an improvement and others report no effect. A systematic review of evidence on the impact of motivational interviews on contraceptive use in women of childbearing age was carried out using MEDLINE, EMBASE, BNI, Cochrane library, CINHAL, African Index Medicus, Web of Science, the Reproductive Health Library, and the Science Citation Index (inception-January 2013) without language restriction. Search terms included 'motivational interview* AND contraception OR family planning OR maternal OR pregnancy'. Randomised controlled trials comparing the effect of motivational interviews with standard practice on effective contraception use in women of reproductive age were included. The outcome measures were use of effective contraception or use of high-level contraception, and subsequent births or pregnancies. The random effects model was used to pool the risk ratios from individual studies. Eight randomised controlled trials were included in the review with a total of 3424 women at high risk of pregnancy. Meta-analysis showed an increase in effective contraceptive use with motivational interviews when compared with control (RR 1.32 95%CI 1.11, 1.56: P=0.002) in the period of zero to four months post intervention. No difference in effective contraceptive use was shown at four to eight months (RR 1.10, 95%CI 0.93, 1.32: P=0.27), and between eight to twelve months (RR 1.18 95%CI 0.96, 1.46: P=0.12). No evidence of effect in the reduction of subsequent pregnancies or births at twelve to twenty-four months was seen with motivational interviews (RR 0.80 95

Identifying content-based and relational techniques to change behaviour in motivational interviewing.

PubMed

Hardcastle, Sarah J; Fortier, Michelle; Blake, Nicola; Hagger, Martin S

2017-03-01

Motivational interviewing (MI) is a complex intervention comprising multiple techniques aimed at changing health-related motivation and behaviour. However, MI techniques have not been systematically isolated and classified. This study aimed to identify the techniques unique to MI, classify them as content-related or relational, and evaluate the extent to which they overlap with techniques from the behaviour change technique taxonomy version 1 [BCTTv1; Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., … Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46, 81-95]. Behaviour change experts (n = 3) content-analysed MI techniques based on Miller and Rollnick's [(2013). Motivational interviewing: Preparing people for change (3rd ed.). New York: Guildford Press] conceptualisation. Each technique was then coded for independence and uniqueness by independent experts (n = 10). The experts also compared each MI technique to those from the BCTTv1. Experts identified 38 distinct MI techniques with high agreement on clarity, uniqueness, preciseness, and distinctiveness ratings. Of the identified techniques, 16 were classified as relational techniques. The remaining 22 techniques were classified as content based. Sixteen of the MI techniques were identified as having substantial overlap with techniques from the BCTTv1. The isolation and classification of MI techniques will provide researchers with the necessary tools to clearly specify MI interventions and test the main and interactive effects of the techniques on health behaviour. The distinction between relational and content-based techniques within MI is also an important advance, recognising that changes in motivation and behaviour in MI is a function of both intervention content and the interpersonal style

The Effect of Motivational Interviewing on Craving and Dependence on Hookah in Suburban Pregnant Women in South East of Iran.

PubMed

Mojahed, Kheirolnesa; Navidian, Ali

2018-05-30

Hookah smoking during pregnancy is a health concern which requires effective interventions. Thus, the authors have aimed to evaluate the effect of motivational interviewing on craving and dependence on hookah in pregnant women (n = 140) addicted to hookah who reside in the outskirts of Zahedan, a city in southeast of Iran. The subjects were selected using the convenience sampling and randomly divided into either the control or intervention group. The intervention group received five motivational interviewing group sessions about hookah smoking withdrawal, whereas the control group was given the conventional recommendations for quitting hookah. Data were collected after eight weeks during the post intervention period using Hookah Craving Test and Hookah Addiction Severity Index. Next, they were analyzed using independent t-test, paired t-test, and analysis of covariance (ANCOVA). After the motivational interviewing intervention, the independent t-test indicated a significant difference between the intervention and control groups in terms of the mean score of hookah craving (P = 0.0001). Moreover, ANCOVA, with control of the effect of pretest and duration of hookah addiction, demonstrated a significant difference between the two groups regarding the mean score of hookah dependence after the intervention (P = 0.0001). Motivational interviewing had a significant positive impact on decreased hookah craving and dependence (two indices of withdrawal). Therefore, healthcare providers are recommended to incorporate motivational interviewing-based education into prenatal care programs to promote the chance of hookah smoking withdrawal.

Developing and Pilot Testing the Readiness and Motivation Interview for Families in Pediatric Weight Management.

PubMed

Geller, Josie; Avis, Jillian; Srikameswaran, Suja; Zelichowska, Joanna; Dartnell, Katie; Scheuerman, Bailey; Perez, Arnaldo; Rasquinha, Allison; Brown, Krista E; Chanoine, Jean-Pierre; Ball, Geoff

2015-12-01

Clinical acumen is often used to assess families' motivation prior to initiating pediatric obesity management due to a lack of available tools. The purpose of this pilot study was to (i) develop and (ii) pilot test the "Readiness and Motivation Interview for Families" (RMI-Family) in pediatric weight management. We conducted 5 focus groups with parents (n = 15), youth with obesity (n = 11), and health care providers (n = 8) to explore perceptions of barriers to making healthy behaviour changes, which led to the creation of the RMI-Family as a semi-structured interview. Five domains (treat foods, overeating, emotional eating, total physical activity, and screen time) emerged from the focus groups to inform the development of the RMI-Family, which was then pilot tested with a sample of youth with obesity and their parents (n = 11 dyads). Interviewers administered the RMI-Family to youth (age 12.8 ± 1.7 years; body mass index [BMI] z-score: 2.71 ± 0.43) and parents (age 47.1 ± 3.7 years; BMI: 33.5 ± 10.1 kg/m(2)). The RMI-Family was feasible to administer, easily understood by families, and may be a useful tool for assessing families' motivation. Research is underway to determine the psychometric properties and utility of the RMI-Family in predicting clinical outcomes in pediatric weight management.

From In-Session Behaviors to Drinking Outcomes: A Causal Chain for Motivational Interviewing

ERIC Educational Resources Information Center

Moyers, Theresa B.; Martin, Tim; Houck, Jon M.; Christopher, Paulette J.; Tonigan, J. Scott

2009-01-01

Client speech in favor of change within motivational interviewing sessions has been linked to treatment outcomes, but a causal chain has not yet been demonstrated. Using a sequential behavioral coding system for client speech, the authors found that, at both the session and utterance levels, specific therapist behaviors predict client change talk.…

A Randomized Trial of Motivational Interviewing and Feedback with Heavy Drinking College Students

ERIC Educational Resources Information Center

Juarez, Patricia; Walters, Scott T.; Daugherty, Mikyta; Radi, Christopher

2006-01-01

Motivational interviewing (MI) is a brief intervention that has been shown to reduce heavy drinking among college students. Because all college studies of MI to date have included a personalized feedback report, it remains unclear which of the components is necessary to produce behavior change. This study evaluated the separate and collective…

The Effect of Positive Group Psychotherapy and Motivational Interviewing on Smoking Cessation: A Qualitative Descriptive Study.

PubMed

Lee, Eun Jin

The purpose of this study was to describe the process and evaluate the effect of positive group psychotherapy and motivational interviewing as an intervention for smoking cessation. A qualitative descriptive study was conducted at a university in South Korea. Positive group psychotherapy and motivational interviewing were attended by 36 smokers for 1 hour once a week, for 6 hours. A recorded exit interview was conducted after the intervention. The resulting transcripts were analyzed with content analysis and thematic analysis. Among the 36 study participants, the importance of stopping smoking was rated higher in the successful cessation (defined as those who ceased smoking for at least 3 months; hereafter, success group) group (8.6 ± 0.4, n = 10) than in the failed cessation (defined as those who did not cease smoking for at least 3 months; hereafter, failure group) group (7.75 ± 0.3, n = 26; p < .01). The confidence to stop smoking was rated higher by the successes (8.4 ± 0.3) than by the failures (5.5 ± 0.4; p < .01). More successes wanted to stop smoking for the sake of their loved ones (60%) and health (50%), whereas more failures wanted to stop smoking for saving money (45.5%). Failures had more cross-addiction than successes (three to four addictions: 31.5% vs. 20%). When participants were asked to find 10 personality merits, 78% of the successes and 47% of the failures found their 10 merits. The therapeutic process was described as "sharing the smoking cessation process with others," "detailed guidance for stress management and smoking cessation," and "compliments about efforts for smoking cessation." The importance of and confidence in smoking cessation were predictors for successful cessation for 3-6 months. Motivational interviewing increased motivations, whereas positive group psychotherapy increased positive thoughts and confidence.

Effect of motivational group interviewing-based safety education on Workers' safety behaviors in glass manufacturing.

PubMed

Navidian, Ali; Rostami, Zahra; Rozbehani, Nasrin

2015-09-19

Worker safety education using models that identify and reinforce factors affecting behavior is essential. The present study aimed to determine the effect of safety education based on motivational interviewing on awareness of, attitudes toward, and engagement in worker safety in the glass production industry in Hamedan, Iran, in 2014. This was a quasi-experimental interventional study including a total of 70 production line workers at glass production facilities in Hamedan. The workers were randomly assigned to either an intervention or a control group, with 35 workers in each group. Participants in the control group received four one-hour safety education sessions, in the form of traditional lectures. Those in the intervention group received four educational sessions based on motivational group interviewing, which were conducted in four groups of eight to ten participants each. The instruments used included a researcher-developed questionnaire with checklists addressing safety awareness, and attitude and performance, which were completed before and 12 weeks after the intervention. The data were analyzed using descriptive statistics, independent and paired t-tests, and chi-squared tests. Having obtained the differences in scores before and after the intervention, we determined mean changes in the scores of awareness, attitude, and use of personal protective equipment among workers who underwent motivational group interviewing (3.74 ± 2.16, 1.71 ± 3.16, and 3.2 ± 1.92, respectively, p < 0.05). These scores were significantly greater than those of control workers who underwent traditional educational sessions (1.28 ± 1.93, 1.1 ± 3.07, and 0.2 ± 1.26, respectively). Our findings revealed that incorporation of motivational interviewing principles into safety education programs had the positive effect of enhancing workers' knowledge, attitude, and, particularly, implementation of safe behaviors. The application of this advisory approach

A Randomized Trial of Motivational Interviewing to Improve Middle School Students' Academic Performance

ERIC Educational Resources Information Center

Strait, Gerald Gill; Smith, Bradley H.; McQuillin, Sam; Terry, John; Swan, Suzanne; Malone, Patrick S.

2012-01-01

Motivational interviewing (MI) is an effective method of promoting change in adults, but research on adolescents is limited. This study tests the efficacy of MI for promoting academic achievement in middle school students. Participants were 103 6th-, 7th-, and 8th-grade students randomly assigned to either a MI (n = 50) or a waitlist control…

The Use of English as Ad Hoc Institutional Standard in the Belgian Asylum Interview

ERIC Educational Resources Information Center

Maryns, Katrijn

2017-01-01

In institutional settings of globalization, labelled languages are generally preferred over multilingual repertoires and mobile language resources. Drawing on linguistic-ethnographic analysis of the way English is treated as an invariable "ad hoc" idiom in the Belgian asylum interview, this article demonstrates how institutional measures…

Client experiences of motivational interviewing: An interpersonal process recall study.

PubMed

Jones, Sarah A; Latchford, Gary; Tober, Gillian

2016-03-01

To explore clients' experience of the therapy process in motivational interviewing (MI) for alcohol abuse. A qualitative study using grounded theory. Interviews with nine clients were conducted using interpersonal process recall (IPR), a methodology which utilizes a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe the important moments in the therapy session. The transcribed interviews were then analysed using grounded theory. A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. The themes which emerged partly confirm processes of MI previously hypothesized to be important, but also highlight the importance of factors common to all therapeutic approaches. The aspects of therapy which clients in this study felt were important are similar to those hypothesized to underlie the effectiveness of MI, including a non-confrontational approach, affirmation, and developing discrepancies between beliefs and behaviour. These were embedded in aspects common to all therapies, including the qualities of the therapist and the therapeutic relationship. Client's perspectives on therapeutic processes are an important area of research, and IPR is a particularly suitable method. © 2015 The British Psychological Society.

The Development of Instruments to Measure Motivational Interviewing Skill Acquisition for School-Based Personnel

ERIC Educational Resources Information Center

Small, Jason W.; Lee, Jon; Frey, Andy J.; Seeley, John R.; Walker, Hill M.

2014-01-01

As specialized instructional support personnel begin learning and using motivational interviewing (MI) techniques in school-based settings, there is growing need for context-specific measures to assess initial MI skill development. In this article, we describe the iterative development and preliminary evaluation of two measures of MI skill adapted…

Technology to Support Motivational Interviewing.

PubMed

Gance-Cleveland, Bonnie; Ford, Loretta C; Aldrich, Heather; Oetzel, Keri Bolton; Cook, Paul; Schmiege, Sarah; Wold, Mary

This paper reports the findings of motivational interviewing (MI) training with and without technology support on school-based health center (SBHC) providers' satisfaction with MI training, providers' self-report of behavioral counseling related to childhood overweight/obesity, and parents' perception of care after training. The effects of training and technology on MI is part of a larger comparative effectiveness, cluster randomized trial. Twenty-four SBHCs in six states received virtual training on MI. Half the sites received HeartSmartKids™, a bilingual (English/Spanish), decision-support technology. The technology generated tailored patient education materials. Standard growth charts were plotted and health risks were highlighted to support MI counseling. The results of the MI training included provider satisfaction with MI training and parent assessment of the components of MI in their child's care. Providers and parents were surveyed at baseline, after training, and six months after training. Providers were satisfied with training and reported improvements in counseling proficiency (p<0.0007) and psychological/emotional assessment (p=0.0004) after training. Parents in the technology group reported significant improvement in provider support for healthy eating (p=0.04). Virtual training has the potential of preparing providers to use MI to address childhood obesity. Technology improved parent support for healthy eating. Future research should evaluate the impact of technology to support MI on patient outcomes. Childhood obesity guidelines emphasize that MI should be used to promote healthy weight in children. Training providers on MI may help more providers incorporate obesity guidelines in their practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Using Motivational Interviewing to reduce threats in conversations about environmental behavior

PubMed Central

Klonek, Florian E.; Güntner, Amelie V.; Lehmann-Willenbrock, Nale; Kauffeld, Simone

2015-01-01

Human behavior contributes to a waste of environmental resources and our society is looking for ways to reduce this problem. However, humans may perceive feedback about their environmental behavior as threatening. According to self-determination theory (SDT), threats decrease intrinsic motivation for behavior change. According to self-affirmation theory (SAT), threats can harm individuals’ self-integrity. Therefore, individuals should show self-defensive biases, e.g., in terms of presenting counter-arguments when presented with environmental behavior change. The current study examines how change recipients respond to threats from change agents in interactions about environmental behavior change. Moreover, we investigate how Motivational Interviewing (MI) — an intervention aimed at increasing intrinsic motivation — can reduce threats at both the social and cognitive level. We videotaped 68 dyadic interactions with change agents who either did or did not use MI (control group). We coded agents verbal threats and recipients’ verbal expressions of motivation. Recipients also rated agents’ level of confrontation and empathy (i.e., cognitive reactions). As hypothesized, threats were significantly lower when change agents used MI. Perceived confrontations converged with observable social behavior of change agents in both groups. Moreover, behavioral threats showed a negative association with change recipients’ expressed motivation (i.e., reasons to change). Contrary to our expectations, we found no relation between change agents’ verbal threats and change recipients’ verbally expressed self-defenses (i.e., sustain talk). Our results imply that MI reduces the adverse impact of threats in conversations about environmental behavior change on both the social and cognitive level. We discuss theoretical implications of our study in the context of SAT and SDT and suggest practical implications for environmental change agents in organizations. PMID:26257676

Using Motivational Interviewing to reduce threats in conversations about environmental behavior.

PubMed

Klonek, Florian E; Güntner, Amelie V; Lehmann-Willenbrock, Nale; Kauffeld, Simone

2015-01-01

Human behavior contributes to a waste of environmental resources and our society is looking for ways to reduce this problem. However, humans may perceive feedback about their environmental behavior as threatening. According to self-determination theory (SDT), threats decrease intrinsic motivation for behavior change. According to self-affirmation theory (SAT), threats can harm individuals' self-integrity. Therefore, individuals should show self-defensive biases, e.g., in terms of presenting counter-arguments when presented with environmental behavior change. The current study examines how change recipients respond to threats from change agents in interactions about environmental behavior change. Moreover, we investigate how Motivational Interviewing (MI) - an intervention aimed at increasing intrinsic motivation - can reduce threats at both the social and cognitive level. We videotaped 68 dyadic interactions with change agents who either did or did not use MI (control group). We coded agents verbal threats and recipients' verbal expressions of motivation. Recipients also rated agents' level of confrontation and empathy (i.e., cognitive reactions). As hypothesized, threats were significantly lower when change agents used MI. Perceived confrontations converged with observable social behavior of change agents in both groups. Moreover, behavioral threats showed a negative association with change recipients' expressed motivation (i.e., reasons to change). Contrary to our expectations, we found no relation between change agents' verbal threats and change recipients' verbally expressed self-defenses (i.e., sustain talk). Our results imply that MI reduces the adverse impact of threats in conversations about environmental behavior change on both the social and cognitive level. We discuss theoretical implications of our study in the context of SAT and SDT and suggest practical implications for environmental change agents in organizations.

Learning motivational interviewing in a real-life setting: a randomised controlled trial in the Swedish Prison Service.

PubMed

Forsberg, Lars; Ernst, Denise; Farbring, Carl Åke

2011-07-01

Motivational interviewing (MI) is a client-centred, directive counselling style for helping people to explore and resolve ambivalence about behaviour change and shown to decrease drug and alcohol use. A five-session semi-structured MI intervention [Beteende, Samtal, Förändring (BSF; Behaviour, Counselling, Change)] was implemented in Swedish prisons. To examine whether, in a real-life implementation of semi-structured MI, staff receiving ongoing MI training, based on audio-recorded feedback in peer groups (BSF+), possess greater MI skill compared with staff receiving workshop-only MI training (BSF), and staff conducting usual prison planning interviews (UPI). Prisoners were randomised to one of the three interventions. The fi rst sessions between staff and prisoner with complete data were assessed with the Motivational Interviewing Treatment Integrity Code 3.0. Content analysis of 45 staff: prisoner sessions revealed that counsellors in the BSF+ group were significantly more competent in MI than those in the UPI group, but there was no difference in MI competency between the BSF and UPI groups. Overall, staff were rated as not having achieved beginning proficiency. Our findings suggest that staff delivering motivational interviewing programmes for substance-misusing prisoners in Sweden are not being given sufficient training for the task. Previous literature has suggested that staff need more than a basic 3- to 5-day workshop training, but our findings suggest that they may need longer-term continuing supervision and support than previously recognised.

Effectiveness of Motivational Interviewing Interventions for Adolescent Substance Use Behavior Change: A Meta-Analytic Review

ERIC Educational Resources Information Center

Jensen, Chad D.; Cushing, Christopher C.; Aylward, Brandon S.; Craig, James T.; Sorell, Danielle M.; Steele, Ric G.

2011-01-01

Objective: This study was designed to quantitatively evaluate the effectiveness of motivational interviewing (MI) interventions for adolescent substance use behavior change. Method: Literature searches of electronic databases were undertaken in addition to manual reference searches of identified review articles. Databases searched include…

Motivational interviewing and the decisional balance procedure for cessation induction in smokers not intending to quit.

PubMed

Krigel, Susan W; Grobe, James E; Goggin, Kathy; Harris, Kari Jo; Moreno, Jose L; Catley, Delwyn

2017-01-01

The decisional balance (DB) procedure examines the pros and cons of behavior change and was considered a component in early formulations of Motivational Interviewing (MI). However, there is controversy and conflicting findings regarding the use of a DB exercise within the treatment of addictions and a need to clarify the role of DB as a component of MI. College tobacco smokers (N=82) with no intentions on quitting were randomly assigned to receive a single counseling session of either Motivational Interviewing using only the decisional balance component (MIDB), or health education around smoking cessation (HE). Assessments were obtained at baseline, immediately post-treatment, 1week, and 4weeks. Compared to HE, the MIDB sessions scored significantly higher on the Motivational Interviewing Treatment Integrity (MITI) scale (all standardized differences d>1, p<0.001). Unexpectedly, self-report Pros of smoking scores increased for MIDB but decreased for HE (MIDB vs HE standardized difference d=0.5; 95%CI 0.1 to 1.0, p=0.021). Both groups showed significant reductions in smoking rates and increases in motivation to quit, quit attempts, and self-reported abstinence, with no significant group differences. Changes in the Pros of smoking were correlated with MITI scores, but not with cessation outcomes. In contrast, increases in the Cons of smoking and therapeutic alliance were predictive of better cessation outcomes. The decisional balance exercise as formulated by earlier versions of MI may be counter-productive and cautions around its use are warranted. Instead, improved cessation outcomes appear associated with increasing perceived benefits of quitting and positive therapeutic alliance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integrating Motivational Interviewing and Self-Determination Theory with Cognitive Behavioral Therapy to Prevent Suicide

ERIC Educational Resources Information Center

Britton, Peter C.; Patrick, Heather; Wenzel, Amy; Williams, Geoffrey C.

2011-01-01

Cognitive behavioral therapy (CBT) has been found to be effective in preventing suicide-related behavior. However, it is often difficult to engage patients who are at-risk in treatment. Motivational Interviewing (MI) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments. As a…

Changes in Physical Activity and Psychological Variables Following a Web-Based Motivational Interviewing Intervention: Pilot Study.

PubMed

Karnes, Sasha L; Meyer, Barbara B; Berger, Lisa M; Brondino, Michael J

2015-10-29

Web-based interventions for enhancing physical activity participation are in demand for application in health care settings. Recent research suggests Web-based interventions that are based on motivational interviewing are effective to increase physical activity. It is unclear whether motivational interviewing can influence targeted psychological variables such as perceived readiness, willingness, and ability to participate in physical activity. The aims of this study were to determine whether there were changes in physical activity and psychological variables associated with readiness, willingness, and perceived ability to participate in physical activity following completion of a novel Web-based intervention. The goal of the motivational interviewing-based intervention was to increase physical activity. Twenty-three underactive or inactive urban dwelling adults were recruited at a medical office for participation in a 4-session Web-based intervention lasting approximately 15 minutes per week. Sessions were based on principles of motivational interviewing. Assessment of physical activity was conducted using pedometers immediately prior to intervention participation (pre) and immediately post intervention (post1). Self-report assessments of physical activity and psychological variables were conducted using online surveys at pre, post1, and again at one month following intervention participation (post2). Comparisons of pre and post1 pedometer recordings revealed significant increases in steps per day (t22=2.09, P=.049). There were also significant changes in total physical activity energy expenditure per week (χ(2) 2=8.4, P=.02) and in moderate intensity physical activity energy expenditure per week (χ(2) 2=13.9, P<.001) over time following participation in the Web-based intervention. Significant changes in psychological variables following participation in the Web-based intervention included: (1) change in stage classification over time (χ(2) 2=21.5, P<.001

Contingent Vouchers and Motivational Interviewing for Cigarette Smokers in Residential Substance Abuse Treatment

PubMed Central

Rohsenow, Damaris J.; Tidey, Jennifer W.; Martin, Rosemarie A.; Colby, Suzanne M.; Sirota, Alan D.; Swift, Robert M.; Monti, Peter M.

2015-01-01

Residential drug treatment provides an opportunity to intervene with smokers substance use disorders (SUD). A randomized controlled clinical trial compared: (1) Contingent Vouchers (CV) for smoking abstinence to Noncontingent Vouchers (NCV), crossed with (2) Motivational Interviewing (MI) or Brief Advice (BA), for 184 smokers in SUD treatment. During the voucher period, 36% of carbon monoxide readings indicated smoking abstinence for those receiving CV versus 13% with NCV (p < .001). Post-treatment point-prevalence abstinence rates were low (3–4% at each follow up), with more abstinence when CV was combined with MI (6.6% on average) than with BA (0% on average). No differential effects on drug use or motivation to quit smoking occurred. Thus, CV had limited effects on long-term smoking abstinence in this population but effects were improved when CV was combined with MI. More effective methods are needed to increase motivation to quit smoking and quit rates in this high-risk population. PMID:25805668

Using Motivational Interviewing to Impact Readiness of RNs to Return to the Classroom.

PubMed

Phifer, Lynne; Robeano, Karen; Ivey, Angela; Blood-Siegfried, Jane

2018-06-01

Supporting nurses with associate degrees in nursing (ADNs) to return to school is challenging for nurse executives. Strategies include tuition reimbursement, scholarships, and flexible scheduling. Despite these measures, it is anticipated that we will fall short of a goal of 80% bachelor's degree-prepared nurses by 2020. The aim of this project was to increase ADN-prepared RN readiness to return to school through motivational interviewing.

Scaling up the evaluation of psychotherapy: evaluating motivational interviewing fidelity via statistical text classification

PubMed Central

2014-01-01

Background Behavioral interventions such as psychotherapy are leading, evidence-based practices for a variety of problems (e.g., substance abuse), but the evaluation of provider fidelity to behavioral interventions is limited by the need for human judgment. The current study evaluated the accuracy of statistical text classification in replicating human-based judgments of provider fidelity in one specific psychotherapy—motivational interviewing (MI). Method Participants (n = 148) came from five previously conducted randomized trials and were either primary care patients at a safety-net hospital or university students. To be eligible for the original studies, participants met criteria for either problematic drug or alcohol use. All participants received a type of brief motivational interview, an evidence-based intervention for alcohol and substance use disorders. The Motivational Interviewing Skills Code is a standard measure of MI provider fidelity based on human ratings that was used to evaluate all therapy sessions. A text classification approach called a labeled topic model was used to learn associations between human-based fidelity ratings and MI session transcripts. It was then used to generate codes for new sessions. The primary comparison was the accuracy of model-based codes with human-based codes. Results Receiver operating characteristic (ROC) analyses of model-based codes showed reasonably strong sensitivity and specificity with those from human raters (range of area under ROC curve (AUC) scores: 0.62 – 0.81; average AUC: 0.72). Agreement with human raters was evaluated based on talk turns as well as code tallies for an entire session. Generated codes had higher reliability with human codes for session tallies and also varied strongly by individual code. Conclusion To scale up the evaluation of behavioral interventions, technological solutions will be required. The current study demonstrated preliminary, encouraging findings regarding the utility

Learning to Change: The Rationale for The Use of Motivational Interviewing in Higher Education

ERIC Educational Resources Information Center

Wells, Harvey; Jones, Anna

2018-01-01

Motivational interviewing is a technique developed for use in clinical contexts in order to help people change unhealthy behaviours. However, because it is centred on change, is non-judgemental and collaborative, it is ideal to be adapted for use in teaching. This paper considers the theoretical basis for its use in higher education settings by…

Dosage Effects of Motivational Interviewing on Middle-School Students' Academic Performance: Randomized Evaluation of One versus Two Sessions

ERIC Educational Resources Information Center

Terry, John; Strait, Gill; McQuillin, Sam; Smith, Bradley H.

2014-01-01

Motivational interviewing (MI) is a brief client-centred intervention that increases intrinsic motivation for change. Little research has been conducted on MI to promote academic behaviours, but two studies found that one session of MI did improve middle-school students' math grades [Strait, G., Smith, B., McQuillin, S., Terry, J., Swan, S., &…

Effects of the stages of change model-based education and motivational interview on exercise behavior in diabetic women.

PubMed

Sekerci, Yasemin Gümüs; Kitis, Yeter

2018-05-08

In this study, we examined the effects of exercise education and a motivational interview program, based on the stages of change model (SCM), on stage of change, using cognitive and behavioral methods, perceived benefits and barriers and self-confidence in Turkish women with diabetes. This intervention study was carried out in 2015 on 55 women selected from a family health centers' population. An exercise guide was prepared based on the SCM for the intervention group. The intervention group was followed seven times at 1-month intervals via home visits, and exercise education and the motivational interview program were conducted to identify changes in behavior. The control group received no intervention. Data were collected from both groups using a personal description form, Exercise Stages of Change Scale, Exercise Processes of Change Scale, Exercise Decisional Balance Scale, and Exercise Self-Efficacy Scale. After the exercise program, each group was re-subjected to the same scales. We used a chi-square test and independent and paired sample t-tests to analyze the data. The stages of change, using cognitive and behavioral methods, perceived benefits and self-confidence for exercise in the intervention group significantly improved compared with that in the control group (p < .05). In the intervention group, 81.5% of the participants started exercising. The exercise education and motivational interview program based on SCM positively affected stages of change, using cognitive and behavioral methods, perceived benefits, perceived barriers, and self-confidence for exercise behavior in women with diabetes. We conclude that the education and motivational interview program based on SCM are effective in promoting exercise habit.

The Evidence for Student-Focused Motivational Interviewing in Educational Settings: A Review of the Literature

ERIC Educational Resources Information Center

Snape, Laura; Atkinson, Cathy

2016-01-01

The current systematic literature review sought to determine the effectiveness of Motivational Interviewing (MI) in educational settings. Student-focused school-based MI (SBMI) studies were assessed using qualitative and quantitative assessment frameworks and data were reported using PRISMA guidelines. Eleven studies met the inclusion criteria,…

A systematic review of motivational interviewing in healthcare: the potential of motivational interviewing to address the lifestyle factors relevant to multimorbidity

PubMed Central

McKenzie, Kylie J.; Pierce, David; Gunn, Jane M.

2015-01-01

Internationally, health systems face an increasing demand for services from people living with multimorbidity. Multimorbidity is often associated with high levels of treatment burden. Targeting lifestyle factors that impact across multiple conditions may promote quality of life and better health outcomes for people with multimorbidity. Motivational interviewing (MI) has been studied as one approach to supporting lifestyle behaviour change. A systematic review was conducted to assess the effectiveness of MI in healthcare settings and to consider its relevance for multimorbidity. Twelve meta-analyses pertinent to multimorbidity lifestyle factors were identified. As an intervention, MI has been found to have a small-to-medium statistically significant effect across a wide variety of single diseases and for a range of behavioural outcomes. This review highlights the need for specific research into the application of MI to determine if the benefits of MI seen with single diseases are also present in the context of multimorbidity. PMID:29090164

Reducing the risk of HIV transmission among men who have sex with men: A feasibility study of the motivational interviewing counseling method.

PubMed

Chen, Jia; Li, Xianhong; Xiong, Yang; Fennie, Kristopher P; Wang, Honghong; Williams, Ann Bartley

2016-09-01

HIV prevalence among Chinese men who have sex with men has rapidly increased in recent years. In this randomized, controlled study, we tested the feasibility and efficacy of motivational interviewing to reduce high-risk sexual behaviors among this population in Changsha, China. Eighty men who have sex with men were randomly assigned to either the intervention group, in which participants received a three-session motivational interviewing intervention over 4 weeks, or the control group, in which participants received usual counseling from peer educators. High-risk behavior indicators and HIV knowledge level were evaluated at baseline and 3 months after the intervention. Motivational interviewing significantly improved consistent anal condom use. However, there was no significant change in consistent condom use for oral sex or in the number of sexual partners over time. HIV knowledge scores improved equally in both groups. This study demonstrated that an intervention using motivational interviewing is feasible and results in increased condom use during anal sex for Chinese men who have sex with men. However, further work must be done to increase the use of condoms during oral sexual encounters. © 2016 John Wiley & Sons Australia, Ltd.

Motivational interviewing: a tool for increasing psychotropic medication adherence for youth.

PubMed

Hamrin, Vanya; McGuinness, Teena M

2013-06-01

There are serious outcomes to nonadherence to psychotropic medications in children and adolescents, including poor school performance, prolonged duration of illness, increased psychopathology, poor interpersonal relationships, increased psychiatric episodes, and suicide attempts. Medication treatment has demonstrated improved psychiatric functioning and a 50% reduction in suicidal behavior. more than 50% of youth with mental health problems are nonadherent with psychiatric medications. A review of literature examining motivational interviewing (MI) for the problem of treatment adherence in children and adolescents is discussed. MI has great potential to improve psychiatric medication adherence in adolescents. An example of how to implement MI with youth is provided.

Evidence, Fidelity, and Organisational Rationales: Multiple Uses of Motivational Interviewing in a Social Services Agency

ERIC Educational Resources Information Center

Björk, Alexander

2016-01-01

In discussions and empirical investigations of the implementation of evidence-based interventions there is often a narrow focus on treatment fidelity. Studying a social services agency trying to incorporate Motivational Interviewing (MI), commonly regarded as evidence-based, this paper problematises a one-sided attention to treatment fidelity by…

Cost-effectiveness analysis of motivational interviewing with feedback to reduce drinking among a sample of college students.

PubMed

Cowell, Alexander J; Brown, Janice M; Mills, Michael J; Bender, Randall H; Wedehase, Brendan J

2012-03-01

This study evaluated the costs and cost-effectiveness of combining motivational interviewing with feedback to address heavy drinking among university freshmen. Microcosting methods were used in a prospective cost and cost-effectiveness study of a randomized trial of assessment only (AO), motivational interviewing (MI), feedback only (FB), and motivational interviewing with feedback (MIFB) at a large public university in the southeastern United States. Students were recruited and screened into the study during freshman classes based on recent heavy drinking. A total of 727 students (60% female) were randomized, and 656 had sufficient data at 3-months' follow-up to be included in the cost-effectiveness analysis. Effectiveness outcomes were changes in average drinks per drinking occasion and number of heavy drinking occasions. Mean intervention costs per student were $16.51 for MI, $17.33 for FB, and $36.03 for MIFB. Cost-effectiveness analysis showed two cost-effective interventions for both outcomes: AO ($0 per student) and MIFB ($36 per student). This is the first prospective cost-effectiveness study to our knowledge to examine MI for heavy drinking among students in a university setting. Despite being the most expensive intervention, MIFB was the most effective intervention and may be a cost-effective intervention, depending on a university's willingness to pay for changes in the considered outcomes.

Cost-Effectiveness Analysis of Motivational Interviewing With Feedback to Reduce Drinking Among a Sample of College Students

PubMed Central

Cowell, Alexander J.; Brown, Janice M.; Mills, Michael J.; Bender, Randall H.; Wedehase, Brendan J.

2012-01-01

Objective: This study evaluated the costs and cost-effectiveness of combining motivational interviewing with feedback to address heavy drinking among university freshmen. Method: Microcosting methods were used in a prospective cost and cost-effectiveness study of a randomized trial of assessment only (AO), motivational interviewing (MI), feedback only (FB), and motivational interviewing with feedback (MIFB) at a large public university in the southeastern United States. Students were recruited and screened into the study during freshman classes based on recent heavy drinking. A total of 727 students (60% female) were randomized, and 656 had sufficient data at 3-months’ follow-up to be included in the cost-effectiveness analysis. Effectiveness outcomes were changes in average drinks per drinking occasion and number of heavy drinking occasions. Results: Mean intervention costs per student were $16.51 for MI, $17.33 for FB, and $36.03 for MIFB. Cost-effectiveness analysis showed two cost-effective interventions for both outcomes: AO ($0 per student) and MIFB ($36 per student). Conclusions: This is the first prospective cost-effectiveness study to our knowledge to examine MI for heavy drinking among students in a university setting. Despite being the most expensive intervention, MIFB was the most effective intervention and may be a cost-effective intervention, depending on a university’s willingness to pay for changes in the considered outcomes. PMID:22333330

Patient-Provider Concordance with Behavioral Change Goals Drives Measures of Motivational Interviewing Consistency

PubMed Central

Laws, M. Barton; Rose, Gary S.; Beach, Mary Catherine; Lee, Yoojin; Rogers, William S.; Velasco, Alyssa Bianca; Wilson, Ira B.

2015-01-01

Objective Motivational Interviewing (MI) consistent talk by a counselor is thought to produce “change talk” in clients. However, it is possible that client resistance to behavior change can produce MI inconsistent counselor behavior. Methods We applied a coding scheme which identifies all of the behavioral counseling about a given issue during a visit (“episodes”), assesses patient concordance with the behavioral goal, and labels providers’ counseling style as facilitative or directive, to a corpus of routine outpatient visits by people with HIV. Using a different data set of comparable encounters, we applied the concepts of episode and concordance, and coded using the Motivational Interviewing Treatment Integrity system. Results Patient concordance/discordance was not observed to change during any episode. Provider directiveness was strongly associated with patient discordance in the first study, and MI inconsistency was strongly associated with discordance in the second. Conclusion Observations that MI-consistent behavior by medical providers is associated with patient change talk or outcomes should be evaluated cautiously, as patient resistance may provoke MI-inconsistency. Practice Implications Counseling episodes in routine medical visits are typically too brief for client talk to evolve toward change. Providers with limited training may have particular difficulty maintaining MI consistency with resistant clients. PMID:25791372

Patient-provider concordance with behavioral change goals drives measures of motivational interviewing consistency.

