scholarly journals Process evaluation of motivational interviewing interventions for behaviour change in health: A scoping review

2021 ◽  
Vol 24 ◽  
pp. S59
Author(s):  
R. Morris ◽  
P. O’Halloran ◽  
M. Rimayanti ◽  
N. Shields ◽  
N. Taylor
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Behaviour Change ◽  
Scoping Review

scholarly journals Study Protocol Feasibility and Pilot Trial of Brief Behaviour Change Counseling Using Five as and a Guiding Style From Motivational Interviewing on Lifestyle Behaviour in Patients With Hypertension or Diabetes in Mangochi, Malawi: BBCC+5 A's+GS Quasi-experimental Study Protocol

2021 ◽  
Author(s):  
prosper Mukobelwa Lutala ◽  
Adamson Muula
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Behaviour Change ◽  
Study Protocol ◽  
Pilot Trial ◽  
Intervention Group ◽  
Sub Saharan Africa ◽  
Behavioural Intervention ◽  
Positive Effects ◽  
Quasi Experimental

Abstract BackgroundDiabetes and hypertension and their lifestyle risk factors are on the increase in sub-Saharan Africa. Despite positive effects of behavioural intervention such as brief behaviour change in some African countries, there has not been significant implementation of the same in Malawi. We therefore decided to conduct this study aimed at implementing brief behaviour change counseling using 5 As and a guiding style from motivational interviewing (BBCC + 5 As + GS) in Mangochi with specific objectives of determining its feasibility and its efficacy.MethodsThis study is a mixed, quasi-experimental, feasibility study which comprises an exploratory 2 arms quantitative part with a qualitative component at the end of the trial. Fifty consecutive eligible participants will be recruited among patients attending two Non-Communicable Diseases (NCDs) clinics (Mangochi District Hospital and Monkey Bay Rural Hospital) and allocated equally to intervention group (receiving brief behaviour change counseling) and non-intervention (routine care only). In addition to a qualitative process evaluation at the end of the third time points, the groups will be assaessed at baseline - 12 weeks and 24 weeks’ post-implementation on the following factors: feasibility outcomes, sociodemographic factors, lifestyle factors, body mass index, waist circumference, hip to waist ratio, lipids (cholesterols, triglycerides), glycated hemoglobin, quality of life domains and theory of planned behaviour constructs’ changes and process evaluation. DiscussionIt is anticipated that the results of this pilot trial will help to determine and assess the feasibility and the provisional efficacy of this intervention, as well as key useful elements of this trial in order to develop it for further exploration in a larger trial.Registration and status of the trialTrial registration: ClinicalTrials.gov, NCT04625452, registered 12 November 2020, https://clinicaltrials.gov/ct2/show/NCT04625452, and recruitment: June 1, 2021.

scholarly journals Barriers to implementing motivational interviewing in addiction treatment: A nominal group technique process evaluation

2021 ◽  
Vol 2 ◽  
pp. 263348952110184
Author(s):  
Melissa R Hatch ◽  
Kristine Carandang ◽  
Joanna C Moullin ◽  
Mark G Ehrhart ◽  
Gregory A Aarons
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Nominal Group Technique ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Nominal Group ◽  
Management Level ◽  
Implementation Program ◽  
Ebp Implementation ◽  
Staff Level

