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

BMC Nursing ◽  
2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Sue Channon ◽  
Marie-Jet Bekkers ◽  
Julia Sanders ◽  
Rebecca Cannings-John ◽  
Laura Robertson ◽  
...  
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Building Blocks ◽  
Family Nurse Partnership

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 Cost-effectiveness of the Family Nurse Partnership (FNP) programme in England: Evidence from the building blocks trial

2017 ◽  
Vol 23 (6) ◽  
pp. 1367-1374 ◽  
Author(s):  
Belen Corbacho ◽  
Kerry Bell ◽  
Eugena Stamuli ◽  
Gerry Richardson ◽  
Sarah Ronaldson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Building Blocks ◽  
The Family ◽  
Family Nurse Partnership

scholarly journals Costs and consequences of the Family Nurse Partnership (FNP) programme in England: evidence from the Building Blocks trial

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1640 ◽  
Author(s):  
Kerry Bell ◽  
Belen Corbacho ◽  
Sarah Ronaldson ◽  
Gerry Richardson ◽  
Kerry Hood ◽  
...  
Keyword(s):  
Home Visiting ◽  
Controlled Trial ◽  
Full Range ◽  
Building Blocks ◽  
Public Health Services ◽  
Intervention Programme ◽  
The Family ◽  
Cost Consequence ◽  
Implementation Costs ◽  
Family Nurse Partnership

Background: The Family Nurse Partnership (FNP) is a licensed intensive home visiting intervention programme delivered to teenage mothers which was originally introduced in England in 2006 by the Department of Health and is now provided through local commissioning of public health services and supported by a national unit led by a consortium of partners. The Building Blocks (BB) trial aimed to explore the effectiveness and cost-effectiveness of this programme. This paper reports the results of an economic evaluation of the Building Blocks randomised controlled trial (RCT) based on a cost-consequence approach. Methods: A large sample of 1618 families was followed-up at various intervals during pregnancy and for two years after birth. A cost-consequence approach was taken to appraise the full range of costs arising from the intervention including both health and social measures of cost alongside the consequences of the trial, specifically, the primary outcomes. Results: A large number of potential factors were identified that are likely to attract additional costs beyond the implementation costs of the intervention including both health and non-health outcomes. Conclusion: Given the extensive costs and only small beneficial consequences observed within the two year follow-up period, the cost-consequence model suggests that the FNP intervention is unlikely to be worth the substantial costs and policy makers may wish to consider other options for investment. Trial registration: ISRCTN23019866 (20/04/2009)

scholarly journals Engaging Unmotivated Smokers to Move Toward Quitting: Design of Motivational Interviewing–Based Chatbot Through Iterative Interactions (Preprint)

2020 ◽  
Author(s):  
Fahad Almusharraf ◽  
Jonathan Rose ◽  
Peter Selby
Keyword(s):  
Motivational Interviewing ◽  
Language Processing ◽  
Interdisciplinary Collaboration ◽  
Low Cost ◽  
Building Blocks ◽  
Training Data ◽  
Free Form ◽  
Computer Engineering ◽  
Cigarette Smokers ◽  
The Web

BACKGROUND At any given time, most smokers in a population are ambivalent with no motivation to quit. Motivational interviewing (MI) is an evidence-based technique that aims to elicit change in ambivalent smokers. MI practitioners are scarce and expensive, and smokers are difficult to reach. Smokers are potentially reachable through the web, and if an automated chatbot could emulate an MI conversation, it could form the basis of a low-cost and scalable intervention motivating smokers to quit. OBJECTIVE The primary goal of this study is to design, train, and test an automated MI-based chatbot capable of eliciting reflection in a conversation with cigarette smokers. This study describes the process of collecting training data to improve the chatbot’s ability to generate MI-oriented responses, particularly reflections and summary statements. The secondary goal of this study is to observe the effects on participants through voluntary feedback given after completing a conversation with the chatbot. METHODS An interdisciplinary collaboration between an MI expert and experts in computer engineering and natural language processing (NLP) co-designed the conversation and algorithms underlying the chatbot. A sample of 121 adult cigarette smokers in 11 successive groups were recruited from a web-based platform for a single-arm prospective iterative design study. The chatbot was designed to stimulate reflections on the pros and cons of smoking using MI’s running head start technique. Participants were also asked to confirm the chatbot’s classification of their free-form responses to measure the classification accuracy of the underlying NLP models. Each group provided responses that were used to train the chatbot for the next group. RESULTS A total of 6568 responses from 121 participants in 11 successive groups over 14 weeks were received. From these responses, we were able to isolate 21 unique reasons for and against smoking and the relative frequency of each. The gradual collection of responses as inputs and smoking reasons as labels over the 11 iterations improved the F1 score of the classification within the chatbot from 0.63 in the first group to 0.82 in the final group. The mean time spent by each participant interacting with the chatbot was 21.3 (SD 14.0) min (minimum 6.4 and maximum 89.2). We also found that 34.7% (42/121) of participants enjoyed the interaction with the chatbot, and 8.3% (10/121) of participants noted explicit smoking cessation benefits from the conversation in voluntary feedback that did not solicit this explicitly. CONCLUSIONS Recruiting ambivalent smokers through the web is a viable method to train a chatbot to increase accuracy in reflection and summary statements, the building blocks of MI. A new set of 21 <i>smoking reasons</i> (both for and against) has been identified. Initial feedback from smokers on the experience shows promise toward using it in an intervention.