PubMed

Laws, Michael Barton; Rose, Gary S; Beach, Mary Catherine; Lee, Yoojin; Rogers, William S; Velasco, Alyssa Bianca; Wilson, Ira B

2015-06-01

Motivational Interviewing (MI) consistent talk by a counselor is thought to produce "change talk" in clients. However, it is possible that client resistance to behavior change can produce MI inconsistent counselor behavior. We applied a coding scheme which identifies all of the behavioral counseling about a given issue during a visit ("episodes"), assesses patient concordance with the behavioral goal, and labels providers' counseling style as facilitative or directive, to a corpus of routine outpatient visits by people with HIV. Using a different data set of comparable encounters, we applied the concepts of episode and concordance, and coded using the Motivational Interviewing Treatment Integrity system. Patient concordance/discordance was not observed to change during any episode. Provider directiveness was strongly associated with patient discordance in the first study, and MI inconsistency was strongly associated with discordance in the second. Observations that MI-consistent behavior by medical providers is associated with patient change talk or outcomes should be evaluated cautiously, as patient resistance may provoke MI-inconsistency. Counseling episodes in routine medical visits are typically too brief for client talk to evolve toward change. Providers with limited training may have particular difficulty maintaining MI consistency with resistant clients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effect of motivational interviewing on rates of early childhood caries: a randomized trial.

PubMed

Harrison, Rosamund; Benton, Tonya; Everson-Stewart, Siobhan; Weinstein, Phil

2007-01-01

The purposes of this randomized controlled trial were to: (1) test motivational interviewing (MI) to prevent early childhood caries; and (2) use Poisson regression for data analysis. A total of 240 South Asian children 6 to 18 months old were enrolled and randomly assigned to either the MI or control condition. Children had a dental exam, and their mothers completed pretested instruments at baseline and 1 and 2 years postintervention. Other covariates that might explain outcomes over and above treatment differences were modeled using Poisson regression. Hazard ratios were produced. Analyses included all participants whenever possible. Poisson regression supported a protective effect of MI (hazard ratio [HR]=0.54 (95%CI=035-0.84)-that is, the M/ group had about a 46% lower rate of dmfs at 2 years than did control children. Similar treatment effect estimates were obtained from models that included, as alternative outcomes, ds, dms, and dmfs, including "white spot lesions." Exploratory analyses revealed that rates of dmfs were higher in children whose mothers had: (1) prechewed their food; (2) been raised in a rural environment; and (3) a higher family income (P<.05). A motivational interviewing-style intervention shows promise to promote preventive behaviors in mothers of young children at high risk for caries.

Motivational Interviewing May Improve Exercise Experience for People with Multiple Sclerosis: A Small Randomized Trial

ERIC Educational Resources Information Center

Smith, Douglas C.; Lanesskog, Deirdre; Cleeland, Leah; Motl, Robert; Weikert, Madeline; Dlugonski, Deirdre

2012-01-01

People with multiple sclerosis (MS) are likely to benefit from regular exercise, but physical inactivity is more common among people with MS than among the general population. This small randomized study evaluated whether motivational interviewing (MI) affects adherence to and personal experience in an exercise program. Inactive people with MS…

A Cross-Cultural Three-Step Process Model for Assessing Motivational Interviewing Treatment Fidelity in Thailand

ERIC Educational Resources Information Center

Koken, Juline A.; Naar-King, Sylvie; Umasa, Sanya; Parsons, Jeffrey T.; Saengcharnchai, Pichai; Phanuphak, Praphan; Rongkavilit, Chokechai

2012-01-01

The provision of culturally relevant yet evidence-based interventions has become crucial to global HIV prevention and treatment efforts. In Thailand, where treatment for HIV has become widely available, medication adherence and risk behaviors remain an issue for Thai youth living with HIV. Previous research on motivational interviewing (MI) has…

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol.

PubMed

Pérula, Luis A; Bosch, Josep M; Bóveda, Julia; Campiñez, Manuel; Barragán, Nieves; Arboniés, Juan C; Prados, Jose A; Martín, Enrique; Martín, Remedios; Massons, Josep; Criado, Margarita; Ruiz, Roger; Fernández, José A; Buitrago, Francisco; Olaya, Inmaculada; Pérez, Modesto; Ruiz, Joaquin

2011-11-05

The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol

PubMed Central

2011-01-01

Background The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. Methods/Design An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. Discussion Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential

The Effectiveness and Cost of Clinical Supervision for Motivational Interviewing: A Randomized Controlled Trial

PubMed Central

Martino, Steve; Paris, Manuel; Añez, Luis; Nich, Charla; Canning-Ball, Monica; Hunkele, Karen; Olmstead, Todd A.; Carroll, Kathleen M.

2016-01-01

The effectiveness of a competency-based supervision approach called Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA: STEP) was compared to Supervision-As-Usual (SAU) for increasing clinicians’ motivational interviewing (MI) adherence and competence and client retention and primary substance abstinence in a multisite Hybrid Type 2 effectiveness-implementation randomized controlled trial. Participants were 66 clinicians and 450 clients within one of eleven outpatient substance abuse programs. An independent evaluation of audio recorded supervision sessions indicated that MIA: STEP and SAU were highly and comparably discriminable across sites. While clinicians in both supervision conditions improved their MI performance, clinician supervised with MIA: STEP, compared to those in SAU, showed significantly greater increases in the competency in which they used fundamental and advanced MI strategies when using MI across seven intakes through a 16-week follow-up. There were no retention or substance use differences among the clients seen by clinicians in MIA: STEP or SAU. MIA: STEP was substantially more expensive to deliver than SAU. Innovative alternatives to resource-intensive competency-based supervision approaches such as MIA: STEP are needed to promote the implementation of evidence-based practices. PMID:27431042

The Impact of motivational interviewing on illness perception in patients with stable coronary artery disease. A randomised controlled study

PubMed

Mülhauser, Sara; Bonhôte Börner, Martine; Saner, Hugo; Zumstein-Shaha, Maya

2018-04-01

Background: Coronary heart disease (CHD) constitutes one of the most frequent causes of death for individuals > 60 years. Lifestyle dependent risk factors are key. Hence, cardiac rehabilitation is essential for optimal CHD treatment. However, individuals rarely comprehend their illness. Motivational interviewing promotes illness perception. Aim/Methods: A randomised-controlled study was conducted to determine the effect of motivational interviewing on illness perception. Patients with stable coronary heart disease were consecutively recruited after elective percutaneous transluminal coronary angioplasty (PTCA). The intervention group received a short motivational interview (MI) about the disease and related risk factors as an intervention. The control group had usual treatment. Illness perception was assessed (Illness Perception Questionnaire-Revised) prior to the intervention and six months afterwards. Results: A total of 312 patients (intervention group: n = 148, control group: n = 164) were recruited into the study (mean age: 66.2 years). After the intervention, a significant change was observed in the domain of emotional reactions regarding the disease. Conclusion: To improve illness perception in patients with stable CHD, one short intervention with MI may have an effect. Whether intensifying the MI-intervention is more effective, requires further research.

Motivational Interviewing versus Brief Advice for Cigarette Smokers in Residential Alcohol Treatment

PubMed Central

Rohsenow, Damaris J.; Martin, Rosemarie A.; Monti, Peter M.; Colby, Suzanne M.; Day, Anne M.; Abrams, David B.; Sirota, Alan D.; Swift, Robert M.

2013-01-01

Residential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) Motivational Interviewing (MI) to Brief Advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1 month, 2% at 3, 6 and 12 months. However, patients with more drug use pretreatment (>22 days in 6 months) given BA had more abstinence at 12 months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation. PMID:24210533

Patient empowerment and motivational interviewing: engaging patients to self-manage their own care.

PubMed

McCarley, Patricia

2009-01-01

Patient empowerment is centered on the belief that patients should be in control of their own care and that behavioral changes and adherence to therapies cannot be achieved unless patients internalize the need for self-change. Data have consistently shown improved outcomes among patients on dialysis who are engaged, empowered and self-managing. Motivational interviewing provides a technique that can be applied by nephrology nurses to partner with patients and engage them in the management of their own care.

Motivation-based intervention to promote colonoscopy screening: An integration of a fear management model and motivational interviewing

PubMed Central

Pengchit, Watcharaporn; Walters, Scott T.; Simmons, Rebecca G.; Kohlmann, Wendy; Burt, Randall W.; Schwartz, Marc D.; Kinney, Anita Y.

2011-01-01

Colorectal cancer (CRC) screening rates have been low despite effectiveness of screening in reducing CRC mortality. This article outlines the theoretical background and development of an innovative, telephone-based risk communication designed to promote screening among individuals at increased risk for familial CRC. This ongoing intervention integrates the Extended Parallel Process Model of fear management and the motivational interviewing counselling style. Tailoring and implementation intentions are incorporated. The primary outcome is self-reported colonoscopy within nine months following intervention. If proven effective, the remote intervention could be broadly disseminated to individuals at increased familial CRC risk, especially those in geographically underserved areas. PMID:21464114

An Evaluation of Training for Lay Providers in the Use of Motivational Interviewing to Promote Academic Achievement among Urban Youth

ERIC Educational Resources Information Center

Simon, Patricia; Ward, Nadia L.

2014-01-01

This study examined training outcomes for lay service providers who participated in a motivational interviewing (MI) training program designed to help increase intrinsic motivation and academic achievement among urban, low-income minority youth. Seventeen lay academic advisors received 16 hours of workshop training in MI. Additionally, two 2-hour…

Reinventing the Reel: An Innovative Approach to Resident Skill-Building in Motivational Interviewing for Brief Intervention

ERIC Educational Resources Information Center

Cole, Bonnie; Clark, Denice Crowe; Seale, J. Paul; Shellenberger, Sylvia; Lyme, Alan; Johnson, J. Aaron; Chhabria, Aruna

2012-01-01

To enhance the skills of primary care residents in addressing substance misuse, residency screening, brief intervention, and referral to treatment (SBIRT) programs increasingly offer motivational interviewing (MI) training, but seldom include feedback and coaching. This innovative 2-round "Virginia Reel" approach, supplementing 3 hours of basic MI…

Development and Feasibility of a COPD Self-Management Intervention Delivered with Motivational Interviewing Strategies

PubMed Central

Benzo, Roberto; Vickers, Kristin; Ernst, Denise; Tucker, Sharon; McEvoy, Charlene; Lorig, Kate

2013-01-01

BACKGROUND Self-management (SM) is proposed as the standard of care in chronic obstructive pulmonary disease (COPD) but details of the process and training required to deliver effective SM are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This manuscript carefully describes a self-management intervention using Motivational Interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS The pilot study suggested improvements in quality of life, fidelity to theory and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS A self-management intervention, that includes motivational interviewing as the way if guiding patient into behavior change, is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the SM process for (the specifics of training and delivering the intervention) that facilitates replicability in other settings and could be translated to cardiac rehabilitation. PMID:23434613

Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors

PubMed Central

van Keulen, Hilde M; Mesters, Ilse; Brug, Johannes; Ausems, Marlein; Campbell, Marci; Resnicow, Ken; Zwietering, Paul J; van Breukelen, Gerard; van Mechelen, Willem; Severens, Johan L; de Vries, Hein

2008-01-01

Background A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45–70. This paper describes the design of the Vitalum study. Methods/Design Dutch general medical practices (N = 23) were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881) received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions will be examined by means of

Counselor competence for telephone Motivation Interviewing addressing lifestyle change among Dutch older adults.

PubMed

Mesters, Ilse; Keulen, Hilde M van; de Vries, Hein; Brug, Johannes

2017-12-01

Counselor competence in telephone Motivation Interviewing (MI) to change lifestyle behaviors in a primary care population was assessed using the Motivational Interviewing Treatment Integrity (MITI) rating system. Counselor behavior was evaluated by trained raters. Twenty minutes of a random sample of 336 MI sessions were coded representing 232 counselees. Ninety-four sessions (28%) were double coded to assess inter-rater agreement. The MI fidelity was examined by comparing the MI fidelity scores direction, empathy, spirit, % open questions, % complex reflections, reflections-to-questions ratio, % MI-adherent responses with the matching beginner proficiency MITI threshold. The inter-rater agreements for the MI fidelity summary scores were good (spirit, reflections-to-questions ratio), fair (empathy, % open questions, % MI-adherent responses) or poor (direction, % complex reflection). The MI fidelity scores for direction, empathy, spirit and the percentage of complex reflections exceeded the MITI threshold, but lower scores were found for the percentage of open questions, the reflections-to-questions ratio and the percentage of MI-adherent responses. In conclusion, evidence that MI was implemented was revealed. However, the inter-rater agreements scores and some fidelity scores leave room for improvement indicating that raters and counselors may need more ongoing training and feedback to achieve and maintain adequate competence. These findings apply to more complex skills (as rating complex reflections) in particular. Copyright © 2017 Elsevier Ltd. All rights reserved.

An integrated motivational interviewing and cognitive-behavioural intervention promoting physical activity maintenance for adults with chronic health conditions: A feasibility study.

PubMed

Scott, Sarah E; Breckon, Jeff D; Copeland, Robert J

2018-01-01

Objectives Physical activity is recommended for managing chronic health conditions but is rarely maintained. This feasibility study aimed to evaluate the preliminary efficacy of a motivational interviewing and cognitive-behavioural intervention for long-term physical activity for adults with chronic health conditions. Methods Participants ( N = 37) with stable conditions (e.g. diabetes) were randomized into a three-month motivational interviewing and cognitive-behavioural group ( N = 20) or usual care ( N = 17) after completing a physical activity referral scheme. Participants completed physical activity (e.g. average steps per day and kilocalorie expenditure), psychological (e.g. self-efficacy) and epidemiological (e.g. body mass index) standardized measures at baseline, three- and six-month follow-up. Treatment fidelity and feasibility were assessed. Results Thirty-five participants completed the study (96% retention). The motivational interviewing and cognitive-behavioural group maintained kilocalorie expenditure at three ( p = 0.009) and six months ( p = 0.009). Exercise barrier self-efficacy ( p = 0.03), physical ( p = 0.02) and psychological ( p = 0.01) physical activity experiences were increased at three months only. No difference was found for average steps/day, social support, coping skills and epidemiological factors. Discussion This is the first study to demonstrate the feasibility and preliminary efficacy of motivational interviewing and cognitive-behavioural interventions for promoting physical activity maintenance in a clinical population. A large-scale trial with a longer follow-up (≥6 months) is warranted with treatment fidelity assessment.

Using Motivational Interviewing with School-Age Bullies: A New Use for a Proven, Evidence-Based Intervention

ERIC Educational Resources Information Center

Juhnke, Brenna A.; Juhnke, Gerald A.; Curtis, Russell C.; Thompson, E. Heather; Coll, Kenneth M.; Yu, Fangzhou; Moyer, Michael S.; Mullett, Alison

2013-01-01

Motivational interviewing is a proven, evidence-based intervention. It has been successfully utilized as a potent intervention with students presenting a broad range of concerns from substance abuse to obesity. To date, however, no articles exist within the general counseling literature or the "Journal of School Counseling" specifically…

Applying Motivational Interviewing (MI) in Counselling Obese and Overweight Children and Parents in Swedish Child Healthcare

ERIC Educational Resources Information Center

Soderlund, Lena L.; Malmsten, Janna; Bendtsen, Preben; Nilsen, Per

2010-01-01

Objective: To evaluate how a motivational interviewing (MI) training course for child healthcare nurses in Sweden affected their work with children's weight issues and their attitudes to MI. Design: Cross-sectional survey, descriptive design. Setting: Nurses were recruited from 33 different child healthcare centres in Ostergotland, Sweden. Method:…

Psychometric properties of the Motivational Interviewing Treatment Integrity coding system 4.2 with jail inmates.

PubMed

Owens, Mandy D; Rowell, Lauren N; Moyers, Theresa

2017-10-01

Motivational Interviewing (MI) is an evidence-based approach shown to be helpful for a variety of behaviors across many populations. Treatment fidelity is an important tool for understanding how and with whom MI may be most helpful. The Motivational Interviewing Treatment Integrity coding system was recently updated to incorporate new developments in the research and theory of MI, including the relational and technical hypotheses of MI (MITI 4.2). To date, no studies have examined the MITI 4.2 with forensic populations. In this project, twenty-two brief MI interventions with jail inmates were evaluated to test the reliability of the MITI 4.2. Validity of the instrument was explored using regression models to examine the associations between global scores (Empathy, Partnership, Cultivating Change Talk and Softening Sustain Talk) and outcomes. Reliability of this coding system with these data was strong. We found that therapists had lower ratings of Empathy with participants who had more extensive criminal histories. Both Relational and Technical global scores were associated with criminal histories as well as post-intervention ratings of motivation to decrease drug use. Findings indicate that the MITI 4.2 was reliable for coding sessions with jail inmates. Additionally, results provided information related to the relational and technical hypotheses of MI. Future studies can use the MITI 4.2 to better understand the mechanisms behind how MI works with this high-risk group. Published by Elsevier Ltd.

Motivational interviewing: a valuable tool for the psychiatric advanced practice nurse.

PubMed

Karzenowski, Abby; Puskar, Kathy

2011-01-01

Motivational Interviewing (MI) is well known and respected by many health care professionals. Developed by Miller and Rollnick (2002) , it is a way to promote behavior change from within and resolve ambivalence. MI is individualized and is most commonly used in the psychiatric setting; it is a valuable tool for the Psychiatric Advanced Nurse Practice Nurse. There are many resources that talk about what MI is and the principles used to apply it. However, there is little information about how to incorporate MI into a clinical case. This article provides a summary of articles related to MI and discusses two case studies using MI and why advanced practice nurses should use MI with their patients.

Motivational Interviewing at the Intersections of Depression and Intimate Partner Violence among African American Women

PubMed Central

Wahab, Stéphanie; Trimble, Jammie; Mejia, Angie; Mitchell, S. Renee; Thomas, Mary Jo; Timmons, Vanessa; Waters, A. Star; Raymaker, Dora; Nicolaidis, Christina

2014-01-01

This article focuses on design, training, and delivery of a culturally-tailored, multi-faceted intervention which used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a CBPR approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program. PMID:24857557

Typologies of Altruistic and Financial Motivations for Research Participation.

PubMed

Chin, Lisa J; Berenson, Jacqueline A; Klitzman, Robert L

2016-10-01

Questions arise concerning participants' motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and nonaltruistic motives. Altruistic motivations emerged primarily, with nine typologies: (a) cultural, (b) community related, (c) familial, (d) religious, (e) professional, (f) political (e.g., HIV activism), (g) moral (e.g., making up for past wrongs), (h) existential (e.g., providing sense of meaning), and (i) other psychological (e.g., emotional gratification). Views of compensation varied: not a factor (55%), added incentive (25%), main motivator, but in conjunction with altruism (15%), and primary motivator (5%). HVT participants thus often have both altruistic and financial motives, and related typologies emerged. These findings have critical implications for studies on HIV, other conditions, and research ethics.

An Interview with Allan Wigfield: A Giant on Research on Expectancy Value, Motivation, and Reading Achievement

ERIC Educational Resources Information Center

Bembenutty, Hefer

2012-01-01

This article presents an interview with Allan Wigfield, professor and chair of the Department of Human Development and distinguished scholar-teacher at the University of Maryland. He has authored more than 100 peer-reviewed journal articles and book chapters on children's motivation and other topics. He is a fellow of Division 15 (Educational…

The Impact of Motivational Interviewing on Client Experiences of Cognitive Behavioral Therapy for Generalized Anxiety Disorder

ERIC Educational Resources Information Center

Kertes, Angela; Westra, Henny A.; Angus, Lynne; Marcus, Madalyn

2011-01-01

Motivational Interviewing (MI) has recently been applied to the treatment of anxiety disorders in an effort to bolster engagement with and response rates to cognitive behavioral therapy (CBT). In a recent randomized control trial, the addition of MI as a pretreatment compared to no pretreatment was found to significantly improve response to CBT…

An Explorative Study on the Efficacy and Feasibility of the Use of Motivational Interviewing to Improve Footwear Adherence in Persons with Diabetes at High Risk for Foot Ulceration.

PubMed

Keukenkamp, Renske; Merkx, Maarten J; Busch-Westbroek, Tessa E; Bus, Sicco A

2018-03-01

In this explorative study, we assessed the effect and feasibility of using motivational interviewing to improve footwear adherence in persons with diabetes who are at high risk for foot ulceration and show low adherence to wearing prescribed custom-made footwear. Thirteen individuals with diabetes, ulcer history, and low footwear adherence (ie, <80% of steps taken in prescription footwear) were randomly assigned to standard education (ie, verbal and written instructions) or to standard education plus two 45-min sessions of motivational interviewing. Adherence was objectively measured over 7 days using ankle- and shoe-worn sensors and was calculated as the percentage of total steps that prescribed footwear was worn. Adherence was assessed at home and away from home at baseline and 1 week and 3 months after the intervention. Feasibility was assessed for interviewer proficiency to apply motivational interviewing and for protocol executability. Median (range) baseline, 1-week, and 3-month adherence at home was 49% (6%-63%), 84% (5%-98%), and 40% (4%-80%), respectively, in the motivational interviewing group and 35% (13%-64%), 33% (15%-55%), and 31% (3%-66%), respectively, in the standard education group. Baseline, 1-week, and 3-month adherence away from home was 91% (79%-100%), 97% (62%-99%) and 92% (86%-98%), respectively, in the motivational interviewing group and 78% (32%-97%), 91% (28%-98%), and 93% (57%-100%), respectively, in the standard education group. None of the differences were statistically significant. Interviewer proficiency was good, and the protocol could be successfully executed in the given time frame. Footwear adherence at home increases 1 week after motivational interviewing to clinically relevant but not statistically significant levels (ie, 80%) but then returns over time to baseline levels. Away from home, adherence is already sufficient at baseline and remains so over time. The use of motivational interviewing seems feasible for the given

Adaptation of a Motivational Interviewing Intervention to Improve Antidepressant Adherence among Latinos

PubMed Central

Interian, Alejandro; Martinez, Igda; Rios, Lisbeth Iglesias; Krejci, Jonathan; Guarnaccia, Peter J.

2009-01-01

Poor antidepressant adherence is a significant issue in depression treatment that adversely affects treatment outcomes. While being a common problem, it tends to be more common among Latinos. To address this problem, the current study adapted a Motivational Interviewing (MI) intervention to improve adherence among Latinos with depression. The adaptation process included six focus groups that elicited participants’ perspectives (N = 30), applying the intervention with test cases (N = 7) to fine tune the intervention, and eliciting feedback on the intervention (N = 5). The findings generated from these adaptation phases are described, along with a case example. Examples of adaptations to the MI included reframing antidepressant adherence as a way to luchar (struggle) against problems, focusing on motivation for improving depression and not just medication, refining methods for imparting antidepressant information, and inclusion of personalized visual feedback on dose-taking. The findings provide a description of the antidepressant issues experienced by a group of Latinos, as well as considerations for applying MI with this population. The intervention remained grounded in MI principles, but was contextualized for this Latino group. PMID:20438160

Motivational interviewing as a pedagogical approach in behavioral science education: "walking the talk".

PubMed

Triana, A Catalina; Olson, Michael

2013-01-01

Motivational Interviewing (MI) is an evidence-based approach to facilitating behavior change. This approach has been applied in multiple settings (e.g., healthcare, drug and alcohol treatment, psychotherapy, health and wellness coaching, etc.). This article applies MI in a pedagogical context with medical residents as a semi-directive, learner-centered teaching style for eliciting clinical behavior change. Herein we present the foundational theories that inform this approach, describe the process of teaching, address barriers and challenges, and conclude with a review of performance to date including residents' narrative accounts of their experience with the curriculum.

Combining Motivational Interviewing with Cognitive-Behavioral Treatments for Substance Abuse: Lessons from the COMBINE Research Project

ERIC Educational Resources Information Center

Moyers, Theresa B.; Houck, Jon

2011-01-01

Motivational Interviewing began as a treatment for substance misuse and has strong empirical support as an intervention for these disorders. It is very common for MI to be combined with other types of treatment when it is used for substance abuse, and this article focuses on one example of this: the COMBINE Research Project. We examine the…

Important medical decisions: Using brief motivational interviewing to enhance patients' autonomous decision-making.

PubMed

Pantalon, Michael V; Sledge, William H; Bauer, Stephen F; Brodsky, Beth; Giannandrea, Stephanie; Kay, Jerald; Lazar, Susan G; Mellman, Lisa A; Offenkrantz, William C; Oldham, John; Plakun, Eric M; Rockland, Lawrence H

2013-03-01

The use of motivational interviewing (MI) when the goals of patient and physician are not aligned is examined. A clinical example is presented of a patient who, partly due to anxiety and fear, wants to opt out of further evaluation of his hematuria while the physician believes that the patient must follow up on the finding of hematuria. As patients struggle in making decisions about their medical care, physician interactions can become strained and medical care may become compromised. Physicians sometimes rely on their authority within the doctor-patient relationship to assist patients in making decisions. These methods may be ineffective when there is a conflict in motivations or goals, such as with patient ambivalence and resistance. Furthermore, the values of patient autonomy may conflict with the values of beneficence. A patient simulation exercise is used to demonstrate the value of MI in addressing the motivations of a medical patient when autonomy is difficult to realize because of a high level of resistance to change due to fear. The salience of MI in supporting the value of patient autonomy without giving up the value of beneficence is discussed by providing a method of evaluating the patient's best interests by psychotherapeutically addressing his anxious, fear-based ambivalence.

Motivating first-time, group O blood donors to return: Rationale and design of a randomized controlled trial of a post-donation telephone interview

PubMed Central

France, Janis L.; France, Christopher R.; Carlson, Bruce W.; Kessler, Debra A.; Rebosa, Mark; Shaz, Beth H.; Madden, Katrala; Carey, Patricia M.

2015-01-01

First-time blood donors are essential to the US donor pool, providing nearly a third of all donations. Unfortunately, there are a wide variety of obstacles to repeat donation and new donors are extremely difficult to retain. Because each donor experiences a unique set of deterrents, we developed a post-donation interview based on motivational interview principles in order to flexibly address individual barriers. The primary aim of this randomized clinical trial is to examine retention of first-time, group O blood donors who are randomly assigned to receive either a telephone-delivered interview with motivational and action planning components or a standard-of-care control call approximately six weeks after their donation. Measures of donation attitude, perceived behavioral control, intention, and motivational autonomy will be measured before and after the telephone contact using online surveys, and donation attempts will be tracked for one year using blood center donor databases. We hypothesize that, compared to controls, donors who receive the telephone interview will be more likely to make a donation attempt over the following year. In addition, we will examine possible mechanisms of action of the interview using key predictors of donation behavior as described by Self Determination Theory (i.e., motivational autonomy) and the Theory of Planned Behavior (i.e., attitude, perceived behavioral control, and intention). Results of this intervention may help to support a novel strategy to enhance retention of selected blood donors in an effort to better meet the nation’s blood supply needs. PMID:26247570

Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005.

PubMed

Thompson, Frances E; McNeel, Timothy S; Dowling, Emily C; Midthune, Douglas; Morrissette, Meredith; Zeruto, Christopher A

2009-08-01

The consumption of added sugars (eg, white sugar, brown sugar, and high-fructose corn syrup) displaces nutrient-dense foods in the diet. The intake of added sugars in the United States is excessive. Little is known about the predictors of added sugar intake. To examine the independent relationships of socioeconomic status and race/ethnicity with added sugar intake, and to evaluate the consistency of relationships using a short instrument to those from a different survey using more precise dietary assessment. Cross-sectional, nationally representative, interviewer-administered survey. Adults (aged > or = 18 years) participating in the 2005 US National Health Interview Survey Cancer Control Supplement responding to four added sugars questions (n=28,948). The intake of added sugars was estimated using validated scoring algorithms. Multivariate analysis incorporating sample weights and design effects was conducted. Least squares means and confidence intervals, and significance tests using Wald F statistics are presented. Analyses were stratified by sex and controlled for potential confounders. The intake of added sugars was higher among men than women and inversely related to age, educational status, and family income. Asian Americans had the lowest intake and Hispanics the next lowest intake. Among men, African Americans had the highest intake, although whites and American Indians/Alaskan Natives also had high intakes. Among women, African Americans and American Indians/Alaskan Natives had the highest intakes. Intake of added sugars was inversely related to educational attainment in whites, African Americans, Hispanic men, and American Indians/Alaskan Native men, but was unrelated in Asian Americans. These findings were generally consistent with relationships in National Health and Nutrition Examination Survey 2003-2004 (using one or two 24-hour dietary recalls). Race/ethnicity, family income, and educational status are independently associated with intake of added

A Focused Ethnography of Baccalaureate Nursing Students Who Are Using Motivational Interviewing.

PubMed

Howard, Lisa M; Williams, Beverly A

2016-09-01

The purpose of this article is to describe how nursing students learned and used motivational interviewing (MI) in a community-based clinical context at a primary care vascular risk reduction clinic focused on health promotion. A focused ethnography was used to access a sample of 20 undergraduate nursing students, 16 patients, and 2 instructors. Data were generated from participant observations, field notes, student journals, and interviews (one-on-one and focus group). Central to the students' experience was their transformation because of learning and using MI. Three sub themes describe the social processes that shaped the student experience: learning a relational skill, engaging patients, and collaborating as partners. It is feasible for nursing students to learn MI and use this approach to enhance collaborative care in a primary care setting. The experience can be transformative for students. Supporting patients to adopt healthy lifestyles is a significant role for nurses in practice. The findings provide key insights and strategies for nurse educators teaching students a collaborative communication approach, such as MI, to engage patients in health behavior change. © 2016 Sigma Theta Tau International.

Motivations, aims and communication around advance directives: a mixed-methods study into the perspective of their owners and the influence of a current illness.

PubMed

van Wijmen, Matthijs P S; Pasman, H Roeline W; Widdershoven, Guy A M; Onwuteaka-Philipsen, Bregje D

2014-06-01

What are motivations of owners of an advance directive (AD) to draft an AD, what do they aim for with their AD and do they communicate about their AD? Written questionnaires were sent to a cohort of people owning different types of ADs (n=5768). A purposive sample of people suffering from an illness was selected from the cohort for an in-depth interview (n=29). About half of our population had no direct motivation to draft their AD. Most mentioned motivation for the other half was an illness of a family member or friend. Many different and specific aims for drafting an AD were mentioned. An often mentioned more general aim in people with different ADs was to prevent unnecessary lengthening of life or treatment (14-16%). Most respondents communicated about having an AD with close-ones (63-88%) and with their GP (65-79%). In the interviews people gave vivid examples of experiences of what they hoped to prevent at the end of life. Some mentioned difficulties foreseeing the future and gave examples of response shift. ADs can give directions to caregivers about what people want at the end of life. ADs have to be discussed in detail by their owners and caregivers, since owners often have specific aims with their AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Specifications of motivational interviewing within a cognitive-behavioral therapy of chronic pain].

PubMed

Aguerre, C; Bridou, M; Laroche, F; Csillik, A; Jensen, M

2015-12-01

Cognitive and behavioral approach of chronic pain presents encouraging results by improving physical, functional and psychological states of chronic pain patients. This specific treatment is partially based on the acquisition of new adaptive strategies to help the patients to manage more effectively chronic pain and to improve subsequently their subjective well-being. This requires in parallel to give up noxious emotional, cognitive and behavioral attitudes towards pain. Now, we have to admit that numerous therapeutic failures are directly imputable to difficulties introducing and making the indispensable changes continue in pursuit of the fixed therapeutic objectives. Readiness to change could play a considerable role in the success or not of chronic pain treatment. The main objective of this article is to present the data of the current literature concerning the specificities of the process of change in the field of the chronic pain. We present a review of the literature describing at first, the psychological progress made by chronic pain patients longing to manage their suffering better via the trans-theoretical model of intentional change. Secondly, we develop the contributions of the technique of motivational interviewing in the improvement of chronic pain treatment. The identification of the motivational profile of chronic pain patients will determine how motivational interviewing can be conducted to improve their readiness for change. There are several strategies used with chronic pain patients in pre-contemplative and contemplative stages. Therapists may facilitate the problem recognition (help chronic pain patients to become aware of and identify the nature of the difficulties they face when trying to cope with their physical suffering); increase the personal concern (empowering chronic pain patients so that they feel fully involved in what they offer and invest in the therapy); develop the intention of change (ensure that the change becomes truly

Efficacy of Motivational Interviewing in Conjunction with Caries Risk Assessment (MICRA) Programmes in Improving the Dental Health Status of Preschool Children: A Randomised Controlled Trial.

PubMed

Saengtipbovorn, Saruta

To assess the efficacy of motivational interviewing in conjuction with a caries risk assessment (MICRA) programme to improve the dental health status of preschool children. A randomised controlled trial was conducted among 214 parents or caregivers and their children at Health Centre 54, Bangkok, Thailand, from September 2015 to February 2016. The participants were randomised to the intervention and the control groups (107 participants per group). At baseline, the intervention group received a caries risk assessment, individual counseling by using motivational interviewing, and oral hygiene instruction. The intervention group received reinforcement education and individual counseling by motivational interviewing every 3 months. The control group received a routine programme. Participants were assessed at baseline, 3 months, and 6 months for plaque index and caries. The data were analysed by using descriptive statistics, the chi-squared test, Fisher's exact test, t-test, repeated-measures ANOVA, and negative binomial distribution. After the 6-month follow-up, participants in the intervention group had a significantly lower plaque index, non-cavitated plus cavitated carious lesions, and cavitated carious lesions when compared to the control group. The intervention group had a lower caries incidence, non-cavitated plus cavitated carious lesions (1.81 times) and cavitated carious lesions (2.04 times) than the control group. The combination of motivational interviewing and caries risk assessment in one programme decreased early childhood caries in preschool children. It is not known whether the effects are due to the motivational interviewing, the caries risk assessment, or the combination of both.

Motivational interviewing increases physical activity and self-efficacy in people living in the community after hip fracture: a randomized controlled trial.

PubMed

O'Halloran, Paul D; Shields, Nora; Blackstock, Felicity; Wintle, Elizabeth; Taylor, Nicholas F

2016-11-01

To investigate if motivational interviewing improved physical activity, self-efficacy, quality of life, mobility and mental health in people living in the community after hip fracture. Single-blind randomized controlled trial. Community. A total of 30 adults after hip fracture who had been discharged from rehabilitation to independent living in the community and allocated to a control group ( n = 14) or an intervention group ( n = 16). All participants received usual care. The intervention group also received eight weekly sessions of motivational interviewing as additional input, with the control group having no additional matching input. The primary outcome was physical activity levels as measured by an accelerometer (steps taken per day, time spent walking per day, and time spent sitting or lying each day). Secondary outcomes included self-efficacy (confidence about walking and not falling), health-related quality of life, mobility and mental health. Relative to usual care, the motivational interviewing group took significantly more steps per day (mean = 1237 steps, 95% confidence interval (CI) 12 to 2463), walked for longer per day (mean = 14.4 minutes, 95% CI 0.6 to 28.8), had improved self-efficacy evidenced by being more confident about walking (mean = 1.6 units out of 10, 95% CI 0.3 to 2.9) and not falling (mean = 1.1 units out of 10, 95% CI 0.3 to 1.9) and improved health-related quality of life and mental health. This study provides preliminary evidence that motivational interviewing can result in clinically meaningful improvements in physical activity and psychosocial outcomes for people recovering from hip fracture.

Examining the Feasibility and Acceptability of a Motivational Interviewing Early Intervention Program to Prevent High School Dropout

ERIC Educational Resources Information Center

Iachini, Aidyn L.; Rogelberg, Sandra; Terry, John David; Lutz, Amy

2016-01-01

This article describes Aspire, a new motivational interviewing (MI) early intervention program designed to prevent dropout among students repeating the ninth grade, and then examines the feasibility and acceptability of this program through a mixed-methods approach. The Aspire program is a nine-lesson curriculum grounded in MI with an emphasis on…

Motivational interviewing workshop in a virtual world: learning as avatars.

PubMed

Shershneva, Marianna; Kim, Ji-Hye; Kear, Cynthia; Heyden, Robin; Heyden, Neil; Lee, Jay; Mitchell, Suzanne

2014-04-01

Limited research has been done to understand outcomes of continuing medical education offered in three-dimensional, immersive virtual worlds. We studied a case of a virtual world workshop on motivational interviewing (MI) applied to smoking cessation counseling and its educational impact. To facilitate content development and evaluation, we specified desired MI competencies. The workshop consisted of three sessions, which included lectures, practice with standardized patients, and chat interactions. Data were collected from 13 primary care physicians and residents through workshop observation, and pre- and 3-month post-workshop telephone/Skype interviews and interactions with standardized patients. Interactions with standardized patients were assessed by an expert using a validated MI tool and by standardized patients using a tool developed for this study. For 11 participants who attended two or three sessions, we conducted paired-samples t tests comparing mean differences between the competency scores before and after the workshop. Expert assessment showed significant improvement on six of seven MI competencies. All participants reported learning new knowledge and skills, and nine described incorporating new learning into their clinical practice. Practicing MI with standardized patients and/or observing others' practice appeared to be the most helpful workshop component. The evaluated workshop had positive impact on participants' competencies and practice as related to MI applied to smoking cessation counseling. Our findings support further exploration of three-dimensional virtual worlds as learning environments for continuing medical education.