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics. Methods: This study was conducted during the first cohort of a cluster randomized controlled trial testing the effectiveness of the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI) in substance use disorder treatment agencies and clinics. We used a modified nominal group technique (NGT) in which clinic leaders identified barriers faced during the implementation process. Barriers were categorized, then ranked and rated according to leaders’ perceptions of each barrier’s influence on implementation. The barriers were then contextualized through individual qualitative interviews. Results: Fifteen barriers were identified, grouped into staff-level barriers, management-level barriers, and implementation program barriers. Time and resistance to MI were rated as the most influential staff-level barriers. Among management-level barriers, time was also rated highest, followed by turnover and external contractual constraints. The most influential implementation barrier was client apprehension of recording for fidelity assessment and feedback. Individual interviews supported these findings and provided suggested adaptations for future implementation efforts. Conclusion: EBP implementation is an ongoing process whereby implementation strategies must be proactively and strategically tailored to address emergent barriers. This research described a process evaluation that was used to identify 15 emergent and/or persistent barriers related to staff, management, and the implementation program. Using implementation strategies that can be tailored and/or adapted to such emergent barriers is critical to implementation effectiveness. Plain Language Summary Unforeseen barriers often arise during the course of implementation. Conducting evaluations during implementation allows for tailoring the implementation strategy. As part of a larger study using the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI), we collected data from the first cohort of LOCI clinic leaders to identify barriers to MI implementation that persisted despite advanced planning and to understand unanticipated barriers that arose during implementation. Leaders identified 15 barriers faced during the implementation process that fell into three categories: staff-level barriers, management-level barriers, and implementation program barriers. The leaders ranked time as the most influential barrier at both the staff and management levels. Staff apprehension, resistance to MI implementation, and staff turnover were also of significant concern to leaders. Future implementation efforts may benefit from conducting a similar process evaluation during the implementation phase.

scholarly journals Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Katarina Åsberg ◽  
Marcus Bendtsen
Keyword(s):  
Physical Activity ◽  
Smoking Cessation ◽  
Behaviour Change ◽  
Scoping Review ◽  
Text Messaging ◽  
Text Message ◽  
Feasibility Studies ◽  
Small Sample ◽  
Small Sample Sizes ◽  
Randomised Controlled

Abstract Background Evidence suggests that unhealthy lifestyle behaviours are modifiable risk factors for postoperative complications. Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may therefore be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation. Main text This scoping review included eleven studies covering a range of surgeries: bariatric, orthopaedic, cancer, transplantation and elective surgery. The studies were both randomised controlled trials and feasibility studies and investigated a diverse set of interventions: one game, three smartphone apps, one web-based program and five text message interventions. Feasibility studies reported user acceptability and satisfaction with the behaviour change support. Engagement data showed participation rates ranged from 40 to 90%, with more participants being actively engaged early in the intervention period. In conclusion, the only full-scale randomised controlled trial (RCT), text messaging ahead of bariatric surgery did not reveal any benefits with respect to adherence to preoperative exercise advice when compared to a control group. Two of the pilot studies, one text message intervention, one game, indicated change in a positive direction with respect to alcohol and tobacco outcomes, but between group comparisons were not done due to small sample sizes. The third pilot-study, a smartphone app, found between group changes for physical activity and alcohol, but not with respect to smoking cessation outcomes. Conclusion This review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery.

Motivational Interviewing: A Special Ethical Dilemma?

1995 ◽  
Vol 23 (4) ◽  
pp. 335-339 ◽  
Author(s):  
Jacqueline M. J. Withers
Keyword(s):  
Motivational Interviewing ◽  
Behaviour Change ◽  
Ethical Dilemma ◽  
Ethical Issues ◽  
Life Goals ◽  
Psychological Interventions ◽  
Problem Behaviour ◽  
General Sense ◽  
Therapeutic Goals ◽  
Motivational Interventions

This paper aims to contribute to the discussion of the ethical issues in motivational interventions which have recently been raised by Miller (1994). Motivational interviewing is typically used when a therapist perceives a need for behaviour change in someone who is ambivalent about such change. Motivational interviewing aims to evoke motivation by making salient the inconsistency of continuing with a problem behaviour and other longer term or wider life goals. Miller (1994) discussed what was manipulative about this approach and considered both a descriptive and evaluative component. The ethics of motivational interviewing are considered here, within the context of psychological therapy in a general sense, and questions whether the ethical issues relevant to motivational interviewing are different from other psychological interventions. A distinction between the goals and the means of obtaining therapeutic goals is suggested as useful.