scholarly journals Engaging Unmotivated Smokers to Move Toward Quitting: Design of Motivational Interviewing–Based Chatbot Through Iterative Interactions

10.2196/20251 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e20251
Author(s):  
Fahad Almusharraf ◽  
Jonathan Rose ◽  
Peter Selby
Keyword(s):  
Motivational Interviewing ◽  
Language Processing ◽  
Interdisciplinary Collaboration ◽  
Low Cost ◽  
Building Blocks ◽  
Training Data ◽  
Free Form ◽  
Computer Engineering ◽  
Cigarette Smokers ◽  
The Web

Background At any given time, most smokers in a population are ambivalent with no motivation to quit. Motivational interviewing (MI) is an evidence-based technique that aims to elicit change in ambivalent smokers. MI practitioners are scarce and expensive, and smokers are difficult to reach. Smokers are potentially reachable through the web, and if an automated chatbot could emulate an MI conversation, it could form the basis of a low-cost and scalable intervention motivating smokers to quit. Objective The primary goal of this study is to design, train, and test an automated MI-based chatbot capable of eliciting reflection in a conversation with cigarette smokers. This study describes the process of collecting training data to improve the chatbot’s ability to generate MI-oriented responses, particularly reflections and summary statements. The secondary goal of this study is to observe the effects on participants through voluntary feedback given after completing a conversation with the chatbot. Methods An interdisciplinary collaboration between an MI expert and experts in computer engineering and natural language processing (NLP) co-designed the conversation and algorithms underlying the chatbot. A sample of 121 adult cigarette smokers in 11 successive groups were recruited from a web-based platform for a single-arm prospective iterative design study. The chatbot was designed to stimulate reflections on the pros and cons of smoking using MI’s running head start technique. Participants were also asked to confirm the chatbot’s classification of their free-form responses to measure the classification accuracy of the underlying NLP models. Each group provided responses that were used to train the chatbot for the next group. Results A total of 6568 responses from 121 participants in 11 successive groups over 14 weeks were received. From these responses, we were able to isolate 21 unique reasons for and against smoking and the relative frequency of each. The gradual collection of responses as inputs and smoking reasons as labels over the 11 iterations improved the F1 score of the classification within the chatbot from 0.63 in the first group to 0.82 in the final group. The mean time spent by each participant interacting with the chatbot was 21.3 (SD 14.0) min (minimum 6.4 and maximum 89.2). We also found that 34.7% (42/121) of participants enjoyed the interaction with the chatbot, and 8.3% (10/121) of participants noted explicit smoking cessation benefits from the conversation in voluntary feedback that did not solicit this explicitly. Conclusions Recruiting ambivalent smokers through the web is a viable method to train a chatbot to increase accuracy in reflection and summary statements, the building blocks of MI. A new set of 21 smoking reasons (both for and against) has been identified. Initial feedback from smokers on the experience shows promise toward using it in an intervention.

scholarly journals Process evaluation of an exercise counseling intervention using motivational interviewing