Motivational Interviewing Workshop in a Virtual World: Learning as Avatars

PubMed Central

Shershneva, Marianna; Kim, Ji-Hye; Kear, Cynthia; Heyden, Robin; Heyden, Neil; Lee, Jay; Mitchell, Suzanne

2015-01-01

Background Limited research has been done to understand outcomes of continuing medical education offered in three-dimensional, immersive virtual worlds. Objectives We studied a case of a virtual world workshop on motivational interviewing (MI) applied to smoking cessation counseling and its educational impact. Methods To facilitate content development and evaluation, we specified desired MI competencies. The workshop consisted of three sessions, which included lectures, practice with standardized patients, and chat interactions. Data were collected from 13 primary care physicians and residents through workshop observation, and pre- and three-month post-workshop telephone/Skype interviews and interactions with standardized patients. Interactions with standardized patients were assessed by an expert using a validated MI tool, and by standardized patients using a tool developed for this study. For 11 participants who attended two or three sessions, we conducted paired-samples t-tests comparing mean differences between the competency scores pre- and post-event. Results Expert assessment showed significant improvement on six of seven MI competencies (p< .05). All participants reported learning new knowledge and skills, and nine described incorporating new learning into their clinical practice. Practicing MI with standardized patients and/or observing others' practice appeared to be the most helpful workshop component. Conclusions The evaluated workshop had positive impact on participants' competencies and practice as related to MI applied to smoking cessation counseling. Our findings support further exploration of three-dimensional virtual worlds as learning environments for continuing medical education. PMID:24788420

There's nothing more practical than a good theory: integrating motivational interviewing and self-determination theory.

PubMed

Vansteenkiste, Maarten; Sheldon, Kennon M

2006-03-01

In this article we compare and integrate two well-established approaches to motivating therapeutic change, namely self-determination theory (SDT; Deci & Ryan, 1985, ) and motivational interviewing (MI; Miller & Rollnick, 1991, ). We show that SDT's theoretical focus on the internalization of therapeutic change and on the issue of need-satisfaction is fully compatible with key principles and clinical strategies within MI. We further suggest that basic need-satisfaction might be an important mechanism accounting for the positive effects of MI. Conversely, MI principles may provide SDT researchers with new insight into the application of SDT's theoretical concept of autonomy-support, and suggest new ways of testing and developing SDT. In short, the applied approach of MI and the theoretical approach of SDT might be fruitfully married, to the benefit of both.

An Experimental Study of Interventions for the Acquisition and Retention of Motivational Interviewing Skills among Probation Officers

ERIC Educational Resources Information Center

Asteris, Mark M., Jr.

2012-01-01

This study was designed to investigate the differences in Motivational Interviewing (MI) skill acquisition and retention among probation officers. This study had a randomized, experimental, pretest-posttest control group design using the MITI 3.1.1 and the VASE-R to measure MI skill acquisition and retention. A random sample (n = 24) of probation…

"Old Dogs" and New Skills: How Clinician Characteristics Relate to Motivational Interviewing Skills before, during, and after Training

ERIC Educational Resources Information Center

Carpenter, Kenneth M.; Cheng, Wendy Y.; Smith, Jennifer L.; Brooks, Adam C.; Amrhein, Paul C.; Wain, R. Morgan; Nunes, Edward V.

2012-01-01

Objective: The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their motivational interviewing (MI) skills before, during, and after training were investigated. Method: Fifty-eight community-based addiction clinicians (M = 42.1 years, SD = 10.0; 66% Female) were assessed…

Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

PubMed

Osilla, Karen Chan; Kennedy, David P; Hunter, Sarah B; Maksabedian, Ervant

2016-09-07

Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors. We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds of beta testing. Staff were 3 men and 3 women who were residential support staff (i.e., case managers and administrators). Residents were 8 men (7 African American, 1 Hispanic) and 3 women (2 African American, 1 Hispanic) who had histories of AOD and HIV risk behaviors. We conducted a focus group with staff who gave input on how to improve the delivery of the intervention to enhance understanding and receptivity among new residents. We conducted semi-structured qualitative interviews and collected self-report satisfaction data from residents. Three themes emerged over the course of the resident interviews. Residents reported that the intervention was helpful in discussing their social network, that seeing the visualizations was more impactful than just talking about their network, and that the intervention prompted thoughts about changing their AOD use and HIV risk networks. This study is the first of its kind that has developed, with input from Housing First staff and residents, a motivational interviewing intervention that targets both the structure and composition of one's social network. These results suggest that providing visual network feedback with a guided motivational interviewing discussion is a promising approach to supporting network change. ClinicalTrials.gov Identifier NCT02140359.

Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis.

PubMed

Sayegh, Caitlin S; Huey, Stanley J; Zara, Erica J; Jhaveri, Kinnari

2017-06-01

Motivation is an integral factor in substance use treatment and long-term recovery. However, it is unclear what role intrinsic and extrinsic motivation play across different treatment modalities. A meta-analysis (N = 84) was performed to estimate the pooled effect size of Motivational Interviewing (MI; primarily targeting intrinsic motivation) and contingency management (CM; primarily targeting extrinsic motivation) at different follow-up periods. Collapsed across all substance types, CM had a significant effect at 3-month follow-up, only. In contrast, MI had a significant effect at 6-month follow-up, only. CM had small and medium effects on multiple substances at 3-month follow-up (i.e., tobacco, marijuana, stimulants, polysubstances), but not at 6-month follow-up. MI had 1 significant medium effect at 3-month follow-up (i.e., marijuana), but several significant small effects at 6-month follow-up (i.e., alcohol, tobacco, polysubstances). This meta-analysis suggests that both CM and MI promote reductions in a range of substances, even several months after the intervention concludes. Further, these results provide some evidence that extrinsically focused CM may produce medium follow-up effects in the short run, but intrinsically focused MI may produce small but durable follow-up effects. However, this interpretation is complicated by the differences between the MI and CM studies that preclude statistical tests comparing effect sizes, and few studies assessed motivation itself. Future researchers should investigate how motivational dynamics impact lasting outcomes in substance use treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Implementation of Motivational Interviewing in Substance Use Disorder Treatment: Research Network Participation and Organizational Compatibility.

PubMed

Rieckmann, Traci R; Abraham, Amanda J; Bride, Brian E

Despite considerable empirical evidence that psychosocial interventions improve addiction treatment outcomes across populations, implementation remains problematic. A small body of research points to the importance of research network participation as a facilitator of implementation; however, studies examined limited numbers of evidence-based practices. To address this gap, the present study examined factors impacting implementation of motivational interviewing (MI). This study used data from a national sample of privately funded treatment programs (n = 345) and programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) (n = 156). Data were collected via face-to-face interviews with program administrators and clinical directors (2007-2009). Analysis included bivariate t tests and chi-square tests to compare private and CTN programs, and multivariable logistic regression of MI implementation. A majority (68.0%) of treatment programs reported use of MI. Treatment programs participating in the CTN (88.9%) were significantly more likely to report use of MI compared with non-CTN programs (58.5%; P < 0.01). CTN programs (82.1%) also were more likely to use trainers from the Motivational Interviewing Network of Trainers as compared with private programs (56.1%; P < 0.05). Multivariable logistic regression models reveal that CTN-affiliated programs and programs with a psychiatrist on staff were more likely to use MI. Programs that used the Stages of Change Readiness and Treatment Eagerness Scale assessment tool were more likely to use MI, whereas programs placing greater emphasis on confrontational group therapy were less likely to use MI. Findings suggest the critical role of research network participation, access to psychiatrists, and organizational compatibility in adoption and sustained use of MI.

Motivational Interviewing to Treat Overweight Children: 24-Month Follow-Up of a Randomized Controlled Trial.

PubMed

Broccoli, Serena; Davoli, Anna Maria; Bonvicini, Laura; Fabbri, Alessandra; Ferrari, Elena; Montagna, Gino; Panza, Costantino; Pinotti, Mirco; Storani, Simone; Tamelli, Marco; Candela, Silvia; Bellocchio, Eletta; Giorgi Rossi, Paolo

2016-01-01

Pediatrician-led motivational interviewing can be an effective way of controlling BMI in overweight children in the short term. Its long-term efficacy is unknown. The primary aim was to determine whether the short-term (12-month) impact of family pediatrician-led motivational interviews on the BMI of overweight children could be sustained in the long term (24 months), in the absence of any other intervention. Children were recruited in 2011 by family pediatricians working in the province of Reggio Emilia, Italy, and randomly allocated to receive either 5 interviews delivered over a 12-month period or usual care. Eligible participants were all 4- to 7-year-old overweight children resident in the province of Reggio Emilia who had been receiving care from the pediatrician for ≥ 12 months. The primary outcome of this study was individual variation in BMI between the baseline visit and the 24-month follow-up, assessed by pediatricians not blinded to treatment group allocation. Of 419 eligible families, 372 (89%) participated; 187 children were randomized to receive intervention and 185 to usual care. Ninety-five percent of the children attended the 12-month follow-up, and 91% attended the 24-month follow-up. After the 12-month intervention period, BMI in the intervention group increased less than in the control group (0.46 and 0.78, respectively; difference -0.32; P = .005). At the 24-month follow-up, the difference had disappeared (1.52 and 1.56, respectively; difference -0.04; P = .986). The intervention lost its effectiveness within 1 year of cessation. Sustainable boosters are required for weight control and obesity prevention. Copyright © 2016 by the American Academy of Pediatrics.

Motivational Interviewing and Cognitive-Behavioral Intervention to Improve HIV Medication Adherence Among Hazardous Drinkers

PubMed Central

Parsons, Jeffrey T.; Golub, Sarit A.; Rosof, Elana; Holder, Catherine

2009-01-01

Objective To assess the efficacy of a behavioral intervention designed to improve HIV medication adherence and reduce alcohol consumption among HIV-positive men and women. Design A randomized controlled trial conducted between July 2002 and August 2005. Setting A behavioral research center in New York City. Participants HIV-positive men and women (n = 143) who were on HIV antiretroviral medication and met criteria for hazardous drinking. Intervention Participants were randomly assigned to an 8-session intervention based on motivational interviewing and cognitive-behavioral skills building or a time- and content-equivalent educational condition. Outcome Measures Viral load, CD4 cell count, and self-reported adherence and drinking behavior were assessed at baseline and at 3- and 6-month follow-ups. Results Relative to the education condition, participants in the intervention demonstrated significant decreases in viral load and increases in CD4 cell count at the 3-month follow-up and significantly greater improvement in percent dose adherence and percent day adherence. There were no significant intervention effects for alcohol use, however, and effects on viral load, CD4 cell count, and adherence were not sustained at 6 months. Conclusions An 8-session behavioral intervention can result in improvement in self-report and biologic markers of treatment adherence and disease progression. This type of intervention should be considered for dissemination and integration into HIV clinics providing comprehensive care for HIV-positive persons with alcohol problems. Although the effect was attenuated over time, future studies might test the added effectiveness of booster sessions or ongoing adherence counseling. PMID:18077833

Motivational interviewing for older adults in primary care: a systematic review.

PubMed

Purath, Janet; Keck, Annmarie; Fitzgerald, Cynthia E

2014-01-01

Chronic disease is now the leading cause of death and disability in United States. Many chronic illnesses experienced by older adults can be prevented or managed through behavior change, making patient counseling an essential component of disease prevention and management. Motivational Interviewing (MI), a type of conversational method, has been effective in eliciting health behavior changes in people in a variety of settings and may also be a useful tool to help older adults change. This review of the literature analyzes current research and describes potential biases of MI interventions that have been conducted in primary care settings with older adults. MI shows promise as a technique to elicit health behavior change among older adults. However, further study with this population is needed to evaluate efficacy of MI interventions in primary care settings. Copyright © 2014 Mosby, Inc. All rights reserved.

Improving Access to Care for Warfighters: Virtual Worlds Technology to Enhance Primary Care Training in Post-Traumatic Stress and Motivational Interviewing

DTIC Science & Technology

2016-10-01

creating content, then, build off the BIM (P9) 9. Keep the training relevant with current events in the medical world (zika, infectious disease , etc... training ; curriculum development; motivational interviewing Veterans present to primary care providers (PCPs) with posttraumatic stress (PTS) symptoms...can inform the training curriculum. In total, 11 interviews were conducted with primary care providers and healthcare leadership. The data was

Motivational aftercare planning to better care: Applying the principles of advanced directives and motivational interviewing to discharge planning for people with mental illness.

PubMed

Kisely, Steve; Wyder, Marianne; Dietrich, Josie; Robinson, Gail; Siskind, Dan; Crompton, David

2017-02-01

Improving the input of people with mental illness into their recovery plans can potentially lead to better outcomes. In the present study, we evaluated the introduction of motivational aftercare planning (MAP) into the discharge planning of psychiatric inpatients. MAP is a manualized intervention combining motivational interviewing with advance directives. We measured changes in the level of patient input into discharge planning following training staff in the use of MAP. This included the following: (i) documentation of early relapse signs along with successful past responses; (ii) evidence of aftercare planning; and (iii) the use of the patients' own words in the plan. We used a ward-level controlled before-and-after design comparing one intervention ward with two control wards. We used anonymized recovery plans, with a goal of 50 plans per ward before and after the intervention, to look for evidence of patient input into care planning with a standardized checklist. There were also qualitative interviews with individuals discharged from the unit. We reviewed 100 intervention ward plans and 197 control ones (total n = 297). There were no significant differences in recovery plans from intervention and control wards at baseline. Following MAP training, the intervention ward improved significantly (e.g. identification of triggers increased from 52 to 94%, χ 2  = 23.3, d.f. =1, P < 0.001). This did not occur in the control wards. The qualitative data (n = 20 interviews) showed improvements in participants' experiences of discharge planning. MAP increased inpatient input into discharge planning and was valued by participants. The effect on subsequent health service use needs evaluation. © 2016 Australian College of Mental Health Nurses Inc.

The role of self-efficacy and motivation to explain the effect of motivational interviewing time on changes in risky sexual behavior among people living with HIV: a mediation analysis.

PubMed

Chariyeva, Zulfiya; Golin, Carol E; Earp, Jo Anne; Maman, Suzanne; Suchindran, Chirayath; Zimmer, Catherine

2013-02-01

Little is known about the amount of Motivational Interviewing (MI) needed to reduce risky sexual behavior among People Living with HIV/AIDS (PLWHA) or the roles self-efficacy and motivation to practice safer sex play. Among 183 PLWHA who received safer sex MI and were surveyed every 4 months over a 12 month period, we used hierarchical negative binomial regression models to examine the association between amount of counseling time and sexual risk behavior. We performed mediation analysis to evaluate whether changes in self-efficacy and motivation explained this association. This study found that as MI time and number of provided sessions increased, participants' sexual risk behavior decreased. The effect of MI time and number of sessions on sexual behavior was mediated by self-efficacy but not by motivation to practice safer sex.

The Role of Self-Efficacy and Motivation to Explain the Effect of Motivational Interviewing Time on Changes in Risky Sexual Behavior among People Living with HIV: A Mediation Analysis

PubMed Central

Golin, Carol E.; Earp, Jo Anne; Maman, Suzanne; Suchindran, Chirayath; Zimmer, Catherine

2014-01-01

Little is known about the amount of Motivational Interviewing (MI) needed to reduce risky sexual behavior among People Living with HIV/AIDS (PLWHA) or the roles self-efficacy and motivation to practice safer sex play. Among 183 PLWHA who received safer sex MI and were surveyed every 4 months over a 12 month period, we used hierarchical negative binomial regression models to examine the association between amount of counseling time and sexual risk behavior. We performed mediation analysis to evaluate whether changes in self-efficacy and motivation explained this association. This study found that as MI time and number of provided sessions increased, participants’ sexual risk behavior decreased. The effect of MI time and number of sessions on sexual behavior was mediated by self-efficacy but not by motivation to practice safer sex. PMID:22228069

"Let's Talk about Drugs": Pilot Study of a Community-Level Drug Prevention Intervention Based on Motivational Interviewing Principles

ERIC Educational Resources Information Center

Newbery, Natasha; McCambridge, Jim; Strang, John

2007-01-01

Purpose: The feasibility of a community-level drug prevention intervention based upon the principles of motivational interviewing within a further education college was investigated in a pilot study. Design/methodology/approach: The implementation over the course of a single term of "Let's Talk about Drugs" was studied with both action…

Development of Intensive Motivational Interviewing (IMI) and Modifications for Treating Women with Alcohol Use Disorders.

PubMed

Polcin, Douglas L; Korcha, Rachael; Nayak, Madhabika

2018-06-01

Women have greater vulnerability to alcohol problems than men. They become intoxicated after drinking half as much as men, develop cirrhosis of the liver more rapidly, and have a greater risk of dying from alcohol-related accidents. Despite more serious consequences related to their drinking, treatment for women with alcohol use disorders has been understudied relative to treatment for men. Intensive motivational interviewing (IMI) is a recent psychotherapeutic intervention for substance abuse problems that draws on the principles of brief motivational interviewing (1-2 session). However, the intervention includes 9 sessions designed to enable therapists to have maximum flexibility to facilitate factors known to be important for women with substance use disorders, such as active facilitation of client-therapist collaboration, empowerment, and affirmation of strengths. This paper reviews the development of IMI, initial favorable findings for women with co-occurring methamphetamine and alcohol problems, and the design of an ongoing longitudinal study assessing the effects of MI for women with alcohol problems over a 12-month time period. Relational Theory is used as a conceptual framework for understanding IMI for women. The theory emphasizes understanding, building, and modifying interpersonal relationships as a central goal. From this perspective, self-efficacy, self-esteem, and reduction in drinking are enhanced through interpersonal connections with others. Plans for additional study of IMI are described along with suggestions for therapists.

Intensive motivational interviewing for women with concurrent alcohol problems and methamphetamine dependence.

PubMed

Korcha, Rachael A; Polcin, Douglas L; Evans, Kristy; Bond, Jason C; Galloway, Gantt P

2014-02-01

Motivational interviewing (MI) for the treatment of alcohol and drug problems is typically conducted over 1 to 3 sessions. The current work evaluates an intensive 9-session version of MI (Intensive MI) compared to a standard single MI session (Standard MI) using 163 methamphetamine (MA) dependent individuals. The primary purpose of this paper is to report the unexpected finding that women with co-occurring alcohol problems in the Intensive MI condition reduced the severity of their alcohol problems significantly more than women in the Standard MI condition at the 6-month follow-up. Stronger perceived alliance with the therapist was inversely associated with alcohol problem severity scores. Findings indicate that Intensive MI is a beneficial treatment for alcohol problems among women with MA dependence. © 2013.

Improving Access to Care for Warfighters: Virtual Worlds Technology to Enhance Primary Care Training in Post-Traumatic Stress and Motivational Interviewing

DTIC Science & Technology

2017-10-01

chronic mental and physical health problems. Therefore, the project aims to: (1) iteratively design a new web-based PTS and Motivational Interviewing...result in missed opportunities to intervene to prevent chronic mental and physical health problems. The project aims are to: (1) iteratively design a new...intervene to prevent chronic mental and physical health problems. We propose to: (1) Iteratively design a new web-based PTS and Motivational

Effects of video-feedback on the communication, clinical competence and motivational interviewing skills of practice nurses: a pre-test posttest control group study.

PubMed

Noordman, Janneke; van der Weijden, Trudy; van Dulmen, Sandra

2014-10-01

To examine the effects of individual video-feedback on the generic communication skills, clinical competence (i.e. adherence to practice guidelines) and motivational interviewing skills of experienced practice nurses working in primary care. Continuing professional education may be necessary to refresh and reflect on the communication and motivational interviewing skills of experienced primary care practice nurses. A video-feedback method was designed to improve these skills. Pre-test/posttest control group design. Seventeen Dutch practice nurses and 325 patients participated between June 2010-June 2011. Nurse-patient consultations were videotaped at two moments (T0 and T1), with an interval of 3-6 months. The videotaped consultations were rated using two protocols: the Maastrichtse Anamnese en Advies Scorelijst met globale items (MAAS-global) and the Behaviour Change Counselling Index. Before the recordings, nurses were allocated to a control or video-feedback group. Nurses allocated to the video-feedback group received video-feedback between T0 and T1. Data were analysed using multilevel linear or logistic regression. Nurses who received video-feedback appeared to pay significantly more attention to patients' request for help, their physical examination and gave significantly more understandable information. With respect to motivational interviewing, nurses who received video-feedback appeared to pay more attention to 'agenda setting and permission seeking' during their consultations. Video-feedback is a potentially effective method to improve practice nurses' generic communication skills. Although a single video-feedback session does not seem sufficient to increase all motivational interviewing skills, significant improvement in some specific skills was found. Nurses' clinical competences were not altered after feedback due to already high standards. © 2014 John Wiley & Sons Ltd.

Training Substance Abuse Clinicians in Motivational Interviewing Using Live Supervision via Tele-conferencing

PubMed Central

Smith, Jennifer L.; Carpenter, Kenneth M.; Amrhein, Paul C.; Brooks, Adam C.; Levin, Deborah; Schreiber, Elizabeth A.; Travaglini, Laura A.; Hu, Mei-Chen; Nunes, Edward V.

2012-01-01

Background Training through traditional workshops is relatively ineffective for changing counseling practices. Tele-conferencing Supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method 97 community drug treatment counselors completed a 2-day MI workshop and were randomized to: live supervision via tele-conferencing (TCS; n=32), standard tape-based supervision (Tape; n=32), or workshop alone (Workshop; n=33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) coding system pre-workshop and 1, 8, and 20 weeks post-workshop. Mixed effects linear models were used to test training condition on MI skill at 8 and 20 weeks. Results TCS scored better than Workshop on the MITI for Spirit (mean difference = 0.76; p < .0001; d = 1.01) and Empathy (mean difference = 0.68; p < .001; d = 0.74). Tape supervision fell between TCS and Workshop, with Tape superior to Workshop for Spirit (mean difference = 0.40; p < .05). TCS was superior to Workshop in reducing MI non-adherence and increasing MI adherence, and was superior to Workshp and Tape in increasing the reflection to question ratio. Tape was superior to TCS in increasing complex reflections. Percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold (Spirit and Empathy scores ≥ 6), and were modest, ranging from 13% to 67%, for TCS and Tape. Conclusion TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods in order to bring more clinicians to high levels of proficiency and facilitate the dissemination of evidence-based practices. PMID:22506795

Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study

PubMed Central

2014-01-01

Background Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. Methods A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Results Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In ‘the peripheral’ model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In ‘the add-on’ model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally ‘the integral’ model played out in two ways. In ‘integral-in-theory’ studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In ‘integral-in-practice’ studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due

Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study.

PubMed

O'Cathain, Alicia; Goode, Jackie; Drabble, Sarah J; Thomas, Kate J; Rudolph, Anne; Hewison, Jenny

2014-06-09

Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In 'the peripheral' model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In 'the add-on' model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally 'the integral' model played out in two ways. In 'integral-in-theory' studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In 'integral-in-practice' studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due to the challenges of publishing this research

Adapted motivational interviewing to improve the uptake of treatment for glaucoma in Nigeria: study protocol for a randomized controlled trial.

PubMed

Abdull, Mohammed M; Gilbert, Clare; McCambridge, Jim; Evans, Jennifer

2014-04-29

Glaucoma is a chronic eye disease associated with irreversible visual loss. In Africa, glaucoma patients often present late, with very advanced disease. One-off procedures, such as laser or surgery, are recommended in Africa because of lack of or poor adherence to medical treatment. However, acceptance of surgery is usually extremely low. To prevent blindness, adherence to treatment needs to improve, using acceptable, replicable and cost-effective interventions. After reviewing the literature and interviewing patients in Bauchi (Nigeria) motivational interviewing (MI) was selected as the intervention for this trial, with adaptation for glaucoma (MIG). MI is designed to strengthen personal motivation for, and commitment to a specific goal by eliciting and exploring a person's reasons for change within an atmosphere of acceptance and compassion. The aim of this study is to assess whether MIG increases the uptake of laser or surgery amongst glaucoma patients where this is the recommended treatment. The hypothesis is that MIG increases the uptake of treatment. This will be the first trial of MI in Africa. This is a hospital based, single centre, randomized controlled trial of MIG plus an information sheet on glaucoma and its treatment (the latter being "standard care") compared with standard care alone for glaucoma patients where the treatment recommended is surgery or laser.Those eligible for the trial are adults aged 17 years and above who live within 200 km of Bauchi with advanced glaucoma where the examining ophthalmologist recommends surgery or laser. After obtaining written informed consent, participants will be randomly allocated to MIG plus standard care, or standard care alone. Motivational interviewing will be delivered in Hausa or English by one of two MIG trained personnel. One hundred and fifty participants will be recruited to each arm. The primary outcome is the proportion of participants undergoing laser or surgery within two months of the date given

Adapted motivational interviewing to improve the uptake of treatment for glaucoma in Nigeria: study protocol for a randomized controlled trial

PubMed Central

2014-01-01

Background Glaucoma is a chronic eye disease associated with irreversible visual loss. In Africa, glaucoma patients often present late, with very advanced disease. One-off procedures, such as laser or surgery, are recommended in Africa because of lack of or poor adherence to medical treatment. However, acceptance of surgery is usually extremely low. To prevent blindness, adherence to treatment needs to improve, using acceptable, replicable and cost-effective interventions. After reviewing the literature and interviewing patients in Bauchi (Nigeria) motivational interviewing (MI) was selected as the intervention for this trial, with adaptation for glaucoma (MIG). MI is designed to strengthen personal motivation for, and commitment to a specific goal by eliciting and exploring a person’s reasons for change within an atmosphere of acceptance and compassion. The aim of this study is to assess whether MIG increases the uptake of laser or surgery amongst glaucoma patients where this is the recommended treatment. The hypothesis is that MIG increases the uptake of treatment. This will be the first trial of MI in Africa. Methods This is a hospital based, single centre, randomized controlled trial of MIG plus an information sheet on glaucoma and its treatment (the latter being “standard care”) compared with standard care alone for glaucoma patients where the treatment recommended is surgery or laser. Those eligible for the trial are adults aged 17 years and above who live within 200 km of Bauchi with advanced glaucoma where the examining ophthalmologist recommends surgery or laser. After obtaining written informed consent, participants will be randomly allocated to MIG plus standard care, or standard care alone. Motivational interviewing will be delivered in Hausa or English by one of two MIG trained personnel. One hundred and fifty participants will be recruited to each arm. The primary outcome is the proportion of participants undergoing laser or surgery within two

Dental Hygiene Students' Perceptions of Importance and Confidence in Applying Motivational Interviewing During Patient Care.

PubMed

Mills, Angela; Kerschbaum, Wendy E; Richards, Philip S; Czarnecki, Gail A; Kinney, Janet S; Gwozdek, Anne E

2017-02-01

Purpose: Motivational Interviewing (MI) is an evidence-based, patient-centered counseling approach for eliciting behavior change. In 2012, the University of Michigan (U-M) Dental Hygiene Program significantly enhanced their behavior change curriculum by reinforcing and building upon the Motivational Interviewing segment. The purpose of this study was to examine students' perceptions of the importance of MI and their confidence in applying it during patient care. Methods: A convenience sample of 22 U-M Class of 2015 dental hygiene students who had received an enhanced curriculum participated in this study, utilizing a retrospective, pre-test/post-test design. Results: A Wilcoxon signed rank test was used to compare the differences in average ranks between T1 (Retrospective Pre-Test) and T4 (Post-Test 3) for the importance and confidence questions at each time point for the Class of 2015. Students' perceptions of importance increased with statistical significance in five out of eight MI strategies. Perceptions in confidence increased in seven out of eight strategies. Effect size ranged from .00 to .55. Assessment of qualitative data provided additional insight on student experiences. Conclusion: Student perceptions of importance of using MI and their confidence in applying MI increased in a majority of the strategy categories. Successes with patient health behavior change and challenges with time to integrate this in practice were noted. Research on the longitudinal impact and faculty feedback calibration is recommended. Copyright © 2017 The American Dental Hygienists’ Association.

A motivational interviewing education intervention for home healthcare nurses.

PubMed

Pyle, Joni J

2015-02-01

The ability of registered nurses to communicate well with their patients is foundational to patient-centered care, the management of chronic illness, and general healthcare. It is also vital to the nurse-patient relationship. Nurses, however, tend to identify with their patients' physical needs and rely heavily on the technical skills with which they feel more comfortable. This lack of ability to communicate well with their patients can result in poor nurse-patient understanding, can lead to poor patient outcomes, and a lack of patient engagement and involvement in their care. Motivational interviewing (MI), a patient-centered manner of communication, is a means to direct the nurse-patient interaction in a way that is patient centered. Brief education of MI has shown to be effective in increasing the self-efficacy of nurses in their ability to communicate well with their patients. In 2 geographically diverse Pennsylvania home care settings, MI education was provided to 20 nurses. The educational intervention was designed to increase the self-efficacy of nurses regarding their ability to affect the negative behaviors of chronically ill patients. A pretest and posttest was administered to the nurse participants to determine the effectiveness of the educational intervention. This evidence-based education increased the nurses' overall communication self-efficacy by 25%.

Comparison of motivational interviewing with acceptance and commitment therapy: a conceptual and clinical review.

PubMed

Bricker, Jonathan; Tollison, Sean

2011-10-01

Motivational Interviewing (MI) and Acceptance and Commitment Therapy (ACT) are two emerging therapies that focus on commitment to behavior change. The aim was to provide the first systematic comparison of MI with ACT. A systematic comparison was undertaken of MI and ACT at the conceptual level, with a focus on their philosophical and theoretical bases, and at the clinical level, with a focus on the therapeutic relationship, use of language in therapy, and use of values in therapy. Conceptually, MI and ACT have distinct philosophical bases. MI's theoretical basis focuses on language content, whereas ACT's theoretical basis focuses on language process. Clinically, ACT and MI have distinct approaches to the therapeutic relationship, fundamentally different foci on client language, and different uses of client values to motivate behavior change. ACT, but not MI, directly targets the willingness to experience thoughts, feelings, and sensations. Despite their conceptual and clinical differences, MI and ACT are complementary interventions. Collaborations between MI and ACT researchers may yield fruitful cross-fertilization research on core processes and clinical outcomes.

Comparison of Motivational Interviewing with Acceptance and Commitment Therapy: A conceptual and clinical review

PubMed Central

Bricker, J.B.; Tollison, S.J.

2011-01-01

Background Motivational Interviewing (MI) and Acceptance and Commitment Therapy (ACT) are two emerging therapies that focus on commitment to behavior change. Aim Provide the first systematic comparison of MI with ACT. Methods A systematic comparison of MI and ACT at the conceptual level, with a focus on their philosophical and theoretical bases, and at the clinical level, with a focus on the therapeutic relationship, use of language in therapy, and use of values in therapy. Results Conceptually, MI & ACT have distinct philosophical bases. MI’s theoretical basis focuses on language content, whereas ACT’s theoretical basis focuses on language process. Clinically, ACT and MI have distinct approaches to the therapeutic relationship, fundamentally different foci on client language, and different uses of client values to motivate behavior change. ACT, but not MI, directly targets the willingness to experience thoughts, feelings, and sensations. Conclusions Despite their conceptual and clinical differences, MI and ACT are complementary interventions. Collaborations between MI and ACT researchers may yield fruitful cross-fertilization research on core processes and clinical outcomes. PMID:21338532

Motivational versus confrontational interviewing: a comparison of substance abuse assessment practices at employee assistance programs.

PubMed

Schneider, R J; Casey, J; Kohn, R

2000-02-01

The aim of this study was to conduct a quasi-experimental comparison of two employee assistance program (EAP) assessment approaches with substance abusers: confrontational interviewing (CI) and motivational interviewing (MI). A total of 176 EAP clients from 14 study sites met the study criteria, and 89 (51%) agreed to participate in the study. At three and nine months postassessment, both the MI and CI groups showed similar changes in readiness for change, completion of initial treatment plans, and subsequent treatment. Most important, both the MI and CI participants showed significant and comparable improvement on all of the substance abuse baseline measures as well as measures of family-social well-being and effects of drinking/drugging on work performance. The results open the door for EAP counselors to use an empirically supported assessment style that is at least as effective as the traditional confrontational approach.

Motivational interviewing to enhance treatment attendance in mental health settings: A systematic review and meta-analysis.

PubMed

Lawrence, P; Fulbrook, P; Somerset, S; Schulz, P

2017-11-01

WHAT IS KNOWN ON THE SUBJECT?: Despite differences between samples, some literature reviews have suggested that MI is effective in enhancing treatment attendance for individuals with mental health issues. Little is known regarding the effects of MI as a pre-treatment on individuals who are not seeking treatment for mental health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This systematic review of the literature and meta-analysis demonstrates that MI is most beneficial for individuals who are not seeking mental health treatment. MI represents an opportunity for health promotion when patients are unmotivated but may otherwise be amenable to an intervention. MI is effective as a pre-treatment intervention to motivate individuals to attend further post-MI treatment and counselling. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: MI is a process and a useful tool for clinicians in all therapeutic interactions, to motivate their patients to seek further assistance for mental heath issues. Health promotion and encouragement to attend further treatment sessions can be facilitated through telephone contact. Introduction The stages of change model suggests that individuals seeking treatment are in the "preparation" or the "action" stage of change, which is the desired outcome of successful Motivational Interviewing (MI) interventions. MI is known to enhance treatment attendance among individuals with mental health problems. Aim This study examined the published research on MI as a pre-treatment to enhance attendance among individuals treatment-seeking and non-treatment-seeking for mental health issues. Methods Fourteen randomized controlled trials were identified, and MI efficacy was examined dichotomously: attendance or non-attendance for post-MI therapy. Subgroup analysis investigated treatment-seeking and non-treatment-seeking groups. Results Despite wide variations in sample sizes, blinding and monitoring, intervention fidelity was absent in the majority of published

Self-report after randomly assigned supervision does not predict ability to practice Motivational Interviewing

PubMed Central

Kutner, Bryan A.; Smith, Jennifer L.; Carpenter, K. M.; Hu, M-C.; Amrhein, Paul C.; Nunes, E. V.

2015-01-01

The objective of this study was to investigate the relation between self-report and objective assessment of Motivational Interviewing (MI) skills following training and supervision. After an MI workshop, 96 clinicians from 26 community programs (age 21–68, 65% female, 40.8% Black, 29.6% Caucasian, 24.5% Hispanic, 2.0% Asian, 3.1% other) were randomized to supervision (tele-conferencing or tape-based), or workshop only. At four time points, trainees completed a self-report of MI skill, using items from the MI Understanding questionnaire (MIU), and were objectively assessed by raters using the Motivational Interviewing Treatment Integrity (MITI) system. Correlations were calculated between MIU and MITI scores. A generalized linear mixed model was tested on MIU scores, with MITI scores, supervision condition and time as independent variables. MIU scores increased from pre-workshop (Mean = 4.74, SD = 1.79) to post-workshop (Mean = 6.31, SD = 1.03) (t = 8.69, p < .0001). With supervision, scores continued to increase, from post-workshop to week 8 (Mean = 7.07, SD = 0.91, t = 5.60, p < .0001) and from week 8 to week 20 (Mean = 7.28, SD = 0.94, t = 2.43, p = .02). However, MIU scores did not significantly correlate with MITI scores, with or without supervision. Self- reported ability increased with supervision, but self-report was not an indicator of objectively measured skill. This suggests that training does not increase correspondence between self-report and objective assessment, so community treatment programs should not rely on clinician self- report to assess the need for ongoing training and supervision and it may be necessary to train clinicians to accurately assess their own skill. PMID:25963775

Predictors of the decision to adopt motivational interviewing in community health settings.

PubMed

Williams, Jessica Roberts; Blais, Marissa Puckett; Banks, Duren; Dusablon, Tracy; Williams, Weston O; Hennessy, Kevin D

2014-07-01

The purpose of this study is to concurrently examine the impact of individual and organizational characteristics on the decision to adopt the evidence-based practice (EBP) motivational interviewing (MI) among directors and staff (n = 311) in community health organizations (n = 92). Results from hierarchical linear modeling indicated that, at the individual level, attitudes toward EBPs and race each predicted directors' decisions to adopt, while gender predicted staff's decisionmaking. At the organizational level, organizational climate was inversely associated with both staff's and directors' decisions to adopt MI. Organizational barriers to implementing EBPs and use of reading materials and treatment manuals were related to directors' decision to adopt. Type of organization and staff attributes were associated with staff's decision to adopt. These findings underscore the need to tailor dissemination and implementation strategies to address differences between directors and staff in the adoption of EBPs.