Weight management: insights from the science of human behaviour change

2021 ◽  
Vol 12 (9) ◽  
pp. 396-401
Author(s):  
Tamzin Furtado
Keyword(s):  
Veterinary Medicine ◽  
Motivational Interviewing ◽  
Weight Management ◽  
Behaviour Change ◽  
Companion Animals ◽  
Human Behaviour ◽  
Veterinary Surgeons ◽  
Conversational Style ◽  
Welfare Problem ◽  
Veterinary Surgeon

Helping animal owners to recognise and manage obesity in their animals is a particularly complex area of communications in veterinary medicine. Several studies have outlined the difficulty veterinary professionals face in such discussions, including frustration with the client, embarrassment (particularly if the owner is also overweight), and a sense of inevitable failure. However, obesity continues to be a serious and prevalent welfare problem in dogs, cats, and probably other companion animals as well — hence those discussions will only continue. This review considers veterinary surgeon–client interactions around obesity from the perspective of behaviour change psychology and motivational interviewing, in order to determine how veterinary surgeons and nurses can best assist owners. We consider how an approach based on a supportive and empathetic conversational style could be best suited to these discussions, leading to tailored weight management solutions. Nurses are ideally placed to work with owners in this way.

scholarly journals A pilot study of the S-MAP (Solutions for Medications Adherence Problems) intervention for older adults prescribed polypharmacy in primary care: study protocol

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
D. E. Patton ◽  
J. J. Francis ◽  
E. Clark ◽  
F. Smith ◽  
C. A. Cadogan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Process Evaluation ◽  
Behaviour Change ◽  
Older Patients ◽  
Controlled Trial ◽  
Theoretical Domains Framework ◽  
Self Report ◽  
Community Pharmacies ◽  
Behaviour Change Techniques ◽  
Limited Effectiveness

Abstract Background Adhering to multiple medications as prescribed is challenging for older patients (aged ≥ 65 years) and a difficult behaviour to improve. Previous interventions designed to address this have been largely complex in nature but have shown limited effectiveness and have rarely used theory in their design. It has been recognised that theory (‘a systematic way of understanding events or situations’) can guide intervention development and help researchers better understand how complex adherence interventions work. This pilot study aims to test a novel community pharmacy-based intervention that has been systematically developed using the Theoretical Domains Framework (12-domain version) of behaviour change. Methods As part of a non-randomised pilot study, pharmacists in 12 community pharmacies across Northern Ireland (n = 6) and London, England (n = 6), will be trained to deliver the intervention to older patients who are prescribed ≥ 4 regular medicines and are non-adherent (self-reported). Ten patients will be recruited per pharmacy (n = 120) and offered up to four tailored one-to-one sessions, in the pharmacy or via telephone depending on their adherence, over a 3–4-month period. Guided by an electronic application (app) on iPads, the intervention content will be tailored to each patient’s underlying reasons for non-adherence and mapped to the most appropriate solutions using established behaviour change techniques. This study will assess the feasibility of collecting data on the primary outcome of medication adherence (self-report and dispensing data) and secondary outcomes (health-related quality of life and unplanned hospitalisations). An embedded process evaluation will assess training fidelity for pharmacy staff, intervention fidelity, acceptability to patients and pharmacists and the intervention’s mechanism of action. Process evaluation data will include audio-recordings of training workshops, intervention sessions, feedback interviews and patient surveys. Analysis will be largely descriptive. Discussion Using pre-defined progression criteria, the findings from this pilot study will guide the decision whether to proceed to a cluster randomised controlled trial to test the effectiveness of the S-MAP intervention in comparison to usual care in community pharmacies. The study will also explore how the intervention components may work to bring about change in older patients’ adherence behaviour and guide further refinement of the intervention and study procedures. Trial registration This study is registered at ISRCTN: 10.1186/ISRCTN73831533

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