Technology-delivered adaptations of motivational interviewing for health-related behaviors: A systematic review of the current research

PubMed Central

Shingleton, Rebecca M.; Palfai, Tibor P.

2015-01-01

Objectives The aims of this paper were to describe and evaluate the methods and efficacy of technology-delivered motivational interviewing interventions (TAMIs), discuss the challenges and opportunities of TAMIs, and provide a framework for future research. Methods We reviewed studies that reported using motivational interviewing (MI) based components delivered via technology and conducted ratings on technology description, comprehensiveness of MI, and study methods. Results The majority of studies were fully-automated and included at least one form of media rich technology to deliver the TAMI. Few studies provided complete descriptions of how MI components were delivered via technology. Of the studies that isolated the TAMI effects, positive changes were reported. Conclusion Researchers have used a range of technologies to deliver TAMIs suggesting feasibility of these methods. However, there are limited data regarding their efficacy, and strategies to deliver relational components remain a challenge. Future research should better characterize the components of TAMIs, empirically test the efficacy of TAMIs with randomized controlled trials, and incorporate fidelity measures. Practice Implications TAMIs are feasible to implement and well accepted. These approaches offer considerable potential to reduce costs, minimize therapist and training burden, and expand the range of clients that may benefit from adaptations of MI. PMID:26298219

The Validity of Value-Added Estimates from Low-Stakes Testing Contexts: The Impact of Change in Test-Taking Motivation and Test Consequences

ERIC Educational Resources Information Center

Finney, Sara J.; Sundre, Donna L.; Swain, Matthew S.; Williams, Laura M.

2016-01-01

Accountability mandates often prompt assessment of student learning gains (e.g., value-added estimates) via achievement tests. The validity of these estimates have been questioned when performance on tests is low stakes for students. To assess the effects of motivation on value-added estimates, we assigned students to one of three test consequence…

The barriers and motivators to learning infection control in clinical placements: interviews with midwifery students.

PubMed

Ward, Deborah J

2013-05-01

To investigate the barriers to and motivators for learning infection prevention and control as identified by midwifery students. Semi-structured interviews were undertaken with 15 undergraduate midwifery students within one large university. Data were analysed using Framework Analysis. Barriers to good clinical practice were identified by students which were concordant with previous literature related to reasons for non-compliance with infection control precautions. Issues such as competing demands specific to midwifery were also identified. Factors which act as barriers to learning good practice in placements included conflicting information and practices from different staff and placement areas and staff attitudes towards students who tried to comply with precautions. Motivators to good practice included the perceived vulnerability of infants to infection, the role modelling of good practice to new mothers and the monitoring of practice. This study demonstrated that midwifery students perceive barriers and motivators to learning infection prevention and control in their clinical placements. Many of the barriers identified are related to the attitudes and practices of qualified staff. Some of the motivators are related specifically to midwifery practice. Midwives need to be aware of the effects of what is observed in practice on midwifery students and how their practices and attitudes can influence learning both positively and negatively. As healthcare-associated infection and poor compliance with precautions are a global problem, this research should be of benefit to midwives and midwifery educators worldwide in terms of addressing barriers and ensuring better clinical education. Copyright © 2012 Elsevier Ltd. All rights reserved.

Motivational interviewing skills are positively associated with nutritionist self-efficacy.

PubMed

Marley, Scott C; Carbonneau, Kira; Lockner, Donna; Kibbe, Debra; Trowbridge, Frederick

2011-01-01

To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy. Cross-sectional survey. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics. Sixty-five WIC nutritionists. Counseling self-efficacy on topics related to physical activity and nutritional behaviors and in the presence of language and cultural differences. Multiple linear regression. Nutritionists' perception of their own MI skills was positively associated with their self-efficacy for counseling clients of a culture different than their own, when counseling about physical activity, and when counseling about nutrition behavior. Hispanic ethnicity and social self-concept were positively associated with counseling self-efficacy when culture differences were present. Physical self-concept was positively associated with self-efficacy related to physical activity topics. Nutrition assessment skill was negatively associated with self-efficacy for working with non-English-speaking clients. Development of MI skills and strategies to improve social and physical self-concept may increase WIC nutritionists' counseling self-efficacy, particularly when counseling clients from diverse backgrounds. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Using motivational interviewing in the community pharmacy to increase adult immunization readiness: A pilot evaluation.

PubMed

Brackett, Amber; Butler, Michell; Chapman, Liza

2015-01-01

To investigate whether the use of motivational interviewing (MI) in the community pharmacy improves immunization readiness and rates for hepatitis B, hepatitis A/B combination, herpes zoster, pneumococcal, and tetanus-diphtheria-acellular pertussis immunizations. Kroger Pharmacy. Grocery store pharmacies located in the Atlanta, GA, metropolitan area offering a variety of patient care services, including medication therapy management and immunizations. Patients were identified during workflow, and MI encounters were initiated to those eligible to receive hepatitis A/B combination, hepatitis B, herpes zoster, pneumococcal and/or tetanus-diphtheria-acellular pertussis vaccines. Following each encounter, pharmacists completed patient demographic information and responses to 5-point Likert scale questions assessing patient readiness to receive immunizations at the beginning and end of the encounter, and if follow-up occurred, 5-point Likert scale questions assessing pharmacists' perception of using MI. Immunization rates at the intervention site did not significantly increase due to the small sample size and other project limitations. Patient readiness to receive immunizations improved from the beginning to the end of the MI encounter and was statistically significant for hepatitis B (P = 0.001) and pneumococcal (P = 0.033) vaccines. Pharmacists agreed MI was an effective tool to discuss immunizations, agreed they could communicate more effectively about immunizations, and agreed MI could be incorporated into the community pharmacy workflow. Motivational interviewing may be a useful tool for community pharmacists to use in discussing immunizations. Larger studies need to be completed to determine the impact MI could have on immunization readiness and rates in the community pharmacy.

Pathways to Health: A Cluster Randomized Trial of Nicotine Gum and Motivational Interviewing for Smoking Cessation in Low-Income Housing

ERIC Educational Resources Information Center

Okuyemi, Kolawole S.; James, Aimee S.; Mayo, Matthew S.; Nollen, Nicole; Catley, Delwyn; Choi, Won S.; Ahluwalia, Jasjit S.

2007-01-01

Despite high smoking rates among those living in poverty, few cessation studies are conducted in these populations. This cluster-randomized trial tested nicotine gum plus motivational interviewing (MI) for smoking cessation in 20 low-income housing developments (HDs). Intervention participants (10 HDs, n = 66) received educational materials, 8…

Motivational interviewing and intimate partner violence: a randomized trial.

PubMed

Saftlas, Audrey F; Harland, Karisa K; Wallis, Anne B; Cavanaugh, Joseph; Dickey, Penny; Peek-Asa, Corinne

2014-02-01

To determine if motivational interviewing (MI) improves self-efficacy (primary outcome), depressive symptoms (secondary outcome), and stage-of-readiness-to-change (secondary outcome) among women in abusive relationships. Randomized controlled trial among women who experienced intimate partner violence in a current relationship over the past 12 months. Subjects were recruited from two family planning clinics (December 2007 to May 2010). The intervention included an initial face-to-face session and three telephone sessions administered 1-, 2-, and 4-months postenrollment, each using MI to identify personal goals. Controls were referred to community-based resources. Outcomes were measured by self-administered questionnaires before randomization and 6 months later. Modified intent-to-treat analyses of completed participants were conducted using multivariate analysis of variance for continuous outcomes and polytomous logistic regression for categorical outcomes. Three hundred six eligible women were enrolled (recruitment rate = 64%); 204 completed the 6-month follow-up (completion rate = 67%). Depressive symptoms decreased to a greater extent in MI than referral women (P = .07). Self-efficacy and stage-of-readiness-to-change increased more in MI than referral women, but these differences were not statistically significant. With a lower than projected sample size, our findings did not achieve statistical significance at the 5% level but suggest a beneficial effect of the MI intervention on reducing depressive symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

Self-Report After Randomly Assigned Supervision Does not Predict Ability to Practice Motivational Interviewing.

PubMed

Wain, R Morgan; Kutner, Bryan A; Smith, Jennifer L; Carpenter, Kenneth M; Hu, Mei-Chen; Amrhein, Paul C; Nunes, Edward V

2015-10-01

The objective of this study was to investigate the relation between self-report and objective assessment of motivational interviewing (MI) skills following training and supervision. After an MI workshop, 96 clinicians from 26 community programs (age 21-68, 65% female, 40.8% Black, 29.6% Caucasian, 24.5% Hispanic, 2.0% Asian, 3.1% other) were randomized to supervision (tele-conferencing or tape-based), or workshop only. At four time points, trainees completed a self-report of MI skill, using items from the MI understanding questionnaire (MIU), and were objectively assessed by raters using the Motivational Interviewing Treatment Integrity (MITI) system. Correlations were calculated between MIU and MITI scores. A generalized linear mixed model was tested on MIU scores, with MITI scores, supervision condition and time as independent variables. MIU scores increased from pre-workshop (mean = 4.74, SD = 1.79) to post-workshop (mean = 6.31, SD = 1.03) (t = 8.69, p < .0001). With supervision, scores continued to increase, from post-workshop to week 8 (mean = 7.07, SD = 0.91, t = 5.60, p < .0001) and from week 8 to week 20 (mean = 7.28, SD = 0.94, t = 2.43, p = .02). However, MIU scores did not significantly correlate with MITI scores, with or without supervision. Self-reported ability increased with supervision, but self-report was not an indicator of objectively measured skill. This suggests that training does not increase correspondence between self-report and objective assessment, so community treatment programs should not rely on clinician self-report to assess the need for ongoing training and supervision and it may be necessary to train clinicians to accurately assess their own skill. Copyright © 2015 Elsevier Inc. All rights reserved.

The Roles of Motivation and Coping Behaviours in Managing Stress: Qualitative Interview Study of Hong Kong Expatriate Construction Professionals in Mainland China.

PubMed

Chan, Isabelle Yee Shan; Leung, Mei-Yung; Liang, Qi

2018-03-20

Driven by fast-growing economies worldwide, the number of international construction projects is booming, and employing expatriates has inevitably become a strategy used by construction firms. However, stress arising from expatriate assignments can lead to early return, assignment failure, and staff turnover, causing in significant losses to an organisation. Extensive research has focused on the effectiveness of coping behaviours in relation to stress. However, studies investigating the antecedents of coping are rare. The limited studies to date tend to focus on content-based motivations (identifying what), instead of on how coping behaviours can be motivated in the stress management process (identifying how). Focus on expatriate construction professionals (ECPs) is further limited. Hence, this study aims to investigate from a process theory perspective the role of motivation in the stress management process. Using a qualitative interview study approach, involving 22 in-depth interviews, this study first identifies the content of motivation, coping behaviours, performance, and stress in the context of Hong Kong ECPs working on cross-cultural projects in China; it then unveils and explains the associations between the identified variables. Based on the results, stakeholders are recommended to review pre-departure training, so as to ensure that key elements such as personal awareness of stress (cognitive, affective, and physical), expectancies of coping strategies on stress (adaptive or maladaptive), and expectancies of the influence of stress on performance are covered.

The Roles of Motivation and Coping Behaviours in Managing Stress: Qualitative Interview Study of Hong Kong Expatriate Construction Professionals in Mainland China

PubMed Central

Chan, Isabelle Yee Shan; Leung, Mei-yung; Liang, Qi

2018-01-01

Driven by fast-growing economies worldwide, the number of international construction projects is booming, and employing expatriates has inevitably become a strategy used by construction firms. However, stress arising from expatriate assignments can lead to early return, assignment failure, and staff turnover, causing in significant losses to an organisation. Extensive research has focused on the effectiveness of coping behaviours in relation to stress. However, studies investigating the antecedents of coping are rare. The limited studies to date tend to focus on content-based motivations (identifying what), instead of on how coping behaviours can be motivated in the stress management process (identifying how). Focus on expatriate construction professionals (ECPs) is further limited. Hence, this study aims to investigate from a process theory perspective the role of motivation in the stress management process. Using a qualitative interview study approach, involving 22 in-depth interviews, this study first identifies the content of motivation, coping behaviours, performance, and stress in the context of Hong Kong ECPs working on cross-cultural projects in China; it then unveils and explains the associations between the identified variables. Based on the results, stakeholders are recommended to review pre-departure training, so as to ensure that key elements such as personal awareness of stress (cognitive, affective, and physical), expectancies of coping strategies on stress (adaptive or maladaptive), and expectancies of the influence of stress on performance are covered. PMID:29558458

Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change

ERIC Educational Resources Information Center

Geller, Josie; Dunn, Erin C.

2011-01-01

This paper focuses on the integration of Motivational Interviewing (MI) and cognitive behavioral therapy (CBT) in the treatment of eating disorders. Although CBT is regarded as the treatment of choice in this population, it nevertheless has limitations: some patients fail to engage, drop out from treatment prematurely, or simply do not improve.…

Motivational Interviewing with Parents of Overweight Children: Study Design and Methods for the NOURISH+MI Study

PubMed Central

Bean, Melanie K.; Jeffers, Amy J.; Tully, Carrie B.; Thornton, Laura M.; Mazzeo, Suzanne E.

2014-01-01

There is an urgent need for innovative approaches to pediatric obesity treatment. There is also a demand for targeted strategies that reduce attrition and improve treatment adherence. Intervening exclusively with parents of overweight children is a novel approach with demonstrated efficacy in reducing child body mass index (BMI) percentile. Motivational interviewing (MI), a brief communication style for exploring and resolving ambivalence about behavior change, might enhance treatment engagement when implemented as part of obesity interventions. The aim of this report is to provide the rationale and methods for a novel study of MI with parents in the treatment of their children’s overweight. We designed and are currently implementing NOURISH+MI, a randomized controlled trial examining the feasibility and efficacy of an adjunct values-based MI intervention, implemented within a culturally-tailored parent intervention for overweight children ages 5-11 years, NOURISH+ (Nourishing Our Understanding of Role modeling to Improve Support and Health). Specifically, we are randomly assigning 60 parents to this adjunctive treatment, and investigating if adding two MI sessions prior to the NOURISH+ group intervention will enhance treatment effects. We will be able to compare NOURISH+MI participants with those from the two NOURISH+ treatment conditions (NOURISH+ and control). We hypothesize that children whose parents participate in NOURISH+MI will demonstrate lower attrition and greater adherence with NOURISH+, ultimately leading to greater treatment effects, compared with children whose parents are randomized to NOURISH+ or a control group. Findings will contribute to the emerging literature examining the efficacy of MI within pediatric obesity interventions. PMID:24530488

Nurse-led motivational interviewing to change the lifestyle of patients with type 2 diabetes (MILD-project): protocol for a cluster, randomized, controlled trial on implementing lifestyle recommendations

PubMed Central

Jansink, Renate; Braspenning, Jozé; van der Weijden, Trudy; Niessen, Louis; Elwyn, Glyn; Grol, Richard

2009-01-01

Background The diabetes of many patients is managed in general practice; healthcare providers aim to promote healthful behaviors, such as healthful diet, adequate physical activity, and smoking cessation. These measures may decrease insulin resistance, improve glycemic control, lipid abnormalities, and hypertension. They may also prevent cardiovascular disease and complications of diabetes. However, professionals do not adhere optimally to guidelines for lifestyle counseling. Motivational interviewing to change the lifestyle of patients with type 2 diabetes is intended to improve diabetes care in accordance with the national guidelines for lifestyle counseling. Primary care nurses will be trained in motivational interviewing embedded in structured care in general practice. The aim of this paper is to describe the design and methods of a study evaluating the effects of the nurses' training on patient outcomes. Methods/Design A cluster, randomized, controlled trial involving 70 general practices (35 practices in the intervention arm and 35 in the control arm) starting in March 2007. A total of 700 patients with type 2 diabetes will be recruited. The patients in the intervention arm will receive care from the primary care nurse, who will receive training in an implementation strategy with motivational interviewing as the core component. Other components of this strategy will be adaptation of the diabetes protocol to local circumstances, introduction of a social map for lifestyle support, and educational and supportive tools for sustaining motivational interviewing. The control arm will be encouraged to maintain usual care. The effect measures will be the care process, metabolic parameters (glycosylated hemoglobin, blood pressure and lipids), lifestyle (diet, physical activity, smoking, and alcohol), health-related quality of life, and patients' willingness to change behaviors. The measurements will take place at baseline and after 14 months. Discussion Applying

Use of a Motivational Interviewing-Informed Strategy in Group Orientations to Improve Retention and Intervention Attendance in a Randomized Controlled Trial

ERIC Educational Resources Information Center

Xiao, Lan; Lv, Nan; Rosas, Lisa G.; Karve, Shweta; Luna, Veronica; Jameiro, Elizabeth; Wittels, Nancy; Ma, Jun

2016-01-01

High retention and treatment adherence are essential to ensure the quality of evidence from clinical trials. Strategies for improving these have been explored but actual rates in lifestyle intervention trials indicate challenges. This study examined the use of a motivational interviewing-informed strategy during interactive group orientations…

Evaluating Motivational Interviewing in the Physician Assistant Curriculum.

PubMed

Halbach, Patrick; Keller, Abiola O

2017-09-01

Motivational interviewing (MI) is an evidence-based technique that enables clinicians to help patients modify health behaviors. Although MI is an essential tool for physician assistants (PAs), the extent to which it is addressed in PA curricula in the United States is unknown. This study is a comprehensive description of MI education in PA programs in the United States. Data are from the 2014 Physician Assistant Education Association Annual Program Survey. Descriptive statistics were conducted on de-identified data from all 186 PA programs in the United States. Of the 186 PA programs surveyed, 72.58% (n = 135) reported at least one course providing MI training. Availability of courses providing training in skills essential to the MI process varied. Having a course with verbal communication training was most frequently endorsed, and having a course with training in developing discrepancy was least frequently endorsed. The most popular teaching modality was lecture (84.95%, n = 158), whereas only 41.40% (n = 77) and 58.60% (n = 109) reported role play with evaluation and standardized patient exercises with evaluation, respectively. More than 70% of programs included at least one course in their curriculum that provided training in MI, suggesting that PA programs recognize the importance of MI. Instruction in change talk was not provided in nearly half of the programs. Role-play and standardized patient exercises with evaluation were underused methods despite their proven efficacy in MI education. As the first comprehensive benchmark of MI education for PAs, this study shows that although most programs address MI, opportunities exist to improve MI training in PA programs in the United States.

Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence.

PubMed

Cook, Paul F; Bremer, Robert W; Ayala, A J; Kahook, Malik Y

2010-10-05

Adherence to glaucoma treatment is poor, potentially reducing therapeutic effects. A glaucoma educator was trained to use motivational interviewing (MI), a patient-centered counseling style, to improve adherence. This study was designed to evaluate whether MI was feasible in a busy ophthalmology practice. Feasibility was assessed using five criteria from the National Institutes of Health Behavior Change consortium: fidelity of intervention components to MI theory; success of the training process; delivery of MI-consistent interventions by the glaucoma educator; patient receipt of the intervention based on enrollment, attrition, and satisfaction; and patient enactment of changes in motivation and adherence over the course of the intervention. A treatment manual was designed by a multidisciplinary team with expertise in health psychology, public health, and ophthalmology. The glaucoma educator received 6 hours of training including role-play exercises, self-study, and individual supervision. His MI-related knowledge and skills increased following training, and he delivered exclusively MI-consistent interventions in 66% of patient encounters. 86% (12/14) of eligible patients agreed to be randomized into glaucoma educator support or a control condition. All 8 patients assigned to the glaucoma educator completed at least 2 of 6 planned contacts, and 50% (4/8) completed all 6 contacts. Patients assigned to the glaucoma educator improved over time in both motivation and adherence. The introduction of a glaucoma educator was feasible in a busy ophthalmology practice. Patients improved their adherence while participating in the glaucoma educator program, although this study was not designed to show a causal effect. The use of a glaucoma educator to improve glaucoma patients' medication adherence may be feasible at other ophthalmology clinics, and can be implemented with a standardized training approach. Pilot data show the intervention can be implemented with fidelity, is

Introducing Motivational Interviewing in a Sickness Insurance Context: Translation and Implementation Challenges.

PubMed

Ståhl, Christian; Gustavsson, Maria

2018-06-01

Purpose Motivational interviewing (MI) is a conversational method to support clients in need of behavioral change. In an organizational reform, most Swedish sickness insurance officials were trained in MI to promote clients' return to work (RTW) after sick leave. The aim of this article is to investigate experiences of introducing MI as a tool to promote clients' RTW within a sickness insurance context, with special focus on the translation and implementation of the method. Methods A qualitative approach, comprising 69 interviews with officials, managers, and regional coordinators on two occasions. The material was analyzed through qualitative content analysis. Results Officials were positive about MI, but the application was limited to using certain tools with extensive individual variation. Officials struggled with translating MI into a sickness insurance context, where the implementation strategy largely failed to offer adequate support, due to low managerial priority, competing initiatives, and a high workload. Results of the educational intervention could therefore be seen on an individual but not an organizational level. Conclusions In order to translate MI into a sickness insurance context, training needs to be supported by organizational approaches that promote collective learning and sharing of experiences among officials. The results also illustrate how a method cannot be assumed to be implemented simply because training has been provided. Consequently, the application of the method needs to be carefully monitored in studies of interventions where MI is claimed to be used, in order to measure its effectiveness.

Motivational interviewing and screening colonoscopy in high-risk individuals. A randomized controlled trial.

PubMed

Salimzadeh, Hamideh; Khabiri, Roghaye; Khazaee-Pool, Maryam; Salimzadeh, Somayeh; Delavari, Alireza

2018-06-01

To measure the impact of motivational interviewing (MI) on cancer knowledge and screening practice among first degree relatives (FDRs) of patients with colon cancer. This randomized controlled trial targeted patients with colon cancer first to recruit their possible FDRs. Digit randomization of the eligible index patients into intervention or control groups resulted in allocating their belonging FDRs to the same study arm. FDRs (n = 120) in intervention arm received MI counseling on phone by a trained oncology nurse and FDRs (n = 120) in control group received standard generic information by a physician on phone. Primary outcome was the rate of documented colonoscopy in FDRs within six months after the baseline. A total of 227 FDRs were followed up, 115 in the intervention and 112 in the control group. At follow-up, the uptake of screening colonoscopy in the intervention group was 83.5% versus 48.2% in controls (crude odds ratio, 5.4; 95% confidence interval, 2.9-10.0, P < .001). This was the first randomized controlled trial in Iran that confirmed the efficaciousness of a phone-based MI counseling in improving colonoscopy uptake among family members of patients with colon cancer. Phone-based motivational counseling that involves trained nurses or health providers seems to be feasible approach in Iran health system and enhances screening for colon cancer. Copyright © 2018 Elsevier B.V. All rights reserved.

Motivational interviewing by peer outreach workers: a pilot randomized clinical trial to retain adolescents and young adults in HIV care.

PubMed

Naar-King, Sylvie; Outlaw, Angulique; Green-Jones, Monique; Wright, Kathryn; Parsons, Jeffrey T

2009-07-01

Youth living with HIV (YLH) are at particularly high risk for poor retention in HIV primary care. This study utilized Motivational Interviewing (MI) to improve youth retention in primary care and compared the fidelity and outcomes of peer outreach workers (POW) to masters level staff (MLS). Eighty-seven YLH were randomized to receive two MI sessions from POW or MLS. YLH were aged 16-29 and 92% were African American. Thirty-seven audiotaped sessions were coded with the Motivational Interviewing Treatment Integrity (MITI) coding system. Retention in care was assessed by review of medical records. POW had higher fidelity on two MITI scales, and did not differ from MLS on remaining three scales. While both groups improved the regularity of primary care appointments, the effect size for POW on retention in care and intervention dose was larger than that of MLS. The results suggest that POW can provide MI with quality comparable to MLS with adequate training and supervision. MI provided by POW to improve retention in health care services may increase the cost-effectiveness of evidence-based practices in urban settings.

Argumentation in Science Class: Its Planning, Practice, and Effect on Student Motivation

NASA Astrophysics Data System (ADS)

Taneja, Anju

Studies have shown an association between argumentative discourse in science class, better understanding of science concepts, and improved academic performance. However, there is lack of research on how argumentation can increase student motivation. This mixed methods concurrent nested study uses Bandura's construct of motivation and concepts of argumentation and formative feedback to understand how teachers orchestrate argumentation in science class and how it affects motivation. Qualitative data was collected through interviews of 4 grade-9 science teachers and through observing teacher-directed classroom discourse. Classroom observations allowed the researcher to record the rhythm of discourse by characterizing teacher and student speech as teacher presentation (TP), teacher guided authoritative discussion (AD), teacher guided dialogic discussion (DD), and student initiation (SI). The Student Motivation Towards Science Learning survey was administered to 67 students before and after a class in which argumentation was used. Analysis of interviews showed teachers collaborated to plan argumentation. Analysis of discourse identified the characteristics of argumentation and provided evidence of students' engagement in argumentation in a range of contexts. Student motivation scores were tested using Wilcoxon signed rank tests and Mann-Whitney U-tests, which showed no significant change. However, one construct of motivation---active learning strategy---significantly increased. Quantitative findings also indicate that teachers' use of multiple methods in teaching science can affect various constructs of students' motivation. This study promotes social change by providing teachers with insight about how to engage all students in argumentation.

Motivational interviewing and the clinical science of Carl Rogers.

PubMed

Miller, William R; Moyers, Theresa B

2017-08-01

The clinical method of motivational interviewing (MI) evolved from the person-centered approach of Carl Rogers, maintaining his pioneering commitment to the scientific study of therapeutic processes and outcomes. The development of MI pertains to all 3 of the 125th anniversary themes explored in this special issue. Applications of MI have spread far beyond clinical psychology into fields including health care, rehabilitation, public health, social work, dentistry, corrections, coaching, and education, directly impacting the lives of many people. The public relevance and impact of clinical psychology are illustrated in the similarity of MI processes and outcomes across such diverse fields and the inseparability of human services from the person who provides them, in that both relational and technical elements of MI predict client outcomes. Within the history of clinical psychology MI is a clear product of clinical science, arising from the seminal work of Carl Rogers whose own research grounded clinical practice in empirical science. As with Rogers' work 70 years ago, MI began as an inductive empirical approach, observing clinical practice to develop and test hypotheses about what actually promotes change. Research on MI bridges the current divide between evidence-based practice and the well-established importance of therapeutic relationship. Research on training and learning of MI further questions the current model of continuing professional education through self-study and workshops as a way of improving practice behavior and client outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Mindfulness and motivational interviewing: two candidate methods for promoting self-management.

PubMed

Benzo, Roberto P

2013-08-01

There is no conclusive evidence about the way to a promote behavior change in self-management programs for patients with chronic obstructive pulmonary disease (COPD). The latter is a significant knowledge gap as there is a need to promote a sustained effect in interventions like Pulmonary Rehabilitation or Supporting Programs. Embracing patient's values seems to be a key ingredient to ignite genuine motivation for behavior change. This manuscript describes two pilot qualitative studies carried out in patients with severe COPD aimed to engage the patient inner experience and promote self-management: a trial testing motivational interviewing (MI) as one style of helping patients with severe COPD make changes in their behavior and second a trial testing a mindfulness-based intervention. The MI study consisted of a 3-month program of weekly coaching phone calls after one face-to-face visit. The following themes were outstanding: patients value the supportive communication with coach and believe the MI-based coaching created increased level of awareness and accountability. They perceived an increase in physical activity and reported "feeling better" or other benefits not directly related to exercise. The Mindfulness for Health Program was a mandatory 8-week program that consisted on 2-hour classes aimed to cultivate nonjudgmental attention in the moment (through different meditative practices and sharing) plus monthly face-to-face encounters aimed to sustain practice and sharing of life experiences for 1 year. The following themes (at 1 year) were outstanding: appreciating life by seeing hardships as opportunities, valuing the self through compassion and awareness, cultivating connectedness with others, acquiring joy, and adopting healthy behaviors. In the search for the "holy grail" for self-management programs that can promote a behavior change, mindfulness and MI seem promising for cultivating a way to live a life in which people are fully present and consciously

Motivational interviewing interventions and alcohol abuse among college students: a systematic review.

PubMed

Appiah-Brempong, Emmanuel; Okyere, Paul; Owusu-Addo, Ebenezer; Cross, Ruth

2014-01-01

The study sought to assess the effectiveness of Motivational Interviewing (MI) interventions in reducing alcohol consumption among college students, as compared to no intervention or alternative interventions. It also sought to identify the potential moderators to MI intervention effects. Database sources consulted included Cochrane Central Register of Control Trials, PsycINFO, PsycARTICLE, PsycLIT, CINAHL, and MEDLINE. Included studies were (1) underpinned by experimental, quasi-experimental, and nonexperimental designs; (2) studies in which participants were either college males only or females only or both; and (3) studies in which adaptations of MI were based on key MI principles. Excluded studies were (1) non-English language studies; (2) studies not published from 2000-2012; (3) studies in which participants were not college students; (4) studies in which intervention was not delivered by face-to-face approach; and (5) studies that failed to embark on postintervention follow-ups. A total of 115 abstracts were screened. These were narrowed down to 13 studies from which data for the study were extracted. Selected studies were underpinned by experimental, quasi-experimental, and nonexperimental designs. Owing to the heterogeneity in selected studies, a narrative synthesis was used. MI interventions were found to be effective in reducing alcohol consumption among college students, when compared to alternative interventions or no intervention. Potential moderators of MI intervention effects were identified to include practitioner's adherence to MI techniques and individual's drinking motives. MI presents itself as a promising tool that can augment the many existing social-environmental strategies of health promotion.

Maternal and newborn healthcare providers in rural Tanzania: in-depth interviews exploring influences on motivation, performance and job satisfaction.

PubMed

Prytherch, H; Kakoko, D C V; Leshabari, M T; Sauerborn, R; Marx, M

2012-01-01

Major improvements in maternal and neonatal health (MNH) remain elusive in Tanzania. The causes are closely related to the health system and overall human resource policy. Just 35% of the required workforce is actually in place and 43% of available staff consists of lower-level cadres such as auxiliaries. Staff motivation is also a challenge. In rural areas the problems of recruiting and retaining health staff are most pronounced. Yet, it is here that the majority of the population continues to reside. A detailed understanding of the influences on the motivation, performance and job satisfaction of providers at rural, primary level facilities was sought to inform a research project in its early stages. The providers approached were those found to be delivering MNH care on the ground, and thus include auxiliary staff. Much of the previous work on motivation has focused on defined professional groups such as physicians and nurses. While attention has recently broadened to also include mid-level providers, the views of auxiliary health workers have seldom been explored. In-depth interviews were the methodology of choice. An interview guideline was prepared with the involvement of Tanzanian psychologists, sociologists and health professionals to ensure the instrument was rooted in the socio-cultural setting of its application. Interviews were conducted with 25 MNH providers, 8 facility and district managers, and 2 policy-makers. Key sources of encouragement for all the types of respondents included community appreciation, perceived government and development partner support for MNH, and on-the-job learning. Discouragements were overwhelmingly financial in nature, but also included facility understaffing and the resulting workload, malfunction of the promotion system as well as health and safety, and security issues. Low-level cadres were found to be particularly discouraged. Difficulties and weaknesses in the management of rural facilities were revealed. Basic steps

The Characteristics and Motivations of Online Health Information Seekers: Cross-Sectional Survey and Qualitative Interview Study

PubMed Central

Inglis, Nadia; Ronnie, Jennifer; Large, Shirley

2011-01-01

Background Most households in the United Kingdom have Internet access, and health-related Internet use is increasing. The National Health Service (NHS) Direct website is the major UK provider of online health information. Objective Our objective was to identify the characteristics and motivations of online health information seekers accessing the NHS Direct website, and to examine the benefits and challenges of the health Internet. Methods We undertook an online questionnaire survey, offered to users of the NHS Direct website. A subsample of survey respondents participated in in-depth, semistructured, qualitative interviews by telephone or instant messaging/email. Questionnaire results were analyzed using chi-square statistics. Thematic coding with constant comparison was used for interview transcript analysis. Results In total 792 respondents completed some or all of the survey: 71.2% (534/750 with data available) were aged under 45 years, 67.4% (511/758) were female, and 37.7% (286/759) had university-level qualifications. They sought information for themselves (545/781, 69.8%), someone else (172/781, 22.0%), or both (64/781, 8.2%). Women were more likely than men to seek help for someone else or both themselves and someone else (168/509 vs 61/242, χ2 2 = 6.35, P = .04). Prior consultation with a health professional was reported by 44.9% (346/770), although this was less common in younger age groups (<36 years) (χ2 1 = 24.22, P < .001). Participants aged 16 to 75 years (n = 26, 20 female, 6 male) were recruited for interview by telephone (n = 23) and instant messaging/email (n = 3). Four major interview themes were identified: motivations for seeking help online; benefits of seeking help in this way and some of the challenges faced; strategies employed in navigating online health information provision and determining what information to use and to trust; and specific comments regarding the NHS Direct website service. Within the motivation category, four

A Meta-Analysis of Motivational Interviewing Process: Technical, Relational, and Conditional Process Models of Change

PubMed Central

Magill, Molly; Apodaca, Timothy R.; Borsari, Brian; Gaume, Jacques; Hoadley, Ariel; Gordon, Rebecca E.F.; Tonigan, J. Scott; Moyers, Theresa

2018-01-01

Objective In the present meta-analysis, we test the technical and relational hypotheses of Motivational Interviewing (MI) efficacy. We also propose an a priori conditional process model where heterogeneity of technical path effect sizes should be explained by interpersonal/relational (i.e., empathy, MI Spirit) and intrapersonal (i.e., client treatment seeking status) moderators. Method A systematic review identified k = 58 reports, describing 36 primary studies and 40 effect sizes (N = 3025 participants). Statistical methods calculated the inverse variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple target behaviors (i.e., alcohol use, other drug use, other behavior change). Results Therapist MI-consistent skills were correlated with more client change talk (r = .55, p < .001) as well as more sustain talk (r = .40, p < .001). MI-inconsistent skills were correlated with more sustain talk (r = .16, p < .001), but not change talk. When these indicators were combined into proportions, as recommended in the Motivational Interviewing Skill Code, the overall technical hypothesis was supported. Specifically, proportion MI consistency was related to higher proportion change talk (r = .11, p = .004) and higher proportion change talk was related to reductions in risk behavior at follow up (r = −.16, p < .001). When tested as two independent effects, client change talk was not significant, but sustain talk was positively associated with worse outcome (r = .19, p < .001). Finally, the relational hypothesis was not supported, but heterogeneity in technical hypothesis path effect sizes was partially explained by inter- and intra-personal moderators. Conclusions This meta-analysis provides additional support for the technical hypothesis of MI efficacy; future research on the relational hypothesis should occur in the field rather than in the context of clinical trials. PMID:29265832

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

PubMed

Magill, Molly; Apodaca, Timothy R; Borsari, Brian; Gaume, Jacques; Hoadley, Ariel; Gordon, Rebecca E F; Tonigan, J Scott; Moyers, Theresa

2018-02-01

In the present meta-analysis, we test the technical and relational hypotheses of Motivational Interviewing (MI) efficacy. We also propose an a priori conditional process model where heterogeneity of technical path effect sizes should be explained by interpersonal/relational (i.e., empathy, MI Spirit) and intrapersonal (i.e., client treatment seeking status) moderators. A systematic review identified k = 58 reports, describing 36 primary studies and 40 effect sizes (N = 3,025 participants). Statistical methods calculated the inverse variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple target behaviors (i.e., alcohol use, other drug use, other behavior change). Therapist MI-consistent skills were correlated with more client change talk (r = .55, p < .001) as well as more sustain talk (r = .40, p < .001). MI-inconsistent skills were correlated with more sustain talk (r = .16, p < .001), but not change talk. When these indicators were combined into proportions, as recommended in the Motivational Interviewing Skill Code, the overall technical hypothesis was supported. Specifically, proportion MI consistency was related to higher proportion change talk (r = .11, p = .004) and higher proportion change talk was related to reductions in risk behavior at follow up (r = -.16, p < .001). When tested as two independent effects, client change talk was not significant, but sustain talk was positively associated with worse outcome (r = .19, p < .001). Finally, the relational hypothesis was not supported, but heterogeneity in technical hypothesis path effect sizes was partially explained by inter- and intrapersonal moderators. This meta-analysis provides additional support for the technical hypothesis of MI efficacy; future research on the relational hypothesis should occur in the field rather than in the context of clinical trials. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

More than reflections: Empathy in motivational interviewing includes language style synchrony between therapist and client

PubMed Central

Lord, Sarah Peregrine; Sheng, Elisa; Imel, Zac E.; Baer, John; Atkins, David C.

2016-01-01

Empathy is a basic psychological process that involves the development of synchrony in dyads. It is also a foundational ingredient in specific, evidence-based behavioral treatments like motivational interviewing (MI). Ratings of therapist empathy typically rely on a gestalt, “felt sense” of therapist understanding and the presence of specific verbal behaviors like reflective listening. These ratings do not provide a direct test of psychological processes like behavioral synchrony that are theorized to be an important component of empathy in psychotherapy. To explore a new objective indicator of empathy, we hypothesized that synchrony in language style (i.e., matching how statements are phrased) between client and therapists would predict gestalt ratings of empathy over and above the contribution of reflections. We analyzed 122 MI transcripts with high and low empathy ratings based on the Motivational Interviewing Treatment Integrity (MITI) global rating scale. Linguistic inquiry and word count was used to estimate language style synchrony (LSS) of adjacent client and therapist talk turns. High empathy sessions showed greater LSS across 11 language style categories compared to low empathy sessions (p < .01), and overall, average LSS was notably higher in high empathy vs. low empathy sessions (d = 0.62). Regression analyses showed that LSS was predictive of empathy ratings over and above reflection counts; a 1 SD increase in LSS is associated with 2.4 times increase in the odds of a high empathy rating, controlling for therapist reflections (odds ratio = 2.4, 95% CI: 1.36, 4.24, p < .01). These findings suggest empathy ratings are related to synchrony in language style, over and above synchrony of content as measured by therapist reflections. Novel indicators of therapist empathy may have implications for the study of MI process as well as the training of therapists. PMID:25892166

A pilot test of a motivational interviewing social network intervention to reduce substance use among housing first residents.

PubMed

Kennedy, David P; Osilla, Karen Chan; Hunter, Sarah B; Golinelli, Daniela; Maksabedian Hernandez, Ervant; Tucker, Joan S

2018-03-01

This article presents findings of a pilot test of a Motivational Interviewing social network intervention (MI-SNI) to enhance motivation to reduce high risk alcohol and other drug (AOD) use among formerly homeless individuals transitioning to housing. Delivered in-person by a facilitator trained in MI, this four-session computer-assisted intervention provides personalized social network visualization feedback to help participants understand the people in their network who trigger their alcohol and other drug (AOD) use and those who support abstinence. If ready, participants are encouraged to make changes to their social network to help reduce their own high-risk behavior. Participants were 41 individuals (33 male, 7 female, 1 other; 23 African-American, 5 non-Latino White, 6 Latino, 7 other, mean age 48) who were transitioning from homelessness to permanent supportive housing. They were randomly assigned to either the MI-SNI condition or usual care. Readiness to change AOD use, AOD abstinence self-efficacy, and AOD use were assessed at baseline and shortly after the final intervention session for the MI-SNI arm and around 3-months after baseline for the control arm. Acceptability of the intervention was also evaluated. MI-SNI participants reported increased readiness to change AOD use compared to control participants. We also conducted a subsample analysis for participants at one housing program and found a significant intervention effect on readiness to change AOD use, AOD abstinence self-efficacy, and alcohol use compared to control participants. Participants rated the intervention as highly acceptable. We conclude that a brief computer-assisted Motivational Interviewing social network intervention has potential to efficaciously impact readiness to change AOD use, AOD abstinence self-efficacy, and AOD use among formerly homeless individuals transitioning to permanent supportive housing, and warrants future study in larger clinical trials. Copyright © 2017

Transformations of asymptotically AdS hyperbolic initial data and associated geometric inequalities

NASA Astrophysics Data System (ADS)

Cha, Ye Sle; Khuri, Marcus

2018-01-01

We construct transformations which take asymptotically AdS hyperbolic initial data into asymptotically flat initial data, and which preserve relevant physical quantities. This is used to derive geometric inequalities in the asymptotically AdS hyperbolic setting from counterparts in the asymptotically flat realm, whenever a geometrically motivated system of elliptic equations admits a solution. The inequalities treated here relate mass, angular momentum, charge, and horizon area. Furthermore, new mass-angular momentum inequalities in this setting are conjectured and discussed.

An Example of How to Supplement Goal Setting to Promote Behavior Change for Families Using Motivational Interviewing.

PubMed

Draxten, Michelle; Flattum, Colleen; Fulkerson, Jayne

2016-10-01

The purpose of this study was to describe the components and use of motivational interviewing (MI) within a behavior change intervention to promote healthful eating and family meals and prevent childhood obesity. The Healthy Home Offerings via the Mealtime Environment (HOME) Plus intervention was part of a two-arm randomized-controlled trial and included 81 families (children 8-12 years old and their parents) in the intervention condition. The intervention included 10 monthly, 2-hour group sessions and 5 bimonthly motivational/goal-setting phone calls. Data were collected for intervention families only at each of the goal-setting calls and a behavior change assessment was administered at the 10th/final group session. Descriptive statistics were used to analyze the MI call data and behavior assessment. Overall group attendance was high (68% attending ≥7 sessions). Motivational/goal-setting phone calls were well accepted by parents, with an 87% average completion rate. More than 85% of the time, families reported meeting their chosen goal between calls. Families completing the behavioral assessment reported the most change in having family meals more often and improving home food healthfulness. Researchers should use a combination of delivery methods using MI when implementing behavior change programs for families to promote goal setting and healthful eating within pediatric obesity interventions.

Does Motivational Interviewing (MI) Work with Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes

ERIC Educational Resources Information Center

Young, Tabitha L.; Gutierrez, Daniel; Hagedorn, W. Bryce

2013-01-01

This study investigated the relationships between motivational interviewing (MI) and client symptoms, attendance, and satisfaction. Seventy-nine clients attending a university-based counseling center were purposefully assigned to treatment or control conditions. Statistical analyses revealed client symptoms in both groups improved. However,…

Training a Spinal Cord Injury Rehabilitation Team in Motivational Interviewing

PubMed Central

Lusilla-Palacios, Pilar; Castellano-Tejedor, Carmina

2015-01-01

Background. An acute spinal cord injury (ASCI) is a severe condition that requires extensive and very specialized management of both physical and psychological dimensions of injured patients. Objective. The aim of the part of the study reported here was twofold: (1) to describe burnout, empathy, and satisfaction at work of these professionals and (2) to explore whether a tailored program based on motivational interviewing (MI) techniques modifies and improves such features. Methods. This paper presents findings from an intervention study into a tailored training for professionals (N = 45) working in a spinal cord injury (SCI) unit from a general hospital. Rehabilitation professionals' empathy skills were measured with the Jefferson Scale of Physician Empathy (JSPE), burnout was measured with the Maslach Burnout Inventory (MBI), and additional numeric scales were used to assess the perceived job-related stress and perceived satisfaction with job. Results. Findings suggest that professionals are performing quite well and they refer to satisfactory empathy, satisfaction at work, and no signs of burnout or significant stress both before and after the training. Conclusions. No training effect was observed in the variables considered in the study. Some possible explanations for these results and future research directions are discussed in depth in this paper. The full protocol of this study is registered in ClinicalTrials.gov (identifier: NCT01889940). PMID:26770827

Typologies of altruistic and financial motivations for research participation: A qualitative study of MSM in HIV vaccine trials

PubMed Central

Chin, Lisa J; Berenson, Jacqueline A.; Klitzman, Robert L

2016-01-01

Questions arise concerning participants’ motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and non-altruistic motives. Altruistic motivations emerged primarily, with nine typologies: 1) cultural; 2) community-related; 3) familial; 4) religious; 5) professional; 6) political (e.g., HIV activism); 7) moral (e.g., making up for past wrongs); 8) existential (e.g., providing sense of meaning); and 9) other psychological (e.g., emotional gratification). Views of compensation varied: not a factor (55%); added incentive (25%); main motivator, but in conjunction with altruism (15%); and primary motivator (5%). HVT participants thus often have both altruistic and financial motives, and related typologies emerged. These findings have critical implications for studies on HIV, other conditions, and research ethics. PMID:28251864

[Efficacy of motivational interviewing for reducing medication errors in chronic patients over 65 years with polypharmacy: Results of a cluster randomized trial].

PubMed

Pérula de Torres, Luis Angel; Pulido Ortega, Laura; Pérula de Torres, Carlos; González Lama, Jesús; Olaya Caro, Inmaculada; Ruiz Moral, Roger

2014-10-21

To evaluate the effectiveness of an intervention based on motivational interviewing to reduce medication errors in chronic patients over 65 with polypharmacy. Cluster randomized trial that included doctors and nurses of 16 Primary Care centers and chronic patients with polypharmacy over 65 years. The professionals were assigned to the experimental or the control group using stratified randomization. Interventions consisted of training of professionals and revision of patient treatments, application of motivational interviewing in the experimental group and also the usual approach in the control group. The primary endpoint (medication error) was analyzed at individual level, and was estimated with the absolute risk reduction (ARR), relative risk reduction (RRR), number of subjects to treat (NNT) and by multiple logistic regression analysis. Thirty-two professionals were randomized (19 doctors and 13 nurses), 27 of them recruited 154 patients consecutively (13 professionals in the experimental group recruited 70 patients and 14 professionals recruited 84 patients in the control group) and completed 6 months of follow-up. The mean age of patients was 76 years (68.8% women). A decrease in the average of medication errors was observed along the period. The reduction was greater in the experimental than in the control group (F=5.109, P=.035). RRA 29% (95% confidence interval [95% CI] 15.0-43.0%), RRR 0.59 (95% CI:0.31-0.76), and NNT 3.5 (95% CI 2.3-6.8). Motivational interviewing is more efficient than the usual approach to reduce medication errors in patients over 65 with polypharmacy. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Telephone-administered motivational interviewing to reduce risky sexual behavior in HIV-infected rural persons: a pilot randomized clinical trial.

PubMed

Cosio, David; Heckman, Timothy G; Anderson, Timothy; Heckman, Bernadette D; Garske, John; McCarthy, John

2010-03-01

Although several studies have characterized patterns and predictors of continued risky sexual behavior in HIV-infected rural persons, far less research has evaluated interventions to reduce risky sex in this group. This pilot randomized clinical trial compared 2 brief telephone-administered interventions designed to reduce continued risky sexual behaviors in HIV-infected rural persons. Participants were 79 HIV-infected rural persons who reported 1 or more occasions of unprotected anal, vaginal, or oral sex in the past 2 months. Participants were recruited through AIDS service organizations in rural areas of 27 states and assigned randomly to either a 2-session, motivational interviewing plus skills-building intervention (i.e., integrated intervention; n = 48) or a 2-session, skills-building only comparison intervention (n = 31). Participants completed self-report measures of sexual behaviors and factors related to risky sex at preintervention and 2-month follow-up. Before enrolling into the intervention, 37% of participants had 2 or more sexual partners in the past 2 months, 29% had sex with 1 or more partners without knowing their partners' HIV serostatus, and almost one-third of participants located sex partners in high-risk environments (e.g., public parks, roadside rest areas). A 2 x 2 repeated measures multivariate analyses of variance found that integrated intervention participants reported greater increases in risk-reduction motivation and greater increases in condom-protected vaginal and oral intercourse occasions at follow-up compared to skills-building only participants. Brief telephone-administered interventions that integrate motivational interviewing with skills-building show potential to reduce risky sexual behaviors in HIV-infected rural persons. Additional and large-scale evaluations of this intervention approach appear warranted.

Talking with consumers about energy reductions: recommendations from a motivational interviewing perspective

PubMed Central

Klonek, Florian E.; Kauffeld, Simone

2015-01-01

Reduction of energy costs has become a concern for many organizations. First, we review energy-saving studies in organizations in which consumers showed resistance to change their behavior. Second, we relate resistance to change to the psycholinguistic construct “sustain talk” that describes verbal arguments against behavior change (e.g., “Work processes have priority here”). Third, we argue how Motivational Interviewing (MI)—an interaction-approach to facilitate behavior change—might be helpful in dealing with this behavior. We transfer MI to interactions about energy-savings in organizations and demonstrate how qualification in MI for energy managers may affect these interactions. Therefore, we present three short case scenarios (i.e., video vignettes) that demonstrate socio-interactional mechanisms underlying energy-relevant decisions and behaviors. Consumer' verbal responses are graphed as one single time-variant index of readiness versus resistance (R-index) in order to illustrate interactional dynamics. In sum, we combine theoretical and empirical perspectives from multiple disciplines and discuss an innovative socio-interaction approach that may facilitate energy-efficient behavior in organizations. PMID:25821440

The relationship between baseline drinking status, peer motivational interviewing microskills and drinking outcomes in a brief alcohol intervention for matriculating college students: A replication

PubMed Central

Tollison, Sean J.; Mastroleo, Nadine R.; Mallett, Kimberly A.; Witkiewitz, Katie; Lee, Christine M.; Ray, Anne E.; Larimer, Mary E.

2013-01-01

The purpose of this study was to replicate and extend previous findings (Tollison, Lee, Neighbors, Neil, Olson, & Larimer, 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for more complex models to be tested in a sample with different characteristics than Tollison et al. (2008). Matriculating students who participated in high school sports (N = 327) took part in a Brief Alcohol Screening and Intervention for College Students (BASICS) led by peer facilitators trained in Motivational Interviewing. Participants were assessed pre- and immediately post-intervention on contemplation to change, as well as pre-, 5 months and 10 months post-intervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (MITI, Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Contrary to our previous study, results indicated that a higher number of open questions was positively related to increases in drinking, especially for heavier drinkers. Congruent with the previous study, more simple reflections was positively related to increases in drinking. Finally, this study revealed that heavier baseline drinking was associated with more simple reflections. There were no significant results found for changes in contemplation. Results corroborate previous findings that the excessive use of simple reflections may be indicative of counter therapeutic outcomes while raising questions about the relationship between the frequency of open questions and therapeutic outcomes. PMID:23312433

Advancing methods for reliably assessing motivational interviewing fidelity using the Motivational Interviewing Skills Code

PubMed Central

Lord, Sarah Peregrine; Can, Doğan; Yi, Michael; Marin, Rebeca; Dunn, Christopher W.; Imel, Zac E.; Georgiou, Panayiotis; Narayanan, Shrikanth; Steyvers, Mark; Atkins, David C.

2014-01-01

The current paper presents novel methods for collecting MISC data and accurately assessing reliability of behavior codes at the level of the utterance. The MISC 2.1 was used to rate MI interviews from five randomized trials targeting alcohol and drug use. Sessions were coded at the utterance-level. Utterance-based coding reliability was estimated using three methods and compared to traditional reliability estimates of session tallies. Session-level reliability was generally higher compared to reliability using utterance-based codes, suggesting that typical methods for MISC reliability may be biased. These novel methods in MI fidelity data collection and reliability assessment provided rich data for therapist feedback and further analyses. Beyond implications for fidelity coding, utterance-level coding schemes may elucidate important elements in the counselor-client interaction that could inform theories of change and the practice of MI. PMID:25242192

Motivational processes in mild cognitive impairment and Alzheimer's disease: results from the Motivational Reserve in Alzheimer's (MoReA) study.

PubMed

Forstmeier, Simon; Maercker, Andreas

2015-11-17

Brain reserve, i.e., the ability of the brain to tolerate age- and disease-related changes in a way that cognitive function is still maintained, is assumed to be based on the lifelong training of various abilities. The Motivational Reserve in Alzheimer's (MoReA) is a longitudinal study that aims to examine motivational processes as a protective factor in mild Alzheimer's dementia (AD) and mild cognitive impairment (MCI). This paper presents the results of motivational variables, frequency of diagnoses, and prediction of global cognition as well as depression in a one-year longitudinal study. The sample consists of 64 subjects with MCI and 47 subjects with mild AD at baseline. At baseline, the physical/neurological examinations, standard clinical assessment, neuropsychological testing, and assessment of motivational variables were performed. At follow-up (FU) one year later, neuropsychological testing including cognition, functional abilities, behavioral and affective symptoms, and global clinical assessments of severity have been repeated. AD cases have lower motivational capacities as measured with a midlife motivation-related occupational score and informant-reported present motivational processes, but do not differ with regard to delay of gratification (DoG) and self-reported motivational processes. DoG and delay discounting (DD) were relatively stable during the measurement interval. However, 20 % of the MCI cases converted to mild AD at FU, and 17 % of the mild AD cases converted to moderate AD. The rate of depression of Alzheimer's disease was 9 at baseline and 21 % at FU, and the rate of apathy was 7 and 14 %, respectively. Global cognition at FU was mainly predicted by baseline global cognition but also by one of the motivational variables (scenario test). Depression at FU was predicted mainly by two motivational variables (self-reported and informant-reported motivational processes). This research might inform motivation-related strategies for

Motivational interviewing to improve postabortion contraceptive uptake by young women: development and feasibility of a counseling intervention.

PubMed

Whitaker, A K; Quinn, M T; Martins, S L; Tomlinson, A N; Woodhams, E J; Gilliam, M

2015-10-01

The objective was to develop and test a postabortal contraception counseling intervention using motivational interviewing (MI) and to determine the feasibility, impact and patient acceptability of the intervention when integrated into an urban academic abortion clinic. A single-session postabortal contraception counseling intervention for young women aged 15-24 years incorporating principles, skills and style of MI was developed. Medical and social work professionals were trained to deliver the intervention, their competency was assessed, and the intervention was integrated into the clinical setting. Feasibility was determined by assessing ability to approach and recruit participants, ability to complete the full intervention without interruption and participant satisfaction with the counseling. We approached 90% of eligible patients and 71% agreed to participate (n=20). All participants received the full counseling intervention. The median duration of the intervention was 29 min. Immediately after the intervention and at the 1-month follow-up contact, 95% and 77% of participants reported that the session was helpful, respectively. MI counseling can be tailored to the abortion setting. It is feasible to train professionals to use MI principles, skills and style and to implement an MI-based contraception counseling intervention in an urban academic abortion clinic. The sessions are acceptable to participants. The use of motivational interviewing in contraception counseling may be an appropriate and effective strategy for increasing use of contraception after abortion. This study demonstrates that this patient-centered, directive and collaborative approach can be developed into a counseling intervention that can be integrated into an abortion clinic. Copyright © 2015 Elsevier Inc. All rights reserved.

Self-determination theory: its application to health behavior and complementarity with motivational interviewing

PubMed Central

2012-01-01

Mounting evidence implicates health behaviors (e.g., nutrition, physical activity, tobacco abstinence) in various health outcomes. As the science of behavior change has emerged, increasing emphasis has been placed on the use of theory in developing and testing interventions. Self-determination theory (SDT)-a theoretical perspective-and motivational interviewing (MI)-a set of clinical techniques-have both been used in health behavior intervention contexts. Although developed for somewhat different purposes and in relatively different domains, there is a good deal of conceptual overlap between SDT and MI. Accordingly, SDT may offer the theoretical backing that historically has been missing from MI, and MI may offer SDT some specific direction with respect to particular clinical techniques that have not been fully borne out within the confines of health related applications of SDT. Research is needed to empirically test the overlap and distinctions between SDT and MI and to determine the extent to which these two perspectives can be combined or co-exist as somewhat distinct approaches. PMID:22385676

Characteristics of community health organizations and decision-makers considering the adoption of motivational interviewing.

PubMed

Williams, Jessica Roberts; Dusablon, Tracy; Williams, Weston O; Blais, Marissa Puckett; Hennessy, Kevin D

2014-07-01

Research related to the adoption of comparative effectiveness research (CER) in mental health practice is limited. This study explores the factors that influence decisions to adopt motivational interviewing (MI)-an evidence-based practice (EBP) grounded in CER-among decision-makers (n = 311) in community health organizations (n = 92). Descriptive analyses focus on organization and decision-maker characteristics and processes that may influence the decision to adopt an EBP, including demographics, structure and operations, readiness, attitudes, barriers, and facilitators. Within-group agreement is examined to determine the degree to which participants within each organization gave similar responses. Results show characteristics differed according to type of organization (community health versus community behavioral health) and position (directors versus staff). Within-group agreement was also influenced by position. These findings indicate different strategies may be needed to best disseminate CER to the two groups.

Advancing methods for reliably assessing motivational interviewing fidelity using the motivational interviewing skills code.

PubMed

Lord, Sarah Peregrine; Can, Doğan; Yi, Michael; Marin, Rebeca; Dunn, Christopher W; Imel, Zac E; Georgiou, Panayiotis; Narayanan, Shrikanth; Steyvers, Mark; Atkins, David C

2015-02-01

The current paper presents novel methods for collecting MISC data and accurately assessing reliability of behavior codes at the level of the utterance. The MISC 2.1 was used to rate MI interviews from five randomized trials targeting alcohol and drug use. Sessions were coded at the utterance-level. Utterance-based coding reliability was estimated using three methods and compared to traditional reliability estimates of session tallies. Session-level reliability was generally higher compared to reliability using utterance-based codes, suggesting that typical methods for MISC reliability may be biased. These novel methods in MI fidelity data collection and reliability assessment provided rich data for therapist feedback and further analyses. Beyond implications for fidelity coding, utterance-level coding schemes may elucidate important elements in the counselor-client interaction that could inform theories of change and the practice of MI. Copyright © 2015 Elsevier Inc. All rights reserved.

Motivational Interviewing to Prevent Childhood Obesity: A Cluster RCT.

PubMed

Döring, Nora; Ghaderi, Ata; Bohman, Benjamin; Heitmann, Berit L; Larsson, Christel; Berglind, Daniel; Hansson, Lena; Sundblom, Elinor; Magnusson, Margaretha; Blennow, Margareta; Tynelius, Per; Forsberg, Lars; Rasmussen, Finn

2016-05-01

The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached age 4. Child health care centers in 8 Swedish counties were randomized into intervention and control units and included 1355 families with 1369 infants. Over ∼39 months, families in the intervention group participated in 1 group session and 8 individual sessions with a nurse trained in motivational interviewing, focusing on healthy food habits and physical activity. Families in the control group received care as usual. Primary outcomes were children's BMI, overweight prevalence, and waist circumference at age 4. Secondary outcomes were children's and mothers' food and physical activity habits and mothers' anthropometrics. Effects were assessed in linear and log-binominal regression models using generalized estimating equations. There were no statistically significant differences in children's BMI (β = -0.11, 95% confidence interval [CI]: -0.31 to 0.08), waist circumference (β = -0.48, 95% CI: -0.99 to 0.04), and prevalence of overweight (relative risk = 0.95, 95% CI: 0.69 to 1.32). No significant intervention effects were observed in mothers' anthropometric data or regarding mothers' and children's physical activity habits. There was a small intervention effect in terms of healthier food habits among children and mothers. There were no significant group differences in children's and mothers' anthropometric data and physical activity habits. There was, however, some evidence suggesting healthier food habits, but this should be interpreted with caution. Copyright © 2016 by the American Academy of Pediatrics.

Results from the Trial Using Motivational Interviewing, Positive Affect, and Self-Affirmation in African Americans with Hypertension (TRIUMPH).

PubMed

Boutin-Foster, Carla; Offidani, Emanuela; Kanna, Balavenkatesh; Ogedegbe, Gbenga; Ravenell, Joseph; Scott, Ebony; Rodriguez, Anna; Ramos, Rosio; Michelen, Walid; Gerber, Linda M; Charlson, Mary

2016-01-21

Our objective was to determine the effectiveness of combining positive affect and self-affirmation strategies with motivational interviewing in achieving blood pressure control among hypertensive African Americans (AA) compared with AA hypertensives in an education-only control group. Randomized trial. Ambulatory practices in the South Bronx and Harlem, New York City. African American adults with uncontrolled hypertension. Participants were randomized to a positive affect and self-affirmation intervention or an education control group. The positive affect and self-affirmation intervention involved having participants think about things that made them happy and that reminded them of their core values on a daily basis. These strategies were reinforced every two months through motivational interviewing. The control arm received a workbook of strategies on blood pressure control. All participants were called every two months for one year. Blood pressure control rate. A total of 238 participants were randomized. The average age was 56 ± 11 years, approximately 70% were female, 80% were not married, and up to 70% had completed high school. There was no difference in control rates between the intervention and the control group. However, at one year, female participants were more likely to be controlled. Participants with high depressive symptoms or high perceived stress at baseline were less likely to be controlled. While this study did not demonstrate an intervention effect, it does provide important insight into the psychosocial factors that may underlie blood pressure control in African Americans. Implications for future behavioral intervention trials are discussed.

Applying Motivational Interviewing to School-Based Consultation: A Commentary on "Has Consultation Achieved Its Primary Prevention Potential?," an Article by Joseph E. Zins

ERIC Educational Resources Information Center

Blom-Hoffman, Jessica; Rose, Gary S.

2007-01-01

Despite a decade of advances since Zins' 1995 article on prevention, much work lies ahead to make prevention everyday consultation activities for school psychologists. To foster prevention efforts, this commentary discusses how motivational interviewing in school-based consultation (a) might peak consultees' initial interest in change, and (b)…

Parent-teen behavior therapy + motivational interviewing for adolescents with ADHD.

PubMed

Sibley, Margaret H; Graziano, Paulo A; Kuriyan, Aparajita B; Coxe, Stefany; Pelham, William E; Rodriguez, Lourdes; Sanchez, Frances; Derefinko, Karen; Helseth, Sarah; Ward, Anthony

2016-08-01

This study evaluates a parent-teen skills-based therapy for attention deficit/hyperactivity disorder (ADHD) blended with motivational interviewing (MI) to enhance family engagement. Supporting Teens' Autonomy Daily (STAND) is an adolescent-specific treatment for ADHD that targets empirically identified adolescent (i.e., organization, time management, and planning, or OTP skills) and parent-based (i.e., monitoring and contingency management) mechanisms of long-term outcome through individual parent-teen sessions. The current randomized trial (N = 128) evaluates efficacy at posttreatment and 6-month follow-up. Participants were ethnically diverse teens (7.7% non-Hispanic White, 10.8% African American, 78.5% Hispanic, 3.0% other) randomly assigned to STAND or Treatment As Usual (TAU). Primary findings were that (1) STAND was delivered in an MI-adherent fashion and most families fully engaged in treatment (85% completed); (2) STAND produced a range of significant acute effects on ADHD symptoms, OTP skills, homework behavior, parent-teen contracting, implementation of home privileges, parenting stress, and daily homework recording; and (3) 6 months after treatment ceased, effects on ADHD symptom severity, OTP skills, and parenting stress maintained, while parent use of contracting and privilege implementation strategies, as well as teen daily homework recording and homework behavior gains, were not maintained. Skills-based behavior therapy blended with MI is an acutely efficacious treatment for adolescents with ADHD although more work is needed to establish the nature of long-term effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Motivational Interviewing Versus Cognitive Behavioral Group Therapy in the Treatment of Problem and Pathological Gambling: A Randomized Controlled Trial

PubMed Central

Carlbring, Per; Jonsson, Jakob; Josephson, Henrik; Forsberg, Lars

2009-01-01

Pathological gambling is a widespread problem with major implications for society and the individual. There are effective treatments, but little is known about the relative effectiveness of different treatments. The aim of this study was to test the effectiveness of motivational interviewing, cognitive behavioral group therapy, and a no-treatment control (wait-list) in the treatment of pathological gambling. This was done in a randomized controlled trial at an outpatient dependency clinic at Karolinska Institute (Stockholm, Sweden). A total of 150 primarily self-recruited patients with current gambling problems or pathological gambling according to an NORC DSM-IV screen for gambling problems were randomized to four individual sessions of motivational interviewing (MI), eight sessions of cognitive behavioral group therapy (CBGT), or a no-treatment wait-list control. Gambling-related measures derived from timeline follow-back as well as general levels of anxiety and depression were administered at baseline, termination, and 6 and 12 months posttermination. Treatment showed superiority in some areas over the no-treatment control in the short term, including the primary outcome measure. No differences were found between MI and CBGT at any point in time. Instead, both MI and CBGT produced significant within-group decreases on most outcome measures up to the 12-month follow-up. Both forms of intervention are promising treatments, but there is room for improvement in terms of both outcome and compliance. PMID:19967577

A randomized controlled trial of culturally adapted motivational interviewing for Hispanic heavy drinkers: Theory of Adaptation and Study Protocol

PubMed Central

Lee, Christina S.; Colby, Suzanne M.; Magill, Molly; Almeida, Joanna; Tavares, Tonya; Rohsenow, Damaris J.

2016-01-01

Background The NIH Strategic Plan prioritizes health disparities research for socially disadvantaged Hispanics, to reduce the disproportionate burden of alcohol-related negative consequences compared to other racial/ethnic groups. Cultural adaptation of evidence-based treatments, such as motivational interviewing (MI), can improve access and response to alcohol treatment. However, the lack of rigorous clinical trials designed to test the efficacy and theoretical underpinnings of cultural adaptation has made proof of concept difficult. Objective The CAMI2 (Culturally Adapted Motivational Interviewing) study design and its theoretical model, is described to illustrate how MI adapted to social and cultural factors (CAMI) can be discriminated against non-adapted MI. Methods and Design CAMI2, a large, 12 month randomized prospective trial, examines the efficacy of CAMI and MI among heavy drinking Hispanics recruited from the community (n=257). Outcomes are reductions in heavy drinking days (Time Line Follow-Back) and negative consequences of drinking among Hispanics (Drinkers Inventory of Consequences). A second aim examines perceived acculturation stress as a moderator of treatment outcomes in the CAMI condition. Summary The CAMI2 study design protocol is presented and the theory of adaptation is presented. Findings from the trial described may yield important recommendations on the science of cultural adaptation and improve MI dissemination to Hispanics with alcohol risk. PMID:27565832

Client Retrospective Accounts of Corrective Experiences in Motivational Interviewing Integrated With Cognitive Behavioral Therapy for Generalized Anxiety Disorder.

PubMed

Macaulay, Christianne; Angus, Lynne; Khattra, Jasmine; Westra, Henny; Ip, Jennifer

2017-02-01

A corrective experience (CE) is one "in which a person comes to understand or experience affectively an event or relationship in a different and unexpected way" (Castonguay & Hill, 2012, p. 5). CEs disconfirm clients' expectations based on past problematic experiences, and can be emotional, relational, behavioral, and/or cognitive. This qualitative study explored corrective shifts among recovered participants (N = 8) who had received motivational interviewing (MI) integrated with cognitive behavioral therapy (CBT) in a randomized controlled trial comparing CBT alone to MI-CBT for generalized anxiety disorder (Westra, Constantino, & Antony, 2016). We administered a posttherapy interview querying their experience of, and explanations for, any shifts in therapy. Grounded theory analysis yielded three core themes: in command of the worry train, experiencing myself in new ways in therapy, and oriented toward change. Findings are discussed in terms of MI theory, and clinical implications for therapists are provided. © 2016 Wiley Periodicals, Inc.

Development and reliability of a Motivational Interviewing Scenarios Tool for Eating Disorders (MIST-ED) using a skills-based intervention among caregivers.

PubMed

Sepulveda, Ana R; Wise, Caroline; Zabala, Maria; Todd, Gill; Treasure, Janet

2013-12-01

The aims of this study were to develop an eating disorder scenarios tool to assess the motivational interviewing (MI) skills of caregivers and evaluate the coding reliability of the instrument, and to test the sensitivity to change through a pre/post/follow-up design. The resulting Motivational Interview Scenarios Tool for Eating Disorders (MIST-ED) was administered to caregivers (n = 66) who were asked to provide oral and written responses before and after a skills-based intervention, and at a 3-month follow-up. Raters achieved excellent inter-rater reliability (intra-class correlations of 91.8% on MI adherent and 86.1% for MI non-adherent statements for written scenarios and 89.2%, and 85.3% for oral scenarios). Following the intervention, MI adherent statements increased (baseline = 9.4%, post = 61.5% and follow-up 47.2%) and non-MI adherent statements decreased (baseline = 90.6%, post = 38.5% and follow-up = 52.8%). This instrument can be used as a simple method to measure the acquisition of MI skills to improve coping and both response methods are adequate. The tool shows good sensitivity to improved skills. © 2013.

The Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda

PubMed Central

Bateganya, Moses H.; Lule, Haruna; Wanyenze, Rhoda K.

2016-01-01

Provider-initiated HIV testing and counseling (PITC) has rapidly expanded in many countries including Uganda. However, because it provides HIV prevention information without individualized risk assessment and risk reduction counseling it may create missed opportunities for effective HIV prevention counseling. Our objective was to assess the effect of a brief motivational interviewing-based intervention during outpatient PITC in rural Uganda compared to Uganda’s standard-of-care PITC at reducing HIV transmission-relevant sexual risk behavior. We enrolled 333 (160 control, 173 intervention) participants in a historical control trial to test the intervention vs. standard-of-care. Participants received PITC and standard-of-care or the intervention counseling and we assessed sexual risk behavior at baseline and 3 and 6 months follow-up. The intervention condition showed 1.5–2.4 times greater decreases in high risk sexual behavior over time compared to standard-of-care (p = 0.015 and p = 0.004). These data suggest that motivational interviewing based counseling during PITC may be a promising intervention to reduce high-risk sexual behavior and potentially reduce risk of HIV infection. PMID:27037546

The Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda.

PubMed

Kiene, Susan M; Bateganya, Moses H; Lule, Haruna; Wanyenze, Rhoda K

2016-09-01

Provider-initiated HIV testing and counseling (PITC) has rapidly expanded in many countries including Uganda. However, because it provides HIV prevention information without individualized risk assessment and risk reduction counseling it may create missed opportunities for effective HIV prevention counseling. Our objective was to assess the effect of a brief motivational interviewing-based intervention during outpatient PITC in rural Uganda compared to Uganda's standard-of-care PITC at reducing HIV transmission-relevant sexual risk behavior. We enrolled 333 (160 control, 173 intervention) participants in a historical control trial to test the intervention vs. standard-of-care. Participants received PITC and standard-of-care or the intervention counseling and we assessed sexual risk behavior at baseline and 3 and 6 months follow-up. The intervention condition showed 1.5-2.4 times greater decreases in high risk sexual behavior over time compared to standard-of-care (p = 0.015 and p = 0.004). These data suggest that motivational interviewing based counseling during PITC may be a promising intervention to reduce high-risk sexual behavior and potentially reduce risk of HIV infection.

I Move: systematic development of a web-based computer tailored physical activity intervention, based on motivational interviewing and self-determination theory

PubMed Central

2014-01-01

Background This article describes the systematic development of the I Move intervention: a web-based computer tailored physical activity promotion intervention, aimed at increasing and maintaining physical activity among adults. This intervention is based on the theoretical insights and practical applications of self-determination theory and motivational interviewing. Methods/design Since developing interventions in a systemically planned way increases the likelihood of effectiveness, we used the Intervention Mapping protocol to develop the I Move intervention. In this article, we first describe how we proceeded through each of the six steps of the Intervention Mapping protocol. After that, we describe the content of the I Move intervention and elaborate on the planned randomized controlled trial. Discussion By integrating self-determination theory and motivational interviewing in web-based computer tailoring, the I Move intervention introduces a more participant-centered approach than traditional tailored interventions. Adopting this approach might enhance computer tailored physical activity interventions both in terms of intervention effectiveness and user appreciation. We will evaluate this in an randomized controlled trial, by comparing the I Move intervention to a more traditional web-based computer tailored intervention. Trial registration NTR4129 PMID:24580802

A self-determination theory and motivational interviewing intervention to decrease racial/ethnic disparities in physical activity: rationale and design.

PubMed

Miller, Lauren S; Gramzow, Richard H

2016-08-11

Although the mental and physical benefits of physical activity are well-established, there is a racial/ethnic disparity in activity such that minorities are much less likely to engage in physical activity than are White individuals. Research suggests that a lack of motivation may be an important barrier to physical activity for racial/ethnic minorities. Therefore, interventions that increase participants' motivation may be especially useful in promoting physical activity within these groups. Physical activity interventions that utilized the clinical technique of motivational interviewing (MI) in conjunction with the theoretical background of self-determination theory (SDT) have been effective in increasing White individuals' physical activity. Nevertheless, it remains unclear the extent to which these results apply to minority populations. The current study involves conducting a 12-week physical activity intervention based on SDT and MI to promote physical activity in a racially/ethnically-diverse sample. It is hypothesized that this intervention will successfully increase physical activity in participants. Specifically, it is expected that minorities will experience a greater relative increase in physical activity than Whites within the intervention group because minorities are expected to have lower baseline levels of activity. Results from this study will give us a greater understanding of the generalizability of SDT interventions designed to improve motivation for physical activity and level of physical activity. Clinical Trials Gov. Identifier NCT02250950 Registered 24 September 2014.

Interviewing Practices, Conversational Practices, and Rapport: Responsiveness and Engagement in the Standardized Survey Interview.

PubMed

Garbarski, Dana; Schaeffer, Nora Cate; Dykema, Jennifer

2016-08-01

"Rapport" has been used to refer to a range of positive psychological features of an interaction -- including a situated sense of connection or affiliation between interactional partners, comfort, willingness to disclose or share sensitive information, motivation to please, or empathy. Rapport could potentially benefit survey participation and response quality by increasing respondents' motivation to participate, disclose, or provide accurate information. Rapport could also harm data quality if motivation to ingratiate or affiliate caused respondents to suppress undesirable information. Some previous research suggests that motives elicited when rapport is high conflict with the goals of standardized interviewing. We examine rapport as an interactional phenomenon, attending to both the content and structure of talk. Using questions about end-of-life planning in the 2003-2005 wave of the Wisconsin Longitudinal Study, we observe that rapport consists of behaviors that can be characterized as dimensions of responsiveness by interviewers and engagement by respondents. We identify and describe types of responsiveness and engagement in selected question-answer sequences and then devise a coding scheme to examine their analytic potential with respect to the criterion of future study participation. Our analysis suggests that responsive and engaged behaviors vary with respect to the goals of standardization-some conflict with these goals, while others complement them.

Interviewing Practices, Conversational Practices, and Rapport: Responsiveness and Engagement in the Standardized Survey Interview

PubMed Central

Garbarski, Dana; Schaeffer, Nora Cate; Dykema, Jennifer

2016-01-01

“Rapport” has been used to refer to a range of positive psychological features of an interaction -- including a situated sense of connection or affiliation between interactional partners, comfort, willingness to disclose or share sensitive information, motivation to please, or empathy. Rapport could potentially benefit survey participation and response quality by increasing respondents’ motivation to participate, disclose, or provide accurate information. Rapport could also harm data quality if motivation to ingratiate or affiliate caused respondents to suppress undesirable information. Some previous research suggests that motives elicited when rapport is high conflict with the goals of standardized interviewing. We examine rapport as an interactional phenomenon, attending to both the content and structure of talk. Using questions about end-of-life planning in the 2003–2005 wave of the Wisconsin Longitudinal Study, we observe that rapport consists of behaviors that can be characterized as dimensions of responsiveness by interviewers and engagement by respondents. We identify and describe types of responsiveness and engagement in selected question-answer sequences and then devise a coding scheme to examine their analytic potential with respect to the criterion of future study participation. Our analysis suggests that responsive and engaged behaviors vary with respect to the goals of standardization—some conflict with these goals, while others complement them. PMID:27867231

Cost-effectiveness of motivational intervention with significant others for patients with alcohol misuse.

PubMed

Shepard, Donald S; Lwin, Aung K; Barnett, Nancy P; Mastroleo, Nadine; Colby, Suzanne M; Gwaltney, Chad; Monti, Peter M

2016-05-01

To estimate the incremental cost, cost-effectiveness and benefit-cost ratio of incorporating a significant other (SO) into motivational intervention for alcohol misuse. We obtained economic data from the one year with the intervention in full operation for patients in a recent randomized trial. The underlying trial took place at a major urban hospital in the United States. The trial randomized 406 (68.7% male) eligible hazardous drinkers (196 during the economic study) admitted to the emergency department or trauma unit. The motivational interview condition consisted of one in-person session featuring personalized normative feedback. The significant other motivational interview condition comprised one joint session with the participant and SO in which the SO's perspective and support were elicited. We ascertained activities across 445 representative time segments through work sampling (including staff idle time), calculated the incremental cost in per patient of incorporating an SO, expressed the results in 2014 US$, incorporated quality and mortality effects from a closely related trial and derived the cost per quality-adjusted life-year (QALY) gained. From a health system perspective, the incremental cost per patient of adding an SO was $341.09 [95% confidence interval (CI) = $244.44-437.74]. The incremental cost per year per hazardous drinker averted was $3623 (CI = $1777-22,709), the cost per QALY gained $32,200 (CI = $15,800-201,700), and the benefit-cost ratio was 4.73 (95% CI = 0.7-9.66). If adding an SO into the intervention strategy were concentrated during the hours with highest risk or in a trauma unit, it would become even more cost-beneficial. Using criteria established by the World Health Organization (cost-effectiveness below the country's gross domestic product per capita), incorporating a significant other into a patient's motivational intervention for alcohol misuse is highly cost-effective. © 2015 Society for the Study of Addiction.

Motivational interviewing for HIV risk reduction among gay men in commercial and public sex settings.

PubMed

Harding, R; Dockrell, M J; Dockrell, J; Corrigan, N

2001-08-01

The present paper addresses the feasibility of combining motivational interviewing and cognitive interventions to HIV risk reduction in commercial venues and public sex environments (PSEs). The logic for these two approaches is considered and an intervention combining key elements of the two is presented. The intervention uses a questionnaire format to encourage individuals to compare their desired versus actual behaviour (i.e. chosen personal risk reduction strategy versus 'slip-ups'/unwanted risk taking), and to recognize their risk-related cognitions. High-risk individuals are identified, and health-focused conversations developed from the brief schedule. The structure and key design issues in the development of a feasible, acceptable and evidence-based tool are reviewed. The limitations of more complex, focused interventions in the context of commercial and PSE settings are discussed.

Costs of using motivational interviewing for problem drinking in the U.S. Air Force.

PubMed

Cowell, Alexander J; Brown, Janice M; Wedehase, Brendan J; Masuda, Yuta J

2010-12-01

Despite the popularity of motivational interviewing (MI) to address heavy drinking, limited evidence exists on the costs of using MI to address heavy drinking. This study examines the costs of using MI to address heavy drinking at four U.S. Air Force (USAF) bases. Clients were referred to and assessed at a base program to address their drinking as a result of an incident; those who were not alcohol dependent were invited to participate in the study. Participants consented and were randomly assigned to one of three intervention arms: individual MI (IMI), group MI (GMI), and Substance Abuse Awareness Seminar (SAAS). Three cost perspectives were taken: USAF, client, and the two combined. Data were collected from bases and public sources. The start-up cost per base ranged from $1340 to $2400 per provider staff member. Average implementation costs across bases were highest for the SAAS intervention ($148 per client).

lmplementing lifestyle change through phone-based motivational interviewing in rural-based women with previous gestational diabetes mellitus.

PubMed

Reinhardt, Judith A; van der Ploeg, Hidde P; Grzegrzulka, Richard; Timperley, Jennifer G

2012-04-01

Substantial numbers of women with past gestational diabetes mellitus (GDM) develop type 2 diabetes mellitus (T2DM). In northern New South Wales 23% of women attending diabetes services between 2007 and 2010 with T2DM previously had GDM. This study investigated whether phone-based lifestyle education using motivational interviewing resulted in positive lifestyle change post GDM for women in a large rural area. Thirty-eight women were recruited to this pilot study following GDM diagnosis and randomly allocated to either the control or intervention group. Following baseline assessment, the intervention group received a 6-month phone-based motivational interviewing program, and access to usual care. The control group received usual care only. Measures were collected at baseline (6 weeks postnatal), and at 6 months follow-up. Outcome measures included body mass index, diet, and physical activity. At follow-up, the intervention group compared to the control group significantly reduced total fat intake by -19 g/d (95%CI: -37 to -1), total carbohydrate intake by -42 g/d (95%CI: -82 to -1), and glycaemic load by -26 units (95%CI: -48 to -4). These women also increased leisure physical activity compared to the control group by 11 min/d (95%CI: 1 to 22); no significant change in total physical activity levels occurred. At follow-up, body mass index in the intervention group improved by -1.5 kg/m2 (95%CI: -2.8 to -0.1) compared to the control group. The intervention group showed positive trends across lifestyle variables compared to the control group. Further large-scale research on the effectiveness of phone-based lifestyle counselling following GDM is warranted.

Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial.

PubMed

Friederichs, Stijn A H; Oenema, Anke; Bolman, Catherine; Lechner, Lilian

2015-08-18

Our main objective in the current study was to evaluate the long-term effectiveness (12 months from baseline) of I Move (a web-based computer tailored physical activity intervention, based on self-determination theory and motivational interviewing). To this end, we compared I Move to a web-based computer tailored physical activity intervention based on traditional health behavior theories (Active Plus), and to a no-intervention control group. As a secondary objective, the present study aimed to identify participant characteristics that moderate the long term effects of I Move and Active Plus. A randomized controlled trial was conducted, comparing three research conditions: 1) the I Move condition, participants in this condition received I Move; 2) the Active Plus condition, participants in this condition received Active Plus; 3) the control condition; participants in this condition received no intervention and were placed on a waiting list. Main outcome measures were weekly minutes of moderate to vigorous physical activity and weekly days with minimal 30 min of physical activity. All measurements were taken by web-based questionnaires via the study website. Intervention effects were analyzed using multilevel linear regression analyses. At 12 months from baseline, I Move was found to be effective in increasing weekly minutes of moderate to vigorous physical activity (ES = .13), while Active Plus was not. In contrast, Active Plus was found to be effective in increasing weekly days with ≥ 30 min PA at 12 months (ES = .11), while I Move was not. No moderators of the effects of I Move were found. The results suggest that web-based computer tailored physical activity interventions might best include elements based on both self-determination theory/motivational interviewing and traditional health behavioral theories. To be more precise, it is arguable that the focus of the theoretical foundations, used in new web-based PA interventions should depend on the

The benefits of motivational interviewing and coaching for improving the practice of comprehensive family assessments in child welfare.

PubMed

Snyder, Elizabeth H; Lawrence, C Nicole; Weatherholt, Tara N; Nagy, Paul

2012-01-01

The engagement of families in child welfare services is critical for successful outcomes related to safety, permanency, and child and family well-being. Motivational interviewing (MI), an effective approach to working with individuals struggling with alcohol and drug addiction, has great appeal for use with families involved with the child welfare system. Consequently, many social service agencies are beginning to integrate MI into their training curriculum. However, research has shown that training in MI alone is not enough; ongoing coaching is crucial in order to transfer learned MI skills into practice.The current study employs qualitative interview data from case-workers in order to examine the implementation of MI and long-term coaching within the child welfare system. Findings showed that MI can be implemented successfully within the child welfare system, and that caseworkers believed MI, supported by ongoing coaching, to be a valuable tool in engaging families in the assessment process.

Action reflections: a client-centered technique to bridge the WHY-HOW transition in Motivational Interviewing.

PubMed

Resnicow, Ken; McMaster, Fiona; Rollnick, Stephen

2012-07-01

When using Motivational Interviewing (MI), once resistance or ambivalence are resolved and motivation is solidified, many practitioners struggle with how best to transition the discussion toward action planning, while still retaining the spirit and style of client centeredness, i.e., moving from the WHY phase to the HOW phase of counseling in a style that is MI-consistent. For many, there is a perception that the counseling style, skills, and strategies used to build motivation are distinct from those used in the action planning phase. The WHY to HOW transition does not, however, necessitate abandoning a client-centered style for a more overtly educational or directive style. Goal setting, action planning, provision of advice, and relapse prevention can be implemented from an autonomy supportive, MI consistent framework. To this end, this article will present a new class of reflection, which we have termed "action reflections", that can be used to help bridge the WHY-HOW gap. Action reflections (AR) allow the clinician to maintain a tone and orientation that are consistent with MI, i.e. autonomy support; guiding versus directing, during the action phase of counseling. They differ from reflecting change talk as they focus not on the WHY of change, but the HOW, WHEN, or WHERE. Action Reflections (ARs) also differ from the more common type of reflections such as those that focus on client feelings, rolling with resistance, or acknowledging ambivalence as ARs usually contain a potential concrete step that the client has directly or obliquely mentioned. Like any type of reflection, ARs represent the clinician's best guess for what the client has said or, more apropos here, where the conversation might be heading. This article describes the various types of ARs and provides examples of each to help clinicians incorporate them into their behavior change counseling.

The Trial Using Motivational Interviewing and Positive Affect and Self-Affirmation in African-Americans with Hypertension (TRIUMPH): From Theory to Clinical Trial Implementation

PubMed Central

Boutin-Foster, Carla; Scott, Ebony; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid; Charlson, Mary; Gbenga, Ogedegbe

2014-01-01

This paper describes the application of a translational research model in developing The Trial Using Motivational Interviewing and Positive Affect and Self-Affirmation in African-Americans with Hypertension (TRIUMPH), a theoretically-based, randomized controlled trial. TRIUMPH targets blood pressure control among African-Americans with hypertension in a community health center and public hospital setting. TRIUMPH applies positive affect, self-affirmation, and motivational interviewing as strategies to increase medication adherence and blood pressure control. A total of 220 participants were recruited in TRIUMPH and are currently being followed. This paper provides a detailed description of the theoretical framework and study design of TRIUMPH and concludes with a critical reflection of the lessons learned in the process of implementing a health behavior intervention in a community-based setting. TRIUMPH provides a model for incorporating the translational science research paradigm to conducting pragmatic behavioral trials in a real-world setting in a vulnerable population. Lessons learned through interactions with our community partners reinforce the value of community engagement in research. PMID:23403073

Motivation, Motivation Intensity, Use of Chinese and Self-Rated Chinese Competence

ERIC Educational Resources Information Center

Liu, Meihua

2017-01-01

This paper reports on the results of an investigation of the relationships between motivation, motivation intensity, use of Chinese outside of class and self-rated competence in Chinese. Analyses of 162 questionnaires and 17 semi-structured interviews revealed the following findings: (1) the participants reported having high integrative…

The Relationship between Baseline Drinking Status, Peer Motivational Interviewing Microskills, and Drinking Outcomes in a Brief Alcohol Intervention for Matriculating College Students: A Replication

ERIC Educational Resources Information Center

Tollison, Sean J.; Mastroleo, Nadine R.; Mallett, Kimberly A.; Witkiewitz, Katie; Lee, Christine M.; Ray, Anne E.; Larimer, Mary E.

2013-01-01

The purpose of this study was to replicate and extend previous findings (Tollison et al., 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for…

Antismoking Ads at the Point of Sale: The Influence of Ad Type and Context on Ad Reactions.

PubMed

Kim, Annice; Nonnemaker, James; Guillory, Jamie; Shafer, Paul; Parvanta, Sarah; Holloway, John; Farrelly, Matthew

2017-06-01

Efforts are underway to educate consumers about the dangers of smoking at the point of sale (POS). Research is limited about the efficacy of POS antismoking ads to guide campaign development. This study experimentally tests whether the type of antismoking ad and the context in which ads are viewed influence people's reactions to the ads. A national convenience sample of 7,812 adult current smokers and recent quitters was randomized to 1 of 39 conditions. Participants viewed one of the four types of antismoking ads (negative health consequences-graphic, negative social consequences-intended emotive, benefits of quitting-informational, benefits of quitting-graphic) in one of the three contexts (alone, next to a cigarette ad, POS tobacco display). We assessed participants' reactions to the ads, including perceived effectiveness, negative emotion, affective dissonance, and motivational reaction. Graphic ads elicited more negative emotion and affective dissonance than benefits of quitting ads. Graphic ads elicited higher perceived effectiveness and more affective dissonance than intended emotive ads. Antismoking ads fared best when viewed alone, and graphic ads were least influenced by the context in which they were viewed. These results suggest that in developing POS campaigns, it is important to consider the competitive pro-tobacco context in which antismoking ads will be viewed.

Design and Methods of a Synchronous Online Motivational Interviewing Intervention for Weight Management

PubMed Central

DiLillo, Vicki; Ingle, Krista; Harvey, Jean Ruth; West, Delia Smith

2016-01-01

Background While Internet-based weight management programs can facilitate access to and engagement in evidence-based lifestyle weight loss programs, the results have generally not been as effective as in-person programs. Furthermore, motivational interviewing (MI) has shown promise as a technique for enhancing weight loss outcomes within face-to-face programs. Objective This paper describes the design, intervention development, and analysis of a therapist-delivered online MI intervention for weight loss in the context of an online weight loss program. Methods The MI intervention is delivered within the context of a randomized controlled trial examining the efficacy of an 18-month, group-based, online behavioral weight control program plus individually administered, synchronous online MI sessions relative to the group-based program alone. Six individual 30-minute MI sessions are conducted in private chat rooms over 18 months by doctoral-level psychologists. Sessions use a semistructured interview format for content and session flow and incorporate core MI components (eg, collaborative agenda setting, open-ended questions, reflective listening and summary statements, objective data, and a focus on evoking and amplifying change talk). Results The project was funded in 2010 and enrollment was completed in 2012. Data analysis is currently under way and the first results are expected in 2016. Conclusions This is the first trial to test the efficacy of a synchronous online, one-on-one MI intervention designed to augment an online group behavioral weight loss program. If the addition of MI sessions proves to be successful, this intervention could be disseminated to enhance other distance-based weight loss interventions. Trial Registration Clinicaltrials.gov NCT01232699; https://clinicaltrials.gov/ct2/show/NCT01232699 PMID:27095604

Balancing workload, motivation and job satisfaction in Rwanda: assessing the effect of adding family planning service provision to community health worker duties.

PubMed

Chin-Quee, Dawn; Mugeni, Cathy; Nkunda, Denis; Uwizeye, Marie Rose; Stockton, Laurie L; Wesson, Jennifer

2016-01-06

Task shifting from higher cadre providers to CHWs has been widely adopted to address healthcare provider shortages, but the addition of any service can potentially add to an already considerable workload for CHWs. Objective measures of workload alone, such as work-related time and travel may not reflect howCHWs actually perceive and react to their circumstances. This study combined perception and objectivemeasures of workload to examine their effect on quality of services, worker performance, and job and clientsatisfaction. Three hundred eighty-three CHWs from control and intervention districts, where the intervention group was trained to provide contraceptive resupply, completed diaries of work-related activities for one month. Interviews were also conducted with a subset of CHWs and their clients. CHW diaries did not reveal significant differences between intervention and control groups in time spent on service provision or travel. Over 90% of CHWs reported workload manageability, job satisfaction, and motivation to perform their jobs. Clients were highly satisfied with CHW services and most stated preference for future services from CHWs. The study demonstrated that adding resupply of hormonal contraceptives to CHWs' tasks would not place undue burden on them. Accordingly, the initiative was scaled up in all 30 districts in the country.

Character Interviews Help Bring Literature to Life.

ERIC Educational Resources Information Center

Swindall, Vickie; Cantrell, R. Jeffrey

1999-01-01

Describes "Character Interviews," a class activity that guides children, especially reluctant readers, to the meaning of a story through a thoughtful understanding of character as they consider a character's emotions and motives, to respond to a question as that character would. Describes the interview process. Offers sample interviews…

Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease.

PubMed

Forstmeier, Simon; Maercker, Andreas; Maier, Wolfgang; van den Bussche, Hendrik; Riedel-Heller, Steffi; Kaduszkiewicz, Hanna; Pentzek, Michael; Weyerer, Siegfried; Bickel, Horst; Tebarth, Franziska; Luppa, Melanie; Wollny, Anja; Wiese, Birgitt; Wagner, Michael

2012-06-01

Midlife motivational abilities, that is, skills to initiate and persevere in the implementation of goals, have been related to mental and physical health, but their association with risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) has not yet been directly investigated. This relation was examined with data from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). A total of 3,327 nondemented participants (50.3% of a randomly selected sample) aged 75-89 years were recruited in primary care and followed up twice (after 1.5 and 3 years). Motivation-related occupational abilities were estimated on the basis of the main occupation (assessed at follow-up II) using the Occupational Information Network (O* NET) database, which provides detailed information on worker characteristics and abilities. Cox proportional hazards models were used to evaluate the relative risk of developing MCI and AD in relation to motivation-related occupational abilities, adjusting for various covariates. Over the 3 years of follow-up, 15.2% participants developed MCI and 3.0% developed AD. In a fully adjusted model, motivation-related occupational abilities were found to be associated with a reduced risk of MCI (HR: 0.77; 95% CI: 0.64-0.92). Motivation-related occupational abilities were associated with reduced risk of AD in ApoE ε4 carriers (HR: 0.48; CI: 0.25-0.91), but not in noncarriers (HR: 0.99; CI: 0.65-1.53). These results suggest that midlife motivational abilities are associated with reduced risk of MCI in general and with reduced risk of AD in ApoE ε4 carriers. Revealing the mechanisms underlying this association may inform novel prevention strategies for decelerating cognitive decline in old age. PsycINFO Database Record (c) 2012 APA, all rights reserved

An evaluation of training for lay providers in the use of Motivational Interviewing to promote academic achievement among urban youth

PubMed Central

Simon, Patricia; Ward, Nadia L.

2015-01-01

This study examined training outcomes for lay service providers who participated in a Motivational Interviewing (MI) training program designed to help increase intrinsic motivation and academic achievement among urban low-income and minority youth. Seventeen lay academic advisors received 16 hours of training in MI. Two, two-hour booster sessions plus five, two- hour weekly group supervision sessions were conducted with lay advisors over a period of seven months. One-hundred percent of lay advisors (n =17) participated in all training, booster sessions and assessments. Seventy-one percent of lay advisors (n=12) completed all group supervision sessions and submitted tapes for review. MI training was associated with increased knowledge of MI principles among lay service providers; increased proficiency in responding to simulated clients in an MI consistent style; increased use of MI adherent behaviors in sessions with real clients and maintenance of high motivation to use MI from pretest to posttest. Although lay advisors increased their knowledge of MI, further training is required for advisors to increase competence in delivering MI. Overall, Implications for using MI in the context of school-based settings is discussed. PMID:26356248

An evaluation of training for lay providers in the use of Motivational Interviewing to promote academic achievement among urban youth.

PubMed

Simon, Patricia; Ward, Nadia L

This study examined training outcomes for lay service providers who participated in a Motivational Interviewing (MI) training program designed to help increase intrinsic motivation and academic achievement among urban low-income and minority youth. Seventeen lay academic advisors received 16 hours of training in MI. Two, two-hour booster sessions plus five, two- hour weekly group supervision sessions were conducted with lay advisors over a period of seven months. One-hundred percent of lay advisors (n =17) participated in all training, booster sessions and assessments. Seventy-one percent of lay advisors (n=12) completed all group supervision sessions and submitted tapes for review. MI training was associated with increased knowledge of MI principles among lay service providers; increased proficiency in responding to simulated clients in an MI consistent style; increased use of MI adherent behaviors in sessions with real clients and maintenance of high motivation to use MI from pretest to posttest. Although lay advisors increased their knowledge of MI, further training is required for advisors to increase competence in delivering MI. Overall, Implications for using MI in the context of school-based settings is discussed.

Expressive Behavior in Parkinson's Disease as a Function of Interview Context

PubMed Central

Takahashi, Kayoko; Tickle-Degnen, Linda; Coster, Wendy J.; Latham, Nancy K.

2010-01-01

OBJECTIVE Parkinson's disease affects the ability to express motivation through face, body, and voice; contextual factors may facilitate or inhibit expressive behavior. The purpose of this study was to determine whether qualities of the interview context are associated with client motivational behavior in Parkinson's disease. METHOD Men and women with Parkinson's disease (N = 106) discussed 2 topics (enjoyable activity vs. frustrating activity) during an assessment with a female or male interviewer. From videotaped clips, displays of 4 categories of motivation and 12 verbal and 18 nonverbal behavioral patterns were rated. RESULTS During the discussion of enjoyable activities, participants used more positive words, smiled more, and were more facially expressive. Participants were less talkative about their negative feelings and appeared to be more apathetic with the same-gender interviewer. CONCLUSION Occupational therapy practitioners should vary the emotional tone of their questions to improve the validity of motivation assessments. PMID:20608279

Motivational Interviewing Skills in Health Care Encounters (MISHCE): Development and psychometric testing of an assessment tool.

PubMed

Petrova, Tatjana; Kavookjian, Jan; Madson, Michael B; Dagley, John; Shannon, David; McDonough, Sharon K

2015-01-01

Motivational interviewing (MI) has demonstrated a significant impact as an intervention strategy for addiction management, change in lifestyle behaviors, and adherence to prescribed medication and other treatments. Key elements to studying MI include training in MI of professionals who will use it, assessment of skills acquisition in trainees, and the use of a validated skills assessment tool. The purpose of this research project was to develop a psychometrically valid and reliable tool that has been designed to assess MI skills competence in health care provider trainees. The goal was to develop an assessment tool that would evaluate the acquisition and use of specific MI skills and principles, as well as the quality of the patient-provider therapeutic alliance in brief health care encounters. To address this purpose, specific steps were followed, beginning with a literature review. This review contributed to the development of relevant conceptual and operational definitions, selecting a scaling technique and response format, and methods for analyzing validity and reliability. Internal consistency reliability was established on 88 video recorded interactions. The inter-rater and test-retest reliability were established using randomly selected 18 from the 88 interactions. The assessment tool Motivational Interviewing Skills for Health Care Encounters (MISHCE) and a manual for use of the tool were developed. Validity and reliability of MISHCE were examined. Face and content validity were supported with well-defined conceptual and operational definitions and feedback from an expert panel. Reliability was established through internal consistency, inter-rater reliability, and test-retest reliability. The overall internal consistency reliability (Cronbach's alpha) for all fifteen items was 0.75. MISHCE demonstrated good inter-rater reliability and good to excellent test-retest reliability. MISHCE assesses the health provider's level of knowledge and skills in brief

Effect of a Motivational Interviewing-Based Health Coaching on Quality of Life in Subjects With COPD.

PubMed

Rehman, Hamid; Karpman, Craig; Vickers Douglas, Kristin; Benzo, Roberto P

2017-08-01

Improving quality of life (QOL) is a key goal in the care of patients with COPD. Pulmonary rehabilitation (PR) has clearly been shown to improve QOL, but is not accessible to many eligible patients. There is a need for alternative programs designed to improve patient well-being that are accessible to all patients with COPD. Our goal was to pilot test a simple, telephone-based health-coaching intervention that was recently shown to decrease readmission among hospitalized COPD patients and stable COPD patients eligible for PR. Subjects received a 3-month intervention consisting of 10 health-coaching telephone calls based on motivational interviewing principles. Outcome measures included dyspnea level, measured by the modified Medical Research Council scale, and QOL, measured by the Chronic Respiratory Questionnaire and a single-item general self-rated health status. Fifty subjects with moderate to severe COPD were enrolled in the study. Forty-four subjects (86%) completed the study intervention. Dyspnea measured by the modified Medical Research Council score improved significantly after the intervention ( P = .002). The domains of fatigue, emotional function, and mastery on the Chronic Respiratory Disease Questionnaire and the single-item QOL question also improved significantly after the 3 months of health coaching ( P = .001, P = .001, P = .007, and P = .03, respectively). Thirty-six (71%) subjects had a clinically meaningful improvement in at least 1 study end point (either in the severity of dyspnea or a domain of QOL). Thirty subjects (58%) had an improvement of ≥0.5 points, the minimum clinically important difference in at least 1 component of the Chronic Respiratory Disease Questionnaire. A telephone-delivered motivational interviewing-based coaching program for COPD patients is a feasible, well-accepted (by both participants and providers), simple, and novel intervention to improve the well-being of patients with COPD. This pilot study provides insight into

Single-session motivational interviewing for drug detoxification inpatients: effects on self-efficacy, stages of change and substance use.

PubMed

Berman, Anne H; Forsberg, Lars; Durbeej, Natalie; Källmén, Håkan; Hermansson, Ulric

2010-02-01

Thirty-five inpatients at a Stockholm hospital drug user detoxification unit received single-session Motivational Interviewing (MI) between 2006 and 2008. At baseline and after 3 months, they were compared to a semi-randomized control group of 52 patients with treatment as usual. In the MI group, self-efficacy increased regarding abstention in connection with positive feelings, appreciation of positive drug effects increased, and participants tended to transition toward preparation/action stages of change. Despite implementation challenges, the study demonstrates the feasibility and effectiveness of single-session MI delivery in the inpatient drug detoxification setting and suggests paths for future research on delivery of single-session MI.

Motivational Interviewing delivered by existing prison staff: a randomized controlled study of effectiveness on substance use after release.

PubMed

Forsberg, Lars Georg; Ernst, Denise; Sundqvist, Kristina; Farbring, Carl Åke

2011-01-01

A sample of 296 drug-using inmates in 14 Swedish prisons was randomized during 2004-2006 into three intervention groups; Motivational Interviewing delivered by counselors with workshop-only training, or by counselors with workshop training followed by peer group supervision, and controls. Drug and alcohol use was measured by the Addiction Severity Index (ASI) at intake and at 10 months after release. Complete data from 114 clients were analyzed by a stepwise regression analysis. All three groups reduced alcohol and drug use. Limitations in the study are discussed and future research is suggested. The study is financed by grants from the Research Committee of the National Prison and Probation Administration.

Using Service Learning to Improve Interviewer and Interviewee Effectiveness

ERIC Educational Resources Information Center

Mann, Melissa J.; Yanson, Regina; Lambert, Alysa D.

2018-01-01

Interviews are a critical component of assessing a candidate's fit in an organization. Students aspiring to be managers or human resource professionals will need to complete an interview to successfully gain employment and then, in turn, will be responsible for conducting interviews to effectively ascertain the capabilities and motivation of job…

A Systemic-Based Interview Guide: Its Validity and Economy in Comparison with an Unstructured Interview Approach--Experimental Results

ERIC Educational Resources Information Center

Kubinger, Klaus D.; Wiesflecker, Sabine; Steindl, Renate

2008-01-01

An interview guide for children and adolescents, which is based on systemic therapy, has recently been added to the collection of published instruments for psychological interviews. This article aims to establish the amount of information gained during a psychological investigation using the Systemic-based Interview Guide rather than an intuitive,…

PERSPECTIVE ON OPPORTUNITIES FOR RESEARCH AND INTERVENTIONS PROVIDED BY COMMUNITY BASED HEALTH INFORMATION SYSTEM ILLUSTRATED BY THE POTENTIAL USE OF MOTIVATIONAL INTERVIEWING INTERVENTION.

PubMed

Gisore, P; Were, F; Ayuku, D; Kaseje, D

2012-05-01

With the growth of Community-Based Health Information (CBHIS) for decision making and service provision in the low income settings, innovative models of addressing Maternal and Newborn Health (MNH) morbidity and mortality are necessary. World Health Organization (WHO) estimates that five hundred thousand mothers and about three million newborns die each year in middle and low income countries. To stimulate interest in utilisation CBHIS for research and interventions, with an illustration of potential using on Motivational Interviewing intervention. Literature searched electronically, discussion with behavioural experts, health system researchers, and maternal and Newborn Health (MNH) experts, and book reviews. Broad selection criteria including all current literature relevantsubjects including CBHIS, behaviour change methods and Community MNH. A checklist for relevance was used to identify the relevant behaviour change intervention to use in the illustration. A method that met the criteria was identified, and based on a discussion with behavioural experts, the decision to use it the illustration was reached. Motivational Interviewing Intervention (MII) should be considered for implementation and study on near-term Pregnant women in a setting where these mothers can be identified and a targeted intervention instituted.

[Motivational interviewing use for promoting health behavior: an approach of doctor/patient relationship].

PubMed

Benarous, X; Legrand, C; Consoli, S M

2014-05-01

Many situations in common medical practice, especially in chronic diseases, require patients to be mobilized for health behavior decisions: for daily intake of an antihypertensive drug, performing a mammography for cancer screening, as well as adopting new diet habits in diabetes. Ability to initiate a health behavior depends on several parameters. Some of them are related to the patient, his personality, his illness and treatment's perception; others directly rely on the physician, his attitude and his communication style during the visit, independently of patient's level of resistance to change. Motivational interviewing (MI) is a communication technique, first developed for patients presenting a substance abuse disorder, to explore their ambivalence, overcome their resistances and give them the willingness of a better self-care. Its general principles and basic techniques can be applied by every practitioner and deserve to be better known, given that scientific literature provides evidence for generalizing it in a variety of medical conditions, in structured patient education programs as well as in usual follow-up, for which time is generally restricted. This article provides an overview of MI recent applications and argues for its diffusion in everyday medical practice. Copyright © 2013. Published by Elsevier SAS.

Enhancing the Impact of Family Justice Centers via Motivational Interviewing: An Integrated Review.

PubMed

Simmons, Catherine A; Howell, Kathryn H; Duke, Michael R; Beck, J Gayle

2016-12-01

The Family Justice Center (FJC) model is an approach to assisting survivors of intimate partner violence (IPV) that focuses on integration of services under one roof and co-location of staff members from a range of multidisciplinary agencies. Even though the FJC model is touted as a best practice strategy to help IPV survivors, empirical support for the effectiveness of this approach is scarce. The current article consolidates this small yet promising body of empirically based literature in a clinically focused review. Findings point to the importance of integrating additional resources into the FJC model to engage IPV survivors who have ambivalent feelings about whether to accept help, leave the abusive relationship, and/or participate in criminal justice processes to hold the offender accountable. One such resource, motivational interviewing (MI), holds promise in aiding IPV survivors with these decisions, but empirical investigation into how MI can be incorporated into the FJC model has yet to be published. This article, therefore, also integrates the body of literature supporting the FJC model with the body of literature supporting MI with IPV survivors. Implications for practice, policy, and research are incorporated throughout this review. © The Author(s) 2015.

Shared Decision Making and Motivational Interviewing: Achieving Patient-Centered Care Across the Spectrum of Health Care Problems

PubMed Central

Elwyn, Glyn; Dehlendorf, Christine; Epstein, Ronald M.; Marrin, Katy; White, James; Frosch, Dominick L.

2014-01-01

Patient-centered care requires different approaches depending on the clinical situation. Motivational interviewing and shared decision making provide practical and well-described methods to accomplish patient-centered care in the context of situations where medical evidence supports specific behavior changes and the most appropriate action is dependent on the patient’s preferences. Many clinical consultations may require elements of both approaches, however. This article describes these 2 approaches—one to address ambivalence to medically indicated behavior change and the other to support patients in making health care decisions in cases where there is more than one reasonable option—and discusses how clinicians can draw on these approaches alone and in combination to achieve patient-centered care across the range of health care problems. PMID:24821899

Feedforward interview technique in obstetrics and gynaecology residents: a fact or fallacy.

PubMed

Sami, Shehla; Ahmad, Amina

2015-01-01

To determine the role of Feedforward Interview (FFI) technique in motivating residents of Obstetrics and Gynaecology for better learning and performance. An explorative study with mixed method approach being employed. Department of Obstetrics and Gynaecology, Sandeman (Provincial) Hospital, Quetta, from November 2010 till May 2013. Feedforward interview technique was complimented by survey questionnaire employing similar philosophy of FFI to triangulate data through two methods. Survey questionnaire was filled-up by 21 residents and analysed by SPSS version 17. Fourteen of these participants were identified for in-depth Feedforward Interviews (FFI), based on nonprobability purposive sampling after informed consent, and content analysis was done. Feedforward interview technique enabled majority of residents in recalling minimum of 3 positive experiences, mainly related to surgical experiences, which enhanced their motivation to aspire for further improvement in this area. Hard work was the main personal contributing factor both in FFI and survey. In addition to identifying clinical experiences enhancing desire to learn, residents also reported need for more academic support as an important factor which could also boost motivation to attain better performance. Feedforward interview technique not only helps residents in recalling positive learning experiences during their training but it also has a significant influence on developing insight about one's performance and motivating residents to achieve higher academic goals.

Influence of Motivational Interviewing on Explicit and Implicit Alcohol-Related Cognition and Alcohol Use in At-Risk Adolescents

PubMed Central

Thush, Carolien; Wiers, Reinout W.; Moerbeek, Mirjam; Ames, Susan L.; Grenard, Jerry L.; Sussman, Steve; Stacy, Alan W.

2011-01-01

Both implicit and explicit cognitions play an important role in the development of addictive behavior. This study investigated the influence of a single-session motivational interview (MI) on implicit and explicit alcohol-related cognition and whether this intervention was successful in consequently decreasing alcohol use in at-risk adolescents. Implicit and explicit alcohol-related cognitions were assessed at pretest and one month posttest in 125 Dutch at-risk adolescents ranging in age from 15 to 23 (51 males) with adapted versions of the Implicit Association Test (IAT) and an expectancy questionnaire. Motivation to change, alcohol use and alcohol-related problems were measured with self-report questionnaires, at pretest, at posttest after one month, and at the six-month follow-up. Although the quality of the intervention was rated positively, the results did not yield support for any differential effects of the intervention on drinking behavior or readiness to change at posttest and six-month follow-up. There were indications of changes in implicit and explicit alcohol-related cognitions between pretest and posttest. Our findings raise questions regarding the use of MI in this particular at-risk adolescent population and the mechanisms through which MI is effective. PMID:19290699

Parent-Teen Behavior Therapy + Motivational Interviewing for Adolescents with ADHD

PubMed Central

Sibley, Margaret H.; Graziano, Paulo A; Kuriyan, Aparajita B.; Coxe, Stefany; Pelham, William E.; Rodriguez, Lourdes; Sanchez, Frances; Derefinko, Karen; Helseth, Sarah; Ward, Anthony

2016-01-01

Objective This study evaluates a parent-teen skills-based therapy for ADHD blended with motivational interviewing (MI) to enhance family engagement. Supporting Teens’ Academic Needs Daily (STAND) is an adolescent-specific treatment for ADHD that targets empirically identified adolescent (i.e., organization, time management, and planning; OTP skills) and parent-based (i.e., monitoring and contingency management) mechanisms of long-term outcome through individual parent-teen sessions. Method The current randomized trial (N=128) evaluates efficacy at post-treatment and six-month follow-up. Participants were ethnically diverse teens (7.7% non-Hispanic White, 10.8% African-American, 78.5% Hispanic, 3.0% other) randomly assigned to STAND or Treatment As Usual (TAU). Results Primary findings were that: (1) STAND was delivered in an MI-adherent fashion and most families fully engaged in treatment (85% completed), (2) STAND produced a range of significant acute effects on ADHD symptoms, OTP skills, homework behavior, parent-teen contracting, implementation of home privileges, parenting stress, and daily homework recording, and (3) six months after treatment ceased, effects on ADHD symptom severity, OTP skills, and parenting stress maintained, while parent use of contracting and privilege implementation strategies, as well as teen daily homework recording and homework behavior gains, were not maintained. Conclusions Skills-based behavior therapy blended with MI is an acutely efficacious treatment for adolescents with ADHD although more work is needed to establish the nature of long-term effects. Public Health Significance A skills-based parent-teen behavior therapy blended with MI successfully engages families and leads to long-term improvement in parent-reported ADHD symptoms, organization skills, and parenting stress. Effects on school setting variables were less robust, requiring continued work to enhance these outcomes. PMID:27077693

Motivational interviewing in health care: results of a brief training in endocrinology.

PubMed

Bean, Melanie K; Biskobing, Diane; Francis, Gary L; Wickham, Edmond

2012-09-01

Despite the importance of lifestyle change in disease management and the growing evidence supporting motivational interviewing (MI) as an effective counseling method to promote behavioral change, to date there are few published reports about MI training in graduate medical education. The study aimed to pilot the feasibility and effectiveness of a brief MI training intervention for endocrinology fellows and other providers. We used a pretest/posttest design to evaluate a brief MI training for 5 endocrinology fellows and 9 other providers. All participants completed subjective assessments of perceived confidence and beliefs about behavioral counseling at pretest and posttest. Objective assessment of MI was conducted using fellows' audiotaped patient encounters, which were coded using a validated tool for adherence to MI before and after the training. Paired t tests examined changes in objective and subjective assessments. The training intervention was well received and feasible in the endocrinology setting. At posttest, participants reported increased endorsement of the MI spirit and improved confidence in MI skills. Objective assessment revealed relative improvements in MI skills across several domains. However, most domains, as assessed by a validated tool, did not reach competency level after the training intervention. Although more intensive training may be needed to develop MI competence, the results of our pilot study suggest that brief, targeted MI training has short-term efficacy and is well received by endocrinology fellows and other providers.

Divergent Thinking and Interview Ratings

ERIC Educational Resources Information Center

Batey, Mark; Rawles, Richard; Furnham, Adrian

2009-01-01

This study examined divergent thinking (DT) test scores of applicants taking part in a selection procedure for an undergraduate psychology degree (N = 370). Interviewers made six specific (creative intelligence, motivation, work habits, emotional stability, sociability, and social responsibility) and one overall recommendation rating on each…

Job Interviews: Keys for Results

ERIC Educational Resources Information Center

Miller, Donald S.; Catt, Stephen E.; Slocombe, Thomas E.

2014-01-01

Many students seem disinterested in learning to handle employment interviews effectively. This article discusses students' motivation to become skilled interviewees and steps educators and counselors can take to increase students' interest in this crucial career activity. The article also discusses mistakes students frequently make during…

Motivational Interviewing Support for a Behavioral Health Internet Intervention for Drivers with Type 1 Diabetes

PubMed Central

Ingersoll, Karen S.; Banton, Thomas; Gorlin, Eugenia; Vajda, Karen; Singh, Harsimran; Peterson, Ninoska; Gonder-Frederick, Linda; Cox, Daniel J.

2015-01-01

While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI) intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized to DD.com plus MI vs. DD.com only. The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t176 df= -2.25; p<.03) and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t177 df= -1.69; p<. 10) or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data. PMID:25774342

Adding Badging to a Marketing Simulation to Increase Motivation to Learn

ERIC Educational Resources Information Center

Saxton, M. Kim

2015-01-01

Badging has become a popular tool for obtaining social recognition for personal accomplishments. This innovation describes a way to add badging to a marketing simulation to increase student motivation to achieve the simulation's goals. Assessments indicate that badging both motivates students to perform better and helps explain students' perceived…

Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia.

PubMed

Kaleth, Anthony S; Slaven, James E; Ang, Dennis C

2018-01-01

Obesity is a common comorbid condition among patients with fibromyalgia (FM). Our objective was to assess if obesity moderates the treatment benefits of exercise-based motivational interviewing (MI) for FM. This is a secondary data analysis of a completed clinical trial of 198 FM patients who were randomized to receive either MI or attention control (AC). Using body mass index (BMI) to divide participants into obese (BMI≥30 kg/m) and nonobese (BMI<30 kg m) groups, mixed linear models were used to determine interaction between treatment arms and obesity status with regards to the primary outcome of global FM symptom severity (Fibromyalgia Impact Questionnaire, FIQ). Secondary measures included pain intensity (Brief Pain Inventory), 6-Minute Walk Test, and self-reported physical activity (Community Health Activities Model Program for Seniors). Of the 198 participants, 91 (46%) were nonobese and 107 (54%) were obese. On global FM symptom severity (FIQ), the interaction between treatment arms and obesity status was significant (P=0.02). In the nonobese group, MI was associated with a greater improvement in FIQ than AC. In the obese group, MI participants reported less improvement in FIQ compared with AC. The interaction analysis was also significant for Brief Pain Inventory pain intensity (P=0.01), but not for the walk test and self-reported physical activity. This is the first study to show that obesity negatively affects the treatment efficacy of MI in patients with FM. Our findings suggest that exercise-based MI may be more effective if initiated after weight loss is achieved.

“Old Dogs” and New Skills: How Clinician Characteristics Relate to Motivational Interviewing Skills Before, During, and After Training

PubMed Central

Carpenter, Kenneth M.; Cheng, Wendy Y.; Smith, Jennifer L.; Brooks, Adam C.; Amrhein, Paul C.; Wain, R. Morgan; Nunes, Edward V.

2012-01-01

Objective The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their Motivational Interviewing (MI) skills before, during, and after training were investigated. Method Fifty-eight community-based addiction clinicians (M = 42.1 yrs., SD =10.0; 66% Female) were assessed prior to enrolling in a two-day MI training workshop and being randomized to one of three post-workshop supervision programs: live supervision via tele-conferencing (TCS), standard tape-based supervision (Tape), or workshop training alone. Audiotaped sessions with clients were rated for MI skillfulness with the Motivational Interviewing Treatment Integrity (MITI) coding system v 2.0 at pre-workshop and 1, 8, and 20 weeks post-workshop. Correlation coefficients and generalized linear models were used to test the relationships between clinician characteristics and MI skill at each assessment point. Results Baseline MI skill levels were the most robust predictors of pre- and post-supervision performances. Clinician characteristics were associated with MI Spirit and reflective listening skill throughout training and moderated the effect of post-workshop supervision method on MI skill. TCS, which provided immediate feedback during practice sessions, was most effective for increasing MI Spirit and reflective listening among clinicians with no graduate degree and stronger vocabulary performances. Tape supervision was more effective for increasing these skills among clinicians with a graduate degree. Further, TCS and Tape were most likely to enhance MI Spirit among clinicians with low average to average verbal and abstract reasoning performances. Conclusions Clinician attributes influence the effectiveness of methods used to promote the acquisition of evidence-based practices among community-based practitioners. PMID:22563640

Integrating motivational interviewing and traditional practices to address alcohol and drug use among urban American Indian/Alaska Native youth

PubMed Central

Dickerson, Daniel L.; Brown, Ryan A.; Johnson, Carrie L.; Schweigman, Kurt; D’Amico, Elizabeth J.

2015-01-01

American Indians/Alaska Natives (AI/AN) exhibit high levels of alcohol and drug (AOD) use and problems. Although approximately 70% of AI/ANs reside in urban areas, few culturally relevant AOD use programs targeting urban AI/AN youth exist. Furthermore, federally-funded studies focused on the integration of evidence-based treatments with AI/AN traditional practices are limited. The current study addresses a critical gap in the delivery of culturally appropriate AOD use programs for urban AI/AN youth, and outlines the development of a culturally tailored AOD program for urban AI/AN youth called Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY). We conducted focus groups among urban AI/AN youth, providers, parents, and elders in two urban communities in northern and southern California aimed at 1) identifying challenges confronting urban AI/AN youth and 2) obtaining feedback on MICUNAY program content. Qualitative data were analyzed using Dedoose, a team-based qualitative and mixed methods analysis software platform. Findings highlight various challenges, including community stressors (e.g., gangs, violence), shortage of resources, cultural identity issues, and a high prevalence of AOD use within these urban communities. Regarding MICUNAY, urban AI/AN youth liked the collaborative nature of the motivational interviewing (MI) approach, especially with regard to eliciting their opinions and expressing their thoughts. Based on feedback from the youth, three AI/AN traditional practices (beading, AI/AN cooking, and prayer/sage ceremony) were chosen for the workshops. MICUNAY is the first AOD use prevention intervention program for urban AI/AN youth that integrates evidence-based treatment with traditional practices. This program addresses an important gap in services for this underserved population. PMID:26306776

How motivation influences breastfeeding duration among low-income women.

PubMed

Racine, Elizabeth F; Frick, Kevin D; Strobino, Donna; Carpenter, Laura M; Milligan, Renee; Pugh, Linda C

2009-05-01

In-depth interviews were conducted with 44 low-income breastfeeding women to explore the incentives and disincentives to breastfeeding experienced within 6 months postpartum. Using an individual net benefit maximization (INBM) framework based on economic theory, we assessed women's motivations, incentives, and disincentives for breastfeeding. Based on the framework and their experience breastfeeding, women fell into 3 groups: intrinsically motivated, extrinsically motivated, and successfully experienced with both intrinsic and extrinsic motivation. Successfully experienced women were most likely to breastfeed to 6 months. Intrinsically motivated women valued breastfeeding but often required information and instruction to reach breastfeeding goals. Extrinsically motivated women were least likely to continue breastfeeding even with support and instruction. Providers can screen women to determine their experience and motivation then tailor interventions accordingly. Intrinsically motivated women may need support and instruction, extrinsically motivated women may benefit from motivational interviewing, and successfully experienced women may need only minimal breastfeeding counseling.

A randomized, clinical trial of education or motivational-interviewing-based coaching compared to usual care to improve cancer pain management.

PubMed

Thomas, Mary Laudon; Elliott, Janette E; Rao, Stephen M; Fahey, Kathleen F; Paul, Steven M; Miaskowski, Christine

2012-01-01

To test the effectiveness of two interventions compared to usual care in decreasing attitudinal barriers to cancer pain management, decreasing pain intensity, and improving functional status and quality of life (QOL). Randomized clinical trial. Six outpatient oncology clinics (three Veterans Affairs [VA] facilities, one county hospital, and one community-based practice in California, and one VA clinic in New Jersey)Sample: 318 adults with various types of cancer-related pain. Patients were randomly assigned to one of three groups: control, standardized education, or coaching. Patients in the education and coaching groups viewed a video and received a pamphlet on managing cancer pain. In addition, patients in the coaching group participated in four telephone sessions with an advanced practice nurse interventionist using motivational interviewing techniques to decrease attitudinal barriers to cancer pain management. Questionnaires were completed at baseline and six weeks after the final telephone calls. Analysis of covariance was used to evaluate for differences in study outcomes among the three groups. Pain intensity, pain relief, pain interference, attitudinal barriers, functional status, and QOL. Attitudinal barrier scores did not change over time among groups. Patients randomized to the coaching group reported significant improvement in their ratings of pain-related interference with function, as well as general health, vitality, and mental health. Although additional evaluation is needed, coaching may be a useful strategy to help patients decrease attitudinal barriers toward cancer pain management and to better manage their cancer pain. By using motivational interviewing techniques, advanced practice oncology nurses can help patients develop an appropriate plan of care to decrease pain and other symptoms.

Use of Motivational Interviewing by Nurse Leaders: Coaching for Performance, Professional Development, and Career Goal Setting.

PubMed

Niesen, Cynthia R; Kraft, Sarah J; Meiers, Sonja J

Motivational interviewing (MI) is a mentoring style used in various health care settings to guide patients toward health promotion and disease management. The aims of this project were (1) to identify evidence supporting the application of MI strategies and principles by nurse leaders to promote healthful leadership development among direct-report staff and (2) to report outcomes of an educational pilot project regarding MI use for new nurse leaders. Correlations between MI and the American Organization of Nurse Executives nurse executive competencies are reviewed and summarized. These competencies shape the roles, responsibilities, and skills required for nurse executives to function proficiently and successfully within health care organizations. Survey responses were gathered from new nurse supervisors and nurse managers following the MI educational session for nurse leaders. The results show acceptability for MI use in professional development of direct-report staff and in other aspects of nursing leadership roles.

Validating a tool to measure auxiliary nurse midwife and nurse motivation in rural Nepal.

PubMed

Morrison, Joanna; Batura, Neha; Thapa, Rita; Basnyat, Regina; Skordis-Worrall, Jolene

2015-05-12

A global shortage of health workers in rural areas increases the salience of motivating and supporting existing health workers. Understandings of motivation may vary in different settings, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool, previously used in Kenya, and explored its validity and reliability to measure the motivation of auxiliary nurse midwives (ANM) and staff nurses (SN) in rural Nepal. Qualitative and quantitative methods were used to assess the content validity, the construct validity, the internal consistency and the reliability of the tool. We translated the tool into Nepali and it was administered to 137 ANMs and SNs in three districts. We collected qualitative data from 78 nursing personnel and district- and central-level stakeholders using interviews and focus group discussions. We calculated motivation scores for ANMs and SNs using the quantitative data and conducted statistical tests for validity and reliability. Motivation scores were compared with qualitative data. Descriptive exploratory analysis compared mean motivation scores by ANM and SN sociodemographic characteristics. The concept of self-efficacy was added to the tool before data collection. Motivation was revealed through conscientiousness. Teamwork and the exertion of extra effort were not adequately captured by the tool, but important in illustrating motivation. The statement on punctuality was problematic in quantitative analysis, and attendance was more expressive of motivation. The calculated motivation scores usually reflected ANM and SN interview data, with some variation in other stakeholder responses. The tool scored within acceptable limits in validity and reliability testing and was able to distinguish motivation of nursing personnel with different sociodemographic characteristics. We found that with minor modifications, the tool provided valid and internally consistent measures of motivation among ANMs

Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

PubMed

Cross, Samuel S; Baernholdt, Dr Marianne

2017-01-01

Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

Motivation in Gifted Students

ERIC Educational Resources Information Center

Phillips, Niki; Lindsay, Geoff

2006-01-01

This study investigated the factors which had influenced the role of motivation in the high levels of achievement of a sample of fifteen gifted students, aged 14/15 years, in five secondary schools in England. The students were interviewed individually, and their parents and teachers were also interviewed for validation of the students' comments.…

Cost-effectiveness of a motivational intervention for alcohol-involved youth in a hospital emergency department.

PubMed

Neighbors, Charles J; Barnett, Nancy P; Rohsenow, Damaris J; Colby, Suzanne M; Monti, Peter M

2010-05-01

Brief interventions in the emergency department targeting risk-taking youth show promise to reduce alcohol-related injury. This study models the cost-effectiveness of a motivational interviewing-based intervention relative to brief advice to stop alcohol-related risk behaviors (standard care). Average cost-effectiveness ratios were compared between conditions. In addition, a cost-utility analysis examined the incremental cost of motivational interviewing per quality-adjusted life year gained. Microcosting methods were used to estimate marginal costs of motivational interviewing and standard care as well as two methods of patient screening: standard emergency-department staff questioning and proactive outreach by counseling staff. Average cost-effectiveness ratios were computed for drinking and driving, injuries, vehicular citations, and negative social consequences. Using estimates of the marginal effect of motivational interviewing in reducing drinking and driving, estimates of traffic fatality risk from drinking-and-driving youth, and national life tables, the societal costs per quality-adjusted life year saved by motivational interviewing relative to standard care were also estimated. Alcohol-attributable traffic fatality risks were estimated using national databases. Intervention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening. The cost-effectiveness ratios for motivational interviewing were more favorable than standard care across all study outcomes and better for men than women. The societal cost per quality-adjusted life year of motivational interviewing was $8,795. Sensitivity analyses indicated that results were robust in terms of variability in parameter estimates. This brief intervention represents a good societal investment compared with other commonly adopted medical interventions.

Resident Assistant Workplace Motivation

ERIC Educational Resources Information Center

Boone, Katherine B.

2018-01-01

The sources of work motivation for resident assistants have received little attention in the literature over the last decade. As the role grows more complex and more expectations are added to the RA position, determining what current factors motivate students to apply for the RA position is essential. This study presents quantitative research to…

Parental views on childhood vaccination against viral gastroenteritis-a qualitative interview study.

PubMed

Lugg, Fiona V; Butler, Christopher C; Evans, Meirion R; Wood, Fiona; Francis, Nick A

2015-08-01

Gastroenteritis (GE) causes significant morbidity, especially in young children. A vaccine against rotavirus, a common cause of viral GE (vGE), was added to the childhood immunization schedule in the UK in July 2013 and further related vaccines are under development. To explore parents' beliefs about vGE and their attitudes towards vaccinating. Qualitative interview study with parents of children who had recently experienced an episode of GE. Twenty-eight semi-structured interviews were conducted over the phone with parents. Interviews were audio-recorded, transcribed and analysed using standard thematic approaches. Parents varied in their perception of the threat posed by GE, and parents who did not perceive GE as serious were less enthusiastic about vaccines. Other parents were supportive of vaccines in general and considered benefits to their child, their family and the wider community. Many parents said that they lacked knowledge about efficacy and effectiveness of GE vaccines but their underlying belief about the seriousness of illness motivated their attitudes. Acceptability of GE vaccines to parents could be improved by providing more information on both the burden of illness and the impact of rotavirus vaccine in other comparable countries. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Motivational Interviewing in Health Care: Results of a Brief Training in Endocrinology

PubMed Central

Bean, Melanie K.; Biskobing, Diane; Francis, Gary L.; Wickham, Edmond

2012-01-01

Background Despite the importance of lifestyle change in disease management and the growing evidence supporting motivational interviewing (MI) as an effective counseling method to promote behavioral change, to date there are few published reports about MI training in graduate medical education. Objective The study aimed to pilot the feasibility and effectiveness of a brief MI training intervention for endocrinology fellows and other providers. Methods We used a pretest/posttest design to evaluate a brief MI training for 5 endocrinology fellows and 9 other providers. All participants completed subjective assessments of perceived confidence and beliefs about behavioral counseling at pretest and posttest. Objective assessment of MI was conducted using fellows' audiotaped patient encounters, which were coded using a validated tool for adherence to MI before and after the training. Paired t tests examined changes in objective and subjective assessments. Results The training intervention was well received and feasible in the endocrinology setting. At posttest, participants reported increased endorsement of the MI spirit and improved confidence in MI skills. Objective assessment revealed relative improvements in MI skills across several domains. However, most domains, as assessed by a validated tool, did not reach competency level after the training intervention. Conclusions Although more intensive training may be needed to develop MI competence, the results of our pilot study suggest that brief, targeted MI training has short-term efficacy and is well received by endocrinology fellows and other providers. PMID:23997882

Why are adolescents addicted to online gaming? An interview study in Taiwan.

PubMed

Wan, Chin-Sheng; Chiou, Wen-Bin

2006-12-01

The purpose of this study was twofold: to investigate the conscious and unconscious psychological motivations of online game addicts, and to further discuss the relationship between surface and source motivations. Ten Taiwanese adolescents with online game addiction were selected for in-depth interviews. Through sentence completion test and semi-structured interviews, data were collected and analyzed from the following four realms: (1) surface motivations, (2) source motivations, (3) self-conception, and (4) interpersonal relationships in real life. After content analysis, five categories with distinct themes were formed: (1) addicts' psychological needs and motivations; (2) online games as the everyday focus of the addicts; (3) the interplay of real self and virtual self; (4) online games as the compensatory or extensive satisfaction for addicts' needs; and (5) addicts' self-reflections. The implications of the present study are discussed.

Integrated motivational interviewing and cognitive-behavioural therapy for bipolar disorder with comorbid substance use.

PubMed

Jones, Steven H; Barrowclough, Christine; Allott, Rory; Day, Christine; Earnshaw, Paul; Wilson, Ian

2011-01-01

Although comorbid substance use is a common problem in bipolar disorder, there has been little research into options for psychological therapy. Studies to date have concentrated on purely cognitive-behavioural approaches, which are not equipped to deal with the ambivalence to change exhibited by many towards therapy designed to change substance use. This paper provides the first report of an integrated psychological treatment approach for bipolar disorder with comorbid substance use. The intervention reported combines motivational interviewing and cognitive-behavioural therapy to address ambivalence and equips individuals with strategies to address substance use. Across five individual case studies, preliminary evidence is reported to support the acceptability and the feasibility of this approach. Despite most participants not highlighting their substance use as a primary therapy target, all but one exhibited reduced use of drugs or alcohol at the end of therapy, sustained at 6 months' follow-up. There was some evidence for improvements in mood symptoms and impulsiveness, but this was less clear-cut. The impact of social and relationship issues on therapy process and outcome is discussed. The implications of the current findings for future intervention research in this area are considered. Copyright © 2011 John Wiley & Sons, Ltd.

Motivation to Reduce Risk Behaviors While in Prison: Qualitative Analysis of Interviews with Current and Formerly Incarcerated Women

PubMed Central

Abad, Neetu; Carry, Monique; Herbst, Jeffrey H.; Fogel, Catherine I.

2015-01-01

Prison is an environment in which programs can be implemented to change harmful behaviors among high-risk populations. Incarcerated women experience high rates of HIV and other sexually transmitted diseases (STDs), yet little research has examined women’s motivation to reduce risky behaviors during incarceration. In-depth individual interviews were conducted with former and current women prisoners in two North Carolina correctional facilities and analyzed to identify barriers and facilitators of behavior change while in prison. Analyses revealed key motivators of behavior change: Viewing prison as a place to recover from past trauma, removing oneself from negative social networks, gaining access to needed mental and physical health services, and engaging in self-care and self-reflection. Barriers to behavior change include fear of recidivism, stigma of being in prison, and return to undesirable social networks post-release. Moreover, women noted that the provision of mental health services, educational enhancement and housing assistance could help them reduce engagement in high-risk behaviors after their incarceration. These findings can be incorporated into HIV/STD risk reduction interventions to facilitate positive behavior change among incarcerated women prisoners. Prison itself is a tremendous education in the need for patience and perseverance. It is above all a test of one’s commitment.—Nelson Mandela, 1995 PMID:26693183

Influence of motivational interviewing on explicit and implicit alcohol-related cognition and alcohol use in at-risk adolescents.

PubMed

Thush, Carolien; Wiers, Reinout W; Moerbeek, Mirjam; Ames, Susan L; Grenard, Jerry L; Sussman, Steve; Stacy, Alan W

2009-03-01

Both implicit and explicit cognitions play an important role in the development of addictive behavior. This study investigated the influence of a single-session motivational interview (MI) on implicit and explicit alcohol-related cognition and whether this intervention was successful in consequently decreasing alcohol use in at-risk adolescents. Implicit and explicit alcohol-related cognitions were assessed at pretest and one month posttest in 125 Dutch at-risk adolescents ranging in age from 15 to 23 (51 males) with adapted versions of the Implicit Association Test (IAT) and an expectancy questionnaire. Motivation to change, alcohol use and alcohol-related problems were measured with self-report questionnaires, at pretest, at posttest after one month, and at the six-month follow-up. Although the quality of the intervention was rated positively, the results did not yield support for any differential effects of the intervention on drinking behavior or readiness to change at posttest and six-month follow-up. There were indications of changes in implicit and explicit alcohol-related cognitions between pretest and posttest. Our findings raise questions regarding the use of MI in this particular at-risk adolescent population and the mechanisms through which MI is effective. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Motivation to Reduce Risk Behaviors While in Prison: Qualitative Analysis of Interviews with Current and Formerly Incarcerated Women.

PubMed

Abad, Neetu; Carry, Monique; Herbst, Jeffrey H; Fogel, Catherine I

2013-10-01

Prison is an environment in which programs can be implemented to change harmful behaviors among high-risk populations. Incarcerated women experience high rates of HIV and other sexually transmitted diseases (STDs), yet little research has examined women's motivation to reduce risky behaviors during incarceration. In-depth individual interviews were conducted with former and current women prisoners in two North Carolina correctional facilities and analyzed to identify barriers and facilitators of behavior change while in prison. Analyses revealed key motivators of behavior change: Viewing prison as a place to recover from past trauma, removing oneself from negative social networks, gaining access to needed mental and physical health services, and engaging in self-care and self-reflection. Barriers to behavior change include fear of recidivism, stigma of being in prison, and return to undesirable social networks post-release. Moreover, women noted that the provision of mental health services, educational enhancement and housing assistance could help them reduce engagement in high-risk behaviors after their incarceration. These findings can be incorporated into HIV/STD risk reduction interventions to facilitate positive behavior change among incarcerated women prisoners. Prison itself is a tremendous education in the need for patience and perseverance. It is above all a test of one's commitment.-Nelson Mandela, 1995.

A randomized trial of tailoring and motivational interviewing to promote fruit and vegetable consumption for cancer prevention and control.

PubMed

Campbell, Marci Kramish; Carr, Carol; Devellis, Brenda; Switzer, Boyd; Biddle, Andrea; Amamoo, M Ahinee; Walsh, Joan; Zhou, Bingqing; Sandler, Robert

2009-10-01

Healthful dietary patterns, including eating fruits and vegetables (F&V) and avoiding obesity, may decrease the risk of cancer and other chronic diseases. In addition to promoting health for the general population, a cancer diagnosis may provide a "teachable moment," facilitating the adoption of more healthful eating habits and leading to lower risk of chronic disease and better overall health. This study was designed to test the effectiveness of two health communication interventions in increasing F&V consumption and physical activity in a sample of older adults (average age of 66 years), including both colorectal cancer (CRC) survivors and noncolorectal cancer-affected (N-CRC) individuals. CRC survivors and N-CRC individuals were recruited from a population-based case-control study and randomly assigned to four conditions using a 2 x 2 design. We tested two different methods of communicating and promoting health behavior change alone or in combination: tailored print communication (TPC) and brief telephone-based motivational interviewing (TMI). A significant increase in F&V consumption was found for the combined intervention group in the entire sample (p < 0.05). When stratified by cancer survivor status, the effect was concentrated in the N-CRC subset (p < 0.01) versus CRC survivors. The combined intervention was also found to be most cost-effective for the N-CRC group, with TPC more cost-effective than TMI. For physical activity, none of the interventions produced statistically significant improvements. This study indicates that combining tailoring and motivational interviewing may be an effective and cost-effective method for promoting dietary behavior change among older healthy adults. More research is needed to identify the optimal dose and timing for intervention strategies to promote dietary and physical activity change among both CRC survivors and the general population.

Integrating Motivational Interviewing and Traditional Practices to Address Alcohol and Drug Use Among Urban American Indian/Alaska Native Youth.

PubMed

Dickerson, Daniel L; Brown, Ryan A; Johnson, Carrie L; Schweigman, Kurt; D'Amico, Elizabeth J

2016-06-01

American Indians/Alaska Natives (AI/AN) exhibit high levels of alcohol and drug (AOD) use and problems. Although approximately 70% of AI/ANs reside in urban areas, few culturally relevant AOD use programs targeting urban AI/AN youth exist. Furthermore, federally-funded studies focused on the integration of evidence-based treatments with AI/AN traditional practices are limited. The current study addresses a critical gap in the delivery of culturally appropriate AOD use programs for urban AI/AN youth, and outlines the development of a culturally tailored AOD program for urban AI/AN youth called Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY). We conducted focus groups among urban AI/AN youth, providers, parents, and elders in two urban communities in northern and southern California aimed at 1) identifying challenges confronting urban AI/AN youth and 2) obtaining feedback on MICUNAY program content. Qualitative data were analyzed using Dedoose, a team-based qualitative and mixed methods analysis software platform. Findings highlight various challenges, including community stressors (e.g., gangs, violence), shortage of resources, cultural identity issues, and a high prevalence of AOD use within these urban communities. Regarding MICUNAY, urban AI/AN youth liked the collaborative nature of the motivational interviewing (MI) approach, especially with regard to eliciting their opinions and expressing their thoughts. Based on feedback from the youth, three AI/AN traditional practices (beading, AI/AN cooking, and prayer/sage ceremony) were chosen for the workshops. To our knowledge, MICUNAY is the first AOD use prevention intervention program for urban AI/AN youth that integrates evidence-based treatment with traditional practices. This program addresses an important gap in services for this underserved population. Copyright © 2015. Published by Elsevier Inc.

Psychological heterogeneity in AD/HD--a dual pathway model of behaviour and cognition.

PubMed

Sonuga-Barke, Edmund J S

2002-03-10

Psychological accounts have characterised attention-deficit/hyperactivity disorder (AD/HD) as either a neuro-cognitive disorder of regulation or a motivational style. Poor inhibitory control is thought to underpin AD/HD children's dysregulation while delay aversion is a dominant characteristic of their motivational style. A recent 'head to head' study of these two accounts suggest that delay aversion and poor inhibitory control are independent co-existing characteristics of AD/HD (combined type). In the present paper we build on these findings to propose a dual pathway model of AD/HD that recognises two quite distinct sub-types of the disorder. In one AD/HD is the result of the dysregulation of action and thought resulting from poor inhibitory control associated with the meso-cortical branch of the dopamine system projecting in the cortical control centres (e.g. pre-frontal cortex). In the other AD/HD is a motivational style characterised by an altered delay of reward gradient linked to the meso-limbic dopamine branch associated with the reward circuits (e.g. nucleus accumbens). The two pathways are further distinguished at the levels of symptoms, cognitive and motivation profiles and genetic and non-genetic origins.

Predisposition for Empathy, Intercultural Sensitivity, and Intentions for Using Motivational Interviewing in First Year Pharmacy Students

PubMed Central

Kavookjian, Jan; Hutchison, Amber

2017-01-01

Objective. To assess first-year pharmacy (P1) students’ predispositions (eg, perceptions for empathy, intercultural sensitivity, and motivational interviewing (MI) as a patient-centered communication skillset) and identify potential curricula content/communication skills training needs. Methods. A cross-sectional survey was used to collect students’ self-reported perceptions for empathy, intercultural sensitivity, counseling contexts, and projected future MI use. Relationships between variables were explored and logistic regression was used to evaluate intention for using MI in future patient encounters. Results. There were 134 students who participated. Higher predisposition for empathy and for intercultural sensitivity were significantly correlated. Significant predictors for applying MI in future patient encounters were sex, confidence with counseling skills, and current use of MI. Conclusion. Results suggest the need to incorporate innovative training strategies in communication skills curricula. Potential areas include empathy, intercultural sensitivity and significant predictor variables for future MI use. Further investigation in other schools is needed. PMID:29200452

Predisposition for Empathy, Intercultural Sensitivity, and Intentions for Using Motivational Interviewing in First Year Pharmacy Students.

PubMed

Ekong, Gladys; Kavookjian, Jan; Hutchison, Amber

2017-10-01

Objective. To assess first-year pharmacy (P1) students' predispositions (eg, perceptions for empathy, intercultural sensitivity, and motivational interviewing (MI) as a patient-centered communication skillset) and identify potential curricula content/communication skills training needs. Methods. A cross-sectional survey was used to collect students' self-reported perceptions for empathy, intercultural sensitivity, counseling contexts, and projected future MI use. Relationships between variables were explored and logistic regression was used to evaluate intention for using MI in future patient encounters. Results. There were 134 students who participated. Higher predisposition for empathy and for intercultural sensitivity were significantly correlated. Significant predictors for applying MI in future patient encounters were sex, confidence with counseling skills, and current use of MI. Conclusion. Results suggest the need to incorporate innovative training strategies in communication skills curricula. Potential areas include empathy, intercultural sensitivity and significant predictor variables for future MI use. Further investigation in other schools is needed.

Computer-Assisted Motivational Interviewing Intervention to Facilitate Teen Pregnancy Prevention and Fitness Behavior Changes: A Randomized Trial for Young Men.

PubMed

Bell, David L; Garbers, Samantha; Catallozzi, Marina; Hum, R Stanley; Nechitilo, Meredith; McKeague, Ian W; Koumans, Emilia H; House, L Duane; Rosenthal, Susan L; Gold, Melanie A

2018-03-01

Despite recent declines, teen unintended pregnancy and sexually transmitted infections in the United States remain at levels higher than comparable nations. Initiatives to prevent teen pregnancy have focused primarily on female adolescents; how to effectively engage young men to reduce their risk of fathering a teen pregnancy has not been well studied. We proposed to adapt an innovative computer-assisted motivational interviewing (CAMI) intervention, originally designed and tested with young women, for use with young men, aged 15-24 years, to reduce their risk of fathering a teen pregnancy. This manuscript describes the design of a CAMI intervention for young men aimed at preventing teen pregnancy and improving fitness. This randomized controlled trial will recruit 945 sexually active young men between the ages of 15 and 24 years from three health centers in New York City. Participants will be assigned by permuted block randomization to two study arms: one aimed at reducing involvement in unintended teen pregnancy (CAMI-teen pregnancy prevention) and the other at improving overall fitness (CAMI-Fitness). Except for topic, both intervention arms will provide four sessions of Motivational Interviewing coaching and use a mobile app to track behavior and set goals. We will assess young men's sexual and reproductive health behaviors and fitness at baseline, 12, 24, 36, and 64 weeks using a mobile device app created for the study. Pending ongoing study. Results from the study are expected to enhance our understanding of the efficacy of CAMI to enhance young men's reproductive health and fitness behaviors. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

College Seniors' Theory of Their Academic Motivation

ERIC Educational Resources Information Center

Van Etten, Shawn; Pressley, Michael; McInerney, Dennis M.; Liem, Arief Darmanegara

2008-01-01

College seniors participated in an ethnographic interview study about their academic motivations. It was found that grades and graduation are 2 primary distal target goals that motivate their academic efforts during the senior year. A variety of proximal factors were also reported to affect the seniors' motivation. These factors can be divided…

Surgeons' motivation for choice of workplace.

PubMed

Kähler, Lena; Kristiansen, Maria; Rudkjøbing, Andreas; Strandberg-Larsen, Martin

2012-09-01

To ensure qualified health care professionals at public hospitals in the future, it is important to understand which factors attract health care professionals to certain positions. The aim of this study was to explore motives for choosing employment at either public or private hospitals in a group of Danish surgeons, as well as to examine if organizational characteristics had an effect on motivation. Eight qualitative interviews were conducted with surgeons from both public and private hospitals sampled using the snowball method. The interviews were based on a semi-structured interview guide and analyzed by means of phenomenological theory. Motivational factors such as personal influence on the job, the opportunity to provide the best possible patient care, challenging work tasks colleagues, and ideological reasons were emphasized by the surgeons as important reasons for their choice of employment. Motivational factors appeared to be strongly connected to the structure of the organization; especially the size of the organization was perceived to be essential. It is worth noting that salary, in contrast to the general belief, was considered a secondary benefit rather than a primary motivational factor for employment. The study revealed that motivational factors are multidimensional and rooted in organizational structure; i.e. organizational size rather than whether the organization is public or private is crucial. There is a need for further research on the topic, but it seems clear that future health care planning may benefit from taking into account the implications that large organizational structures have for the staff working within these organizations. not relevant. not relevant.

Development of a novel motivational interviewing (MI) informed peer-support intervention to support mothers to breastfeed for longer.

PubMed

Phillips, Rhiannon; Copeland, Lauren; Grant, Aimee; Sanders, Julia; Gobat, Nina; Tedstone, Sally; Stanton, Helen; Merrett, Laura; Rollnick, Stephen; Robling, Michael; Brown, Amy; Hunter, Billie; Fitzsimmons, Deborah; Regan, Sian; Trickey, Heather; Paranjothy, Shantini

2018-04-11

Many women in the UK stop breastfeeding before they would like to, and earlier than is recommended by the World Health Organization (WHO). Given the potential health benefits for mother and baby, new ways of supporting women to breastfeed for longer are required. The purpose of this study was to develop and characterise a novel Motivational Interviewing (MI) informed breastfeeding peer-support intervention. Qualitative interviews with health professionals and service providers (n = 14), and focus groups with mothers (n = 14), fathers (n = 3), and breastfeeding peer-supporters (n = 15) were carried out to understand experiences of breastfeeding peer-support and identify intervention options. Data were audio-recorded, transcribed, and analysed thematically. Consultation took place with a combined professional and lay Stakeholder Group (n = 23). The Behaviour Change Wheel (BCW) guided intervention development process used the findings of the qualitative research and stakeholder consultation, alongside evidence from existing literature, to identify: the target behaviour to be changed; sources of this behaviour based on the Capability, Opportunity and Motivation (COM-B) model; intervention functions that could alter this behaviour; and; mode of delivery for the intervention. Behaviour change techniques included in the intervention were categorised using the Behaviour Change Technique Taxonomy Version 1 (BCTTv1). Building knowledge, skills, confidence, and providing social support were perceived to be key functions of breastfeeding peer-support interventions that aim to decrease early discontinuation of breastfeeding. These features of breastfeeding peer-support mapped onto the BCW education, training, modelling and environmental restructuring intervention functions. Behaviour change techniques (BCTTv1) included social support, problem solving, and goal setting. The intervention included important inter-personal relational features (e.g. trust

Organisational Learning and Employees' Intrinsic Motivation

ERIC Educational Resources Information Center

Remedios, Richard; Boreham, Nick

2004-01-01

This study examined the effects of organisational learning initiatives on employee motivation. Four initiatives consistent with theories of organisational learning were a priori ranked in terms of concepts that underpin intrinsic-motivation theory. Eighteen employees in a UK petrochemical company were interviewed to ascertain their experiences of…

Characteristics of Patients With Existing Advance Directives: Evaluating Motivations Around Advance Care Planning.

PubMed

Genewick, Joanne E; Lipski, Dorothy M; Schupack, Katherine M; Buffington, Angela L H

2018-04-01

Although 80% of patients endorse an advance directive (AD), less than 35% of American adults have a documented AD. Much research has been done on barriers to creating ADs; however, there is a paucity of research addressing motivations for creating ADs. Previous research has identified 4 categories of influence for engaging in advance care planning (ACP). This study aimed to quantify the influence of these 4 motivating categories in creating an AD. Participants included 238 adults with documented ADs. Participants completed an 11-item questionnaire addressing 1 of the 4 hypothesized categories of influence in addressing ACP: concern for self; concern for others; expectations about the impact of ACP; and anecdotes, stories, and experiences. Principle component analysis yielded 2 factors representing dignity and personal control (intrinsic factors) and societal and familial influence (extrinsic factors). Intrinsic factors were the primary and most influential motivating factors among participants. A regression analysis of individual motivating factors showed that prior to age 50, the desire to provide guidance about personal preferences for end-of-life care significantly predicted the creation of an AD, whereas after age 50, the urging of family members significantly predicted the creation of an AD. Results indicated that intrinsic factors were the most influential motivator among participants of all ages. Extrinsic factors appeared to be less influential in the decision to create an AD. Motivating factors were also found to vary by age. These results may help physicians be more targeted in discussions surrounding ADs, thus saving time, which physicians identify as the main barrier in engaging in such discussions, while meeting patients' wishes for their physicians to bring up the topic of ADs.

Teachers' Conceptions of Motivation and Motivating Practices in Second-Language Learning: A Self-Determination Theory Perspective

ERIC Educational Resources Information Center

Muñoz, Ana; Ramirez, Marta

2015-01-01

Based on self-determination theory, we conducted an exploratory study aimed at identifying teachers' beliefs about motivation and motivating practices in second-language teaching at a private language center in Medellin, Colombia. To gather data, 65 teachers were surveyed; from this initial group, 11 were interviewed and observed in class during…

What Do Distance Language Tutors Say about Teacher Motivation?

ERIC Educational Resources Information Center

Xiao, Junhong

2014-01-01

Research into motivation in education mainly centres on students' learning motivation. This article reports on an interview study of teacher motivation with the aim of investigating the effects of student-related factors and tutors' personal factors on the motivation of language tutors in the distance learning context. Findings from the study…

Motivational Interviewing and Dietary Counseling for Obesity in Primary Care: An RCT

PubMed Central

McMaster, Fiona; Bocian, Alison; Harris, Donna; Zhou, Yan; Snetselaar, Linda; Schwartz, Robert; Myers, Esther; Gotlieb, Jaquelin; Foster, Jan; Hollinger, Donna; Smith, Karen; Woolford, Susan; Mueller, Dru; Wasserman, Richard C.

2015-01-01

BACKGROUND AND OBJECTIVE: Few studies have tested the impact of motivational interviewing (MI) delivered by primary care providers on pediatric obesity. This study tested the efficacy of MI delivered by providers and registered dietitians (RDs) to parents of overweight children aged 2 through 8. METHODS: Forty-two practices from the Pediatric Research in Office Settings Network of the American Academy of Pediatrics were randomly assigned to 1 of 3 groups. Group 1 (usual care) measured BMI percentile at baseline and 1- and 2-year follow-up. Group 2 (provider only) delivered 4 MI counseling sessions to parents of the index child over 2 years. Group 3 (provider + RD) delivered 4 provider MI sessions plus 6 MI sessions from a RD. The primary outcome was child BMI percentile at 2-year follow up. RESULTS: At 2-year follow-up, the adjusted BMI percentile was 90.3, 88.1, and 87.1 for groups 1, 2, and 3, respectively. The group 3 mean was significantly (P = .02) lower than group 1. Mean changes from baseline in BMI percentile were 1.8, 3.8, and 4.9 across groups 1, 2, and 3. CONCLUSIONS: MI delivered by providers and RDs (group 3) resulted in statistically significant reductions in BMI percentile. Research is needed to determine the clinical significance and persistence of the BMI effects observed. How the intervention can be brought to scale (in particular, how to train physicians to use MI effectively and how best to train RDs and integrate them into primary care settings) also merits future research. PMID:25825539

Motivators for Alzheimer's disease clinical trial participation.

PubMed

Bardach, Shoshana H; Holmes, Sarah D; Jicha, Gregory A

2018-02-01

Alzheimer's disease (AD) research progress is impeded due to participant recruitment challenges. This study seeks to better understand, from the perspective of individuals engaged in clinical trials (CTs), research motivations. Participants, or their caregivers, from AD treatment and prevention CTs were surveyed about research motivators. The 87 respondents had a mean age of 72.2, were predominantly Caucasian, 55.2% were male, and 56.3% had cognitive impairment. An overwhelming majority rated the potential to help themselves or a loved one and the potential to help others in the future as important motivators. Relatively few respondents were motivated by free healthcare, monetary rewards, or to make others happy. Recruitment efforts should focus on the potential benefit for the individual, their loved ones, and others in the future rather than free healthcare or monetary rewards.

Motivating and/or De-Motivating Environments to Do Action Research: The Case of Teachers of English as a Foreign Language in Ethiopian Universities

ERIC Educational Resources Information Center

Aga, Firdissa Jebessa

2017-01-01

This study intended to investigate the motivating and/or de-motivating environments for teachers of English as a foreign language (EFL) to conduct action research. Data were generated through a questionnaire, interviews, and focus group discussions. The results showed that there were both motivating and de-motivating factors. The motivating…

Motivation: The Value of Developing Intrinsic Motivation in Elementary School Students in Grades Four through Six

ERIC Educational Resources Information Center

Gerstner, Gary M.

2017-01-01

This study sought to fill the gap in the literature concerning intrinsic motivation in elementary students in Grades 4-6 by examining 155 elementary school students and in-depth interviews with three elementary grade teachers. This study used data collected from the self-report survey called the Children's Academic Intrinsic Motivation Inventory…

Adiabatic pumping solutions in global AdS

NASA Astrophysics Data System (ADS)

Carracedo, Pablo; Mas, Javier; Musso, Daniele; Serantes, Alexandre

2017-05-01

We construct a family of very simple stationary solutions to gravity coupled to a massless scalar field in global AdS. They involve a constantly rising source for the scalar field at the boundary and thereby we name them pumping solutions. We construct them numerically in D = 4. They are regular and, generically, have negative mass. We perform a study of linear and nonlinear stability and find both stable and unstable branches. In the latter case, solutions belonging to different sub-branches can either decay to black holes or to limiting cycles. This observation motivates the search for non-stationary exactly timeperiodic solutions which we actually construct. We clarify the role of pumping solutions in the context of quasistatic adiabatic quenches. In D = 3 the pumping solutions can be related to other previously known solutions, like magnetic or translationally-breaking backgrounds. From this we derive an analytic expression.

Young Children’s Motivation to Read and Write: Development in Social Contexts

PubMed Central

Nolen, Susan Bobbitt

2009-01-01

In a 3-year longitudinal, mixed-method study, 67 children in two schools were observed during literacy activities in Grades 1–3. Children and their teachers were interviewed each year about the children’s motivation to read and write. Taking a grounded theory approach, content analysis of the child interview protocols identified the motivations that were salient to children at each grade level in each domain, looking for patterns by grade and school. Analysis of field notes, teacher interviews, and child interviews suggests that children’s motivation for literacy is best understood in terms of development in specific contexts. Development in literacy skill and teachers’ methods of instruction and raising motivation provided affordances and constraints for literate activity and its accompanying motivations. In particular, there was support for both the developmental hypotheses of Renninger and her colleagues (Hidi & Renninger, 2006) and of Pressick-Kilborne and Walker (2002). The positions of poor readers and the strategies they used were negotiated and developed in response to the social meanings of reading, writing, and relative literacy skill co-constructed by students and teachers in each classroom. The relationship of these findings to theories of motivation is discussed. PMID:19727337

Translating person-centered care into practice: A comparative analysis of motivational interviewing, illness-integration support, and guided self-determination.

PubMed

Zoffmann, Vibeke; Hörnsten, Åsa; Storbækken, Solveig; Graue, Marit; Rasmussen, Bodil; Wahl, Astrid; Kirkevold, Marit

2016-03-01

Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. Professionals must critically consider the context in their choice of approach. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Implementation of the physician assistant in Dutch health care organizations: primary motives and outcomes.

PubMed

van Vught, Anneke J A H; van den Brink, Geert T W J; Wobbes, Theo

2014-01-01

Physician assistants (PAs) are trained to perform medical procedures that were traditionally performed by medical physicians. Physician assistants seem to be deployed not only to increase efficiency but also to ensure the quality of care. What is not known is the primary motive for employing PAs within Dutch health care and whether the employment of the PAs fulfills the perceived need for them. Supervising medical specialists who used PAs in their practices were interviewed about their primary motives and outcomes. The interviews were semistructured. Two scientists coded the findings with respect to motives and outcomes. In total, 55 specialists were interviewed about their motives for employing a PA, and 15 were interviewed about the outcomes of employing a PA. With respect to the primary motives for employing a PA, the most frequent motive was to increase continuity and quality of care, followed by relieving the specialist's workload, increasing efficiency of care, and substituting for medical residents. The outcomes were found to be consistent with the motives. In conclusion, the primary motive for employing a PA in Dutch health care is to increase continuity and quality of care.

Feasibility and Usability of Tele-interview for Medical Residency Interview

PubMed Central

Pourmand, Ali; Lee, Hayoung; Fair, Malika; Maloney, Kaylah; Caggiula, Amy

2018-01-01

Every year in the United States, medical students and residency programs dedicate millions of dollars to the residency matching process. On-site interviews for training positions involve tremendous financial investment, and time spent detracts from educational pursuits and clinical responsibilities. Students are usually required to fund their own travel and accommodations, adding additional financial burdens to an already costly medical education. Similarly, residency programs allocate considerable funds to interview-day meals, tours, staffing, and social events. With the rapid onslaught of innovations and advancements in the field of telecommunication, technology has become ubiquitous in the practice of medicine. Internet applications have aided our ability to deliver appropriate, evidence-based care at speeds previously unimagined. Wearable medical tech allows physicians to monitor patients from afar, and telemedicine has emerged as an economical means by which to provide care to all corners of the world. It is against this backdrop that we consider the integration of technology into the residency application process. This article aims to assess the implementation of technology in the form of web-based interviewing as a viable means by which to reduce the costs and productivity losses associated with traditional in-person interview days. PMID:29383060

Interactive weekly mobile phone text messaging plus motivational interviewing in promotion of breastfeeding among women living with HIV in South Africa: study protocol for a randomized controlled trial.

PubMed

Zunza, Moleen; Cotton, Mark F; Mbuagbaw, Lawrence; Lester, Richard; Thabane, Lehana

2017-07-17

South Africa recently phased out access to free formula milk in the public sector in support of breastfeeding for women living with HIV. Few women living with HIV in South Africa choose breastfeeding and among those who do, many stop breastfeeding early. We sought to explore the feasibility of using mobile phone text messaging coupled with motivational interviewing to enhance adherence to breastfeeding practices. A randomized, parallel group, single-center pilot trial. Electronic sequence generation and random allocation will be done centrally. Women of low socioeconomic status, from Cape Town, South Africa will be randomly assigned within 24 h of giving birth at a primary healthcare clinic to a structured weekly text message plus motivational interviewing and usual standard of care, using a permutation of different block sizes. Criteria for feasibility success will include: five participants recruited per week (over 12 weeks), about 75% of all eligible participants consent for study participation, complete evaluation of outcomes in at least 70% of all recruited participants, breastfeeding adherence rates of at least 70% in the intervention group, six months after delivery. Participants will be evaluated soon after giving birth and post-delivery at weeks 2, 6, 10, and 24. Primary analysis will follow the "intention-to-treat" principle. Sub-group analysis will be used to assess sub-group effects. This pilot trial will evaluate the feasibility of conducting a larger trial on communication and support approaches to improve adherence to breastfeeding by HIV-infected women. Text messaging and motivational interviewing are simple interventions which may allow participants to access personalized adherence advice and support. ClinicalTrials.gov: NCT02949713 . Registered on 26 October 2016; Pan African Clinical Trial Registry PACTR201611001855404 . Registered on 8 November 2016.

Therapist adherence to a motivational-interviewing intervention improves treatment entry for substance-misusing adolescents with low problem perception.

PubMed

Smith, Douglas C; Hall, James A; Jang, Mijin; Arndt, Stephan

2009-01-01

This study evaluated whether adherence to the Strengths-Oriented Referral for Teens (SORT) model, a motivational interviewing (MI)-consistent intervention addressing ambivalence about attending treatment, positively predicted adolescents' initial-session attendance. Therapist adherence was rated in 54 audiotaped SORT sessions by coders who were blind to treatment-entry status. Higher adherence scores reflected greater use of MI and solution focused language, discussion of client strengths, and dialogue with families on treatment need and options. Therapist adherence during adolescent segments interacted with adolescent problem perception. Predicted probabilities of attending initial sessions increased for low-problem-perception adolescents at increasingly higher therapist adherence. Although replication studies are needed, the SORT model of providing MI-consistent debriefing following initial assessments appears to be a promising approach for increasing treatment entry. Initial support for the treatment-matching hypothesis was found for substance-misusing adolescents contemplating treatment entry.

Cost-utility Analysis of Supported Self-management with Motiva-tional Interviewing for Patients with Psoriasis.

PubMed

Larsen, Marie H; Wahl, Astrid K; Krogstad, Anne-Lene; Aas, Eline

2016-06-15

There are few studies evaluating the cost-effectiveness of self-management interventions for patients with psoriasis. Motivational interviewing (MI) as a telephone follow-up after climate-heliotherapy was effective on several clinical parameters, but its cost-effectiveness is unknown. A cost-utility analysis was conducted alongside a randomized controlled trial (RCT) comparing MI with usual care. A total of 169 Norwegian patients were included. A within-trial analysis compared the costs and quality-adjusted life years (QALYs). Utilities were measured with the 15D instrument, supplemented with Dermatological Life Quality Index (DLQI). A time-integrated summary score defined the clinical effects. QALYs were adjusted for baseline differences. MI provided equivalent quality of life and utility (15D: -0.0022 QALYs (95% Cl -0.02, 0.01), p = 0.77, and DLQI: -0.62 QALYs (95%CI -0.65, 0.41), p = 0.24, at lower costs €-1103 (-2293, 87), p = 0.058, compared with treatment-as-usual. The MI intervention was thus cost-effective. This result was more evident when using the DLQI as outcome measure compared with 15D.

A Pilot Study of Motivational Interviewing Training in a Virtual World

PubMed Central

Heyden, Robin; Heyden, Neil; Schroy, Paul; Andrew, Stephen; Sadikova, Ekaterina; Wiecha, John

2011-01-01

Background Motivational interviewing (MI) is an evidence-based, patient-centered counseling strategy proven to support patients seeking health behavior change. Yet the time and travel commitment for MI training is often a barrier to the adoption of MI by health care professionals. Virtual worlds such as Second Life (SL) are rapidly becoming part of the educational technology landscape and offer not only the potential to improve access to MI training but also to deepen the MI training experience through the use of immersive online environments. Despite SL’s potential for medical education applications, little work is published studying its use for this purpose and still less is known of educational outcomes for physician training in MI using a virtual-world platform. Objective Our aims were to (1) explore the feasibility, acceptability, and effectiveness of a virtual-world platform for delivering MI training designed for physicians and (2) pilot test instructional designs using SL for MI training. Methods We designed and pilot tested an MI training program in the SL virtual world. We trained and enrolled 13 primary care physicians in a two-session, interactive program in SL on the use of MI for counseling patients about colorectal cancer screening. We measured self-reported changes in confidence and clinical practice patterns for counseling on colorectal cancer screening, and acceptability of the virtual-world learning environment and the MI instructional design. Effectiveness of the MI training was assessed by coding and scoring tape-recorded interviews with a blinded mock patient conducted pre- and post-training. Results A total of 13 physicians completed the training. Acceptability ratings for the MI training ranged from 4.1 to 4.7 on a 5-point scale. The SL learning environment was also highly rated, with 77% (n = 10) of the doctors reporting SL to be an effective educational medium. Learners’ confidence and clinical practice patterns for colorectal cancer

“It sounds like…”: A Natural Language Processing Approach to Detecting Counselor Reflections in Motivational Interviewing

PubMed Central

Can, Doğan; Marín, Rebeca A.; Georgiou, Panayiotis G.; Imel, Zac E.; Atkins, David C.; Narayanan, Shrikanth S.

2016-01-01

The dissemination and evaluation of evidence based behavioral treatments for substance abuse problems rely on the evaluation of counselor interventions. In Motivational Interviewing (MI), a treatment that directs the therapist to utilize a particular linguistic style, proficiency is assessed via behavioral coding - a time consuming, non-technological approach. Natural language processing techniques have the potential to scale up the evaluation of behavioral treatments like MI. We present a novel computational approach to assessing components of MI, focusing on one specific counselor behavior – reflections – that are believed to be a critical MI ingredient. Using 57 sessions from 3 MI clinical trials, we automatically detected counselor reflections in a Maximum Entropy Markov Modeling framework using the raw linguistic data derived from session transcripts. We achieved 93% recall, 90% specificity, and 73% precision. Results provide insight into the linguistic information used by coders to make ratings and demonstrate the feasibility of new computational approaches to scaling up the evaluation of behavioral treatments. PMID:26784286

Effects of intrinsic motivation on feedback processing during learning.

PubMed

DePasque, Samantha; Tricomi, Elizabeth

2015-10-01

Learning commonly requires feedback about the consequences of one's actions, which can drive learners to modify their behavior. Motivation may determine how sensitive an individual might be to such feedback, particularly in educational contexts where some students value academic achievement more than others. Thus, motivation for a task might influence the value placed on performance feedback and how effectively it is used to improve learning. To investigate the interplay between intrinsic motivation and feedback processing, we used functional magnetic resonance imaging (fMRI) during feedback-based learning before and after a novel manipulation based on motivational interviewing, a technique for enhancing treatment motivation in mental health settings. Because of its role in the reinforcement learning system, the striatum is situated to play a significant role in the modulation of learning based on motivation. Consistent with this idea, motivation levels during the task were associated with sensitivity to positive versus negative feedback in the striatum. Additionally, heightened motivation following a brief motivational interview was associated with increases in feedback sensitivity in the left medial temporal lobe. Our results suggest that motivation modulates neural responses to performance-related feedback, and furthermore that changes in motivation facilitate processing in areas that support learning and memory. Copyright © 2015. Published by Elsevier Inc.

Effects of Intrinsic Motivation on Feedback Processing During Learning

PubMed Central

DePasque, Samantha; Tricomi, Elizabeth

2015-01-01

Learning commonly requires feedback about the consequences of one’s actions, which can drive learners to modify their behavior. Motivation may determine how sensitive an individual might be to such feedback, particularly in educational contexts where some students value academic achievement more than others. Thus, motivation for a task might influence the value placed on performance feedback and how effectively it is used to improve learning. To investigate the interplay between intrinsic motivation and feedback processing, we used functional magnetic resonance imaging (fMRI) during feedback-based learning before and after a novel manipulation based on motivational interviewing, a technique for enhancing treatment motivation in mental health settings. Because of its role in the reinforcement learning system, the striatum is situated to play a significant role in the modulation of learning based on motivation. Consistent with this idea, motivation levels during the task were associated with sensitivity to positive versus negative feedback in the striatum. Additionally, heightened motivation following a brief motivational interview was associated with increases in feedback sensitivity in the left medial temporal lobe. Our results suggest that motivation modulates neural responses to performance-related feedback, and furthermore that changes in motivation facilitates processing in areas that support learning and memory. PMID:26112370

A Values-Based Motivational Interviewing (MI) Intervention for Pediatric Obesity: Study Design and Methods for MI Values

PubMed Central

Bean, Melanie K.; Mazzeo, Suzanne E.; Stern, Marilyn; Bowen, Deborah; Ingersoll, Karen

2011-01-01

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity remains relatively understudied. MI Values was developed to implement within an existing multidisciplinary treatment program for obese, ethnically diverse adolescents, the T.E.E.N.S. Program (Teaching, Encouragement, Exercise, Nutrition, Support). T.E.E.N.S. participants who consent to MI Values are randomized to either MI or an education control condition. At weeks 1 and 10 of T.E.E.N.S. participation, the subset of participants assigned to the MI condition engage in individual MI sessions and control participants view health education videos. All MI sessions are audiotaped and coded to monitor treatment fidelity, which has been satisfactory thus far. Participants complete comprehensive assessments at baseline, 3-and 6-month follow-up. We hypothesize that MI participants will demonstrate greater reductions in Body Mass Index (BMI) percentile, improved diet and physical activity behaviors, better compliance with T.E.E.N.S., and lower attrition than participants in the control group. We present study design and methods for MI Values as well as data on feasibility of recruitment methods and treatment integrity. At study completion, findings will contribute to the emerging literature examining the efficacy of MI in the treatment of pediatric obesity. PMID:21554994

External and Internal Sport Motivations of Young Adults

ERIC Educational Resources Information Center

Bollok, Sandor; Takacs, Johanna; Kalmar, Zsuzsanna; Dobay, Beata

2011-01-01

Study aim: To determine and evaluate the spectrum of sport motivation of young adults. Material and methods: A group of 600 subjects, aged 17-19 years, participated in the study. An "ad hoc" questionnaire was applied to assess the 4 motivational factors: competition and success-oriented motivation, external accommodation, physical…

Psychometric properties of the Peer Proficiency Assessment (PEPA): a tool for evaluation of undergraduate peer counselors' motivational interviewing fidelity.

PubMed

Mastroleo, Nadine R; Mallett, Kimberly A; Turrisi, Rob; Ray, Anne E

2009-09-01

Despite the expanding use of undergraduate student peer counseling interventions aimed at reducing college student drinking, few programs evaluate peer counselors' competency to conduct these interventions. The present research describes the development and psychometric assessments of the Peer Proficiency Assessment (PEPA), a new tool for examining Motivational Interviewing adherence in undergraduate student peer delivered interventions. Twenty peer delivered sessions were evaluated by master and undergraduate student coders using a cross-validation design to examine peer based alcohol intervention sessions. Assessments revealed high inter-rater reliability between student and master coders and good correlations between previously established fidelity tools. Findings lend support for the use of the PEPA to examine peer counselor competency. The PEPA, training for use, inter-rater reliability information, construct and predictive validity, and tool usefulness are described.

Dietary and body weight control: therapeutic education, motivational interviewing and cognitive-behavioral approaches for long-term weight loss maintenance.

PubMed

Golay, Alain

2006-01-01

A diet always induces weight loss in the short term. The loss does not depend on the dietary composition but rather on the caloric deficit. However, a drastic diet often induces binge eating disorders and can lead to a weight gain in the long term. A cognitive-behavioral-nutritional approach allows lasting weight loss and best results with low fat diets in the long term. Therapeutic education is a patient-centered humanistic approach which allows patients to be actors in their own treatment and own diet to improve their success in losing weight and their quality of life. Motivational interviewing and cognitive-behavioral approaches are perfect complements to therapeutic education for long-term weight loss maintenance. Finally, the best diet is the one that the patient can follow in the long term.

Motivational interviewing for screening and feedback and encouraging lifestyle changes to reduce relative weight in 4-8 year old children: design of the MInT study.

PubMed

Taylor, Rachael W; Brown, Deirdre; Dawson, Anna M; Haszard, Jill; Cox, Adell; Rose, Elaine A; Taylor, Barry J; Meredith-Jones, Kim; Treacy, Lee; Ross, Jim; William, Sheila M

2010-05-24

Because parental recognition of overweight in young children is poor, we need to determine how best to inform parents that their child is overweight in a way that enhances their acceptance and supports motivation for positive change. This study will assess 1) whether weight feedback delivered using motivational interviewing increases parental acceptance of their child's weight status and enhances motivation for behaviour change, and 2) whether a family-based individualised lifestyle intervention, delivered primarily by a MInT mentor with limited support from "expert" consultants in psychology, nutrition and physical activity, can improve weight outcomes after 12 and 24 months in young overweight children, compared with usual care. 1500 children aged 4-8 years will be screened for overweight (height, weight, waist, blood pressure, body composition). Parents will complete questionnaires on feeding practices, physical activity, diet, parenting, motivation for healthy lifestyles, and demographics. Parents of children classified as overweight (BMI > or = CDC 85th) will receive feedback about the results using Motivational interviewing or Usual care. Parental responses to feedback will be assessed two weeks later and participants will be invited into the intervention. Additional baseline measurements (accelerometry, diet, quality of life, child behaviour) will be collected and families will be randomised to Tailored package or Usual care. Parents in the Usual care condition will meet once with an advisor who will offer general advice regarding healthy eating and activity. Parents in the Tailored package condition will attend a single session with an "expert team" (MInT mentor, dietitian, physical activity advisor, clinical psychologist) to identify current challenges for the family, develop tailored goals for change, and plan behavioural strategies that best suit each family. The mentor will continue to provide support to the family via telephone and in

Managing for Motivation: Herzberg's Motivation-Hygiene Theory and Its Application to 4-H Leadership. National Intern Report.

ERIC Educational Resources Information Center

Freeman, Walter J.

A study examined the organizational factors contributing to the motivation of 4-H volunteer leaders. A modified form of Herzberg's Motivation-Hygiene Theory served as the research design of the study. A total of 149 4-H leaders were interviewed regarding thirteen job factors: recognition; personal growth; relationships with other 4-H leaders,…

Show me the money: incorporating financial motives into the gambling motives questionnaire.

PubMed

Dechant, Kristianne

2014-12-01

Although research has only recently begun to measure what motivates all levels of gambling involvement, motives could offer a theoretically interesting and practical way to subtype gamblers in research and for responsible gambling initiatives. The Gambling Motives Questionnaire (GMQ) is one measure that weaves together much of the gambling motives literature, but it has been criticized for neglecting financial reasons for gambling. This study uses a series of factor analyses to explore the effect of adding nine financial motives to the GMQ in a heterogeneous sample of 1,014 adult past-year gamblers. After trimming trivial financial motives, the penultimate factor analysis of the 15 GMQ items and four financial motives led to a four-factor solution, with factors tapping enhancement, social, coping and financial motives, as predicted. A final factor analysis performed on a modified GMQ-F (i.e., 16 items, including a financial subscale) revealed the same four factors, and hierarchical regression showed that the financial motives improve the GMQ-F's prediction of gambling frequency. This study provides evidence that omitting financial motives is a clear gap in the GMQ, yet suggests that the GMQ is a promising tool that can be conceptually and empirically strengthened with the simple addition of financial items.

Engaging clinicians in motivational interviewing: Comparing online with face-to-face post-training consolidation.

PubMed

Clancy, Richard; Taylor, Andrew

2016-02-01

Motivational interviewing (MI) is an evidence-based intervention that has been widely recommended in clinical settings where consumer behaviour change is a goal of treatment. Training clinicians in MI, as with other translational endeavours, does not always result in changes to clinical practice. The present study compares two post-training approaches to consolidate MI skills following a training workshop. We randomly assigned 63 clinicians working in mental health or drug and alcohol services to receive either face-to-face group consolidation sessions or to access a series of online consolidation resources. We compared clinician engagement and devised a new instrument to measure clinician outcomes. Participants who completed follow-up consolidation retained knowledge, attitudes, and practices, regardless of consolidation method. Face-to-face consolidation sessions were superior to online materials in engaging participants (mean sessions attended was 2.1 (maximum possible = 3) compared to a mean of 1.38 sessions, respectively (t(61) = -2.73, P = 0.008, d = 0.72, 95% confidence interval: 0.19-1.25). Engagement to the completion of consolidation sessions was also influenced by previous training in MI. For every additional hour of previous MI training, there was a 10% increase in the odds that the participant would complete the final consolidation session. © 2016 Australian College of Mental Health Nurses Inc.

Motivational interviewing combined with chess accelerates improvement in executive functions in cocaine dependent patients: a one-month prospective study.

PubMed

Gonçalves, Priscila Dib; Ometto, Mariella; Bechara, Antoine; Malbergier, André; Amaral, Ricardo; Nicastri, Sergio; Martins, Paula A; Beraldo, Livia; dos Santos, Bernardo; Fuentes, Daniel; Andrade, Arthur G; Busatto, Geraldo F; Cunha, Paulo Jannuzzi

2014-08-01

In cocaine-dependent individuals, executive function (EF) deficits are associated with poor treatment outcomes. Psychological interventions and pharmacological approaches have produced only modest effect sizes. To date, studies of this topic have been few and limited. The aim of this study was to examine the effects of a new model of intervention, which integrates chess and Motivational Interviewing, Motivational Chess (MC) METHODS: We evaluated 46 cocaine-dependent inpatients (aged 18-45), in two groups-MC (n=26); and active comparison-AC (n=20). Using neuropsychological tests and an impulsivity scale, we assessed the subjects before and after the study period (one month of abstinence monitored by urine toxicology screening). The MC and AC groups did not differ at baseline. In the post-intervention assessment (after one month), both groups showed significant improvements in attention, mental flexibility, inhibitory control, abstraction abilities, and decision-making (p<0.01). In addition, the improvement in working memory was more significant in the MC group than in the AC group (group-by-time interaction, p=01). One month of abstinence was sufficient to improve various attentional and executive domains in cocaine-dependent subjects. The MC intervention was associated with greater improvements in EFs, especially working memory, suggesting that tailored interventions focusing on complex EFs accelerate the process of cognitive recovery during the initial period of abstinence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The dissemination of motivational interviewing in Swedish county councils: Results of a randomized controlled trial

PubMed Central

Forsberg, Lars; Lindqvist, Helena; Diez, Margarita; Enö Persson, Johanna; Ghaderi, Ata

2017-01-01

Objective A significant number of Swedish practitioners are offered workshop trainings in motivational interviewing through community-based implementation programs. The objective of this randomized controlled trial was to evaluate to what extent the practitioners acquire and retain skills from additional supervision consisting of feedback based on monitoring of practice. Materials and methods A total of 174 practitioners in five county councils across Sweden were randomized to one of the study's two groups: 1) Regular county council workshop training, 2) Regular county council workshop training followed by six sessions of supervision. The participant’s mean age was 43.3 years, and the majority were females (88.1%). Results Recruiting participants proved difficult, which may have led to a biased sample of practitioners highly motivated to learn the method. Although slightly different in form and content, all the workshop trainings increased the participants’ skills to the same level. Also, consistent with previous research, the additional supervision group showed larger gains in proficiency compared to the group who received workshop training only at the six-month follow-up. However, analyses showed generally maintained levels of skills for all the participants at the follow-up assessment, and the majority of participants did not attain beginning proficiency levels at either post-workshop or follow-up. Conclusions The results of this study address the real-life implications of dissemination of evidence-based practices. The maintained level of elevated skills for all participants is a promising finding. However, the low interest for obtaining additional supervision among the Swedish practitioners is problematic. In addition, neither the workshop trainings nor the additional supervision, although improving skills, were sufficient for most of the participants to reach beginning proficiency levels. This raises questions regarding the most efficient form of training

Development of a Fully Automated, Web-Based, Tailored Intervention Promoting Regular Physical Activity Among Insufficiently Active Adults With Type 2 Diabetes: Integrating the I-Change Model, Self-Determination Theory, and Motivational Interviewing Components

PubMed Central

Moreau, Michel; Gagnon, Marie-Pierre

2015-01-01

Background Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention. Objective This paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance. Methods The intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention’s usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase. Results The intervention development cost was

Development of a fully automated, web-based, tailored intervention promoting regular physical activity among insufficiently active adults with type 2 diabetes: integrating the I-change model, self-determination theory, and motivational interviewing components.

PubMed

Moreau, Michel; Gagnon, Marie-Pierre; Boudreau, François

2015-02-17

Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention. This paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance. The intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention's usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase. The intervention development cost was about CDN $59,700 and took approximately

[What medical students want - evaluation of medical recruitment ads by future physicians].

PubMed

Renkawitz, T; Schuster, T; Benditz, A; Craiovan, B; Grifka, J; Lechler, P

2013-10-01

Three-quarters of all hospitals in Germany are now struggling to fill open positions for doctors. The medical job ad is a vital tool for human resources marketing and an important image factor. The present study examines the importance of information and offers in medical recruitment ads on application decisions by medical students. A total of 184 future physicians from clinical semesters participated voluntarily in an anonymous cross-sectional survey. Using a standardised questionnaire, the importance of 49 -individual items extracted from medical recruitment ads were rated with the help of a 4-point Likert Scale. Finally, the study participants prioritised their reasons for an application as a physician. Primary influence on the application decision on medical recruitment ads by medical students had offers/information in relation to education and training aspects and work-life balance. Payment rates for physicians and work load played an important role for the application motivation. Additional earnings for, e. g., emergency calls, providing of medical expertise and assistance with housing, relocation and reimbursement of interview expenses were less crucial. In prioritising key reasons for selecting a prospective employer "regular working hours," an "individual training concept" and an "attractive work-life balance" scored the highest priority. The "opportunity for scientific work" was assigned only a small significance. High importance for the application decision by future physicians on medical recruitment ads is placed on jobs with an opportunity for personal development and aspects that contribute to work-life balance. © Georg Thieme Verlag KG Stuttgart · New York.

Motivational tools to improve probationer treatment outcomes.

PubMed

Taxman, Faye S; Walters, Scott T; Sloas, Lincoln B; Lerch, Jennifer; Rodriguez, Mayra

2015-07-01

Motivational interviewing (MI) is a promising practice to increase motivation, treatment retention, and reducing recidivism among offender populations. Computer-delivered interventions have grown in popularity as a way to change behaviors associated with drug and alcohol use. Motivational Assistance Program to Initiate Treatment (MAPIT) is a three arm, multisite, randomized controlled trial, which examines the impact of Motivational interviewing (MI), a motivational computer program (MC), and supervision as usual (SAU) on addiction treatment initiation, engagement, and retention. Secondary outcomes include drug/alcohol use, probation progress, recidivism (i.e., criminal behavior) and HIV/AIDS testing and treatment among probationers. Participant characteristics are measured at baseline, 2, and 6 months after assignment. The entire study will include 600 offenders, with each site recruiting 300 offenders (Baltimore City, Maryland and Dallas, Texas). All participants will go through standard intake procedures for probation and participate in probation requirements as usual. After standard intake, participants will be recruited and screened for eligibility. The results of this clinical trial will fill a gap in knowledge about ways to motivate probationers to participate in addiction treatment and HIV care. This randomized clinical trial is innovative in the way it examines the use of in-person vs. technological approaches to improve probationer success. NCT01891656. Copyright © 2015. Published by Elsevier Inc.