2015 ◽  
Vol 28 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Margaret M. McCarthy ◽  
Victoria Vaughan Dickson ◽  
Stuart D. Katz ◽  
Kathleen Sciacca ◽  
Deborah A. Chyun
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Counseling Intervention ◽  
Exercise Counseling

scholarly journals Motivational interviewing with community-dwelling older adults after hip fracture (MIHip): protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047970
Author(s):  
Nicholas F Taylor ◽  
Paul D O'Halloran ◽  
Jennifer J Watts ◽  
Rebecca Morris ◽  
Casey L Peiris ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Health Service ◽  
Motivational Interviewing ◽  
Process Evaluation ◽  
Community Dwelling ◽  
Dietary Advice ◽  
Control Group ◽  
Related Function ◽  
Randomised Controlled ◽  
Experimental Group

IntroductionCommunity-dwelling people recovering from hip fracture have the physical capacity to walk in their community but lack the confidence to do so. The primary aim of this trial is to determine whether motivational interviewing increases time spent walking at 12 months in community-dwelling people after hip fracture compared with an attention placebo control group. Secondary aims are to evaluate cost effectiveness, patient and health service outcomes and to complete a process evaluation.Methods and analysisAn assessor-blinded parallel group randomised controlled design with embedded health economic evaluation and process evaluation will compare the effects of n=270 participants randomly allocated to an experimental group (motivational interviewing) or a control group (dietary advice). For inclusion, participants are aged ≥65 years, living at home independently within 6 months of discharge from hospital after hip fracture and able to walk independently and communicate with conversational English. Key exclusion criteria are severe depression or anxiety, impaired intellectual functioning and being medically unstable to walk. Participants allocated to the experimental group will receive 10 (8 weekly and 2 booster) telephone-based sessions of motivational interviewing to increase walking over 16 weeks. Participants allocated to the control group will receive an equivalent dose of telephone-based dietary advice. The primary outcome is daily time spent walking over 7 days assessed at weeks 0, 9, 26 and 52. Secondary outcomes include measures of psychological-related function, mobility-related function, community participation, health-related quality of life and falls. Health service utilisation and associated costs will be assessed. Process evaluation will assess the fidelity of the motivational interviewing intervention and explore contextual factors through semistructured interviews.Ethics and disseminationEthical approval obtained from Eastern Health (E19-002), Peninsula Health (50261/EH-2019), Alfred Health (617/20) and La Trobe University (E19/002/50261). The findings will be disseminated in peer-reviewed journals, conference presentations and public seminars.Trial registration numberACTRN12619000936123.

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 Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Intervention Development and Protocol for the Process Evaluation (Preprint)

2017 ◽  
Author(s):  
Malin Johansson Östbring ◽  
Tommy Eriksson ◽  
Göran Petersson ◽  
Lina Hellström
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Motivational Interviewing ◽  
Process Evaluation ◽  
Medication Review ◽  
Quantitative Methods ◽  
Controlled Trial ◽  
Complex Interventions ◽  
Outcome Evaluation ◽  
Services Research

BACKGROUND Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a randomized controlled trial (RCT) of an intervention aimed at improving pharmacological secondary prevention. Guidelines for the development and evaluation of complex interventions have recently highlighted the need for better reporting of the development of interventions, including descriptions of how the intervention is assumed to work, how this theory informed the process evaluation, and how the process evaluation relates to the outcome evaluation. OBJECTIVE This paper aims to describe how the intervention was designed and developed. The aim of the process evaluation is to better understand how and why the intervention in the MIMeRiC trial was effective or not effective. METHODS The research questions for evaluating the process are based on the conceptual model of change processes assumed in the intervention and will be analyzed by qualitative and quantitative methods. Quantitative data are used to evaluate the medication review in terms of drug-related problems, to describe how patients’ beliefs about medicines are affected by the intervention, and to evaluate the quality of motivational interviewing. Qualitative data will be used to analyze whether patients experienced the intervention as intended, how cardiologists experienced the collaboration and intervention, and how the intervention affected patients’ overall experience of care after coronary heart disease. RESULTS The development and piloting of the intervention are described in relation to the theoretical framework. Data for the process evaluation will be collected until March 2018. Some process evaluation questions will be analyzed before, and others will be analyzed after the outcomes of the MIMeRiC RCT are known. CONCLUSIONS This paper describes the framework for the design of the intervention tested in the MIMeRiC trial, development of the intervention from the pilot stage to the complete trial intervention, and the framework and methods for the process evaluation. Providing the protocol of the process evaluation allows prespecification of the processes that will be evaluated, because we hypothesize that they will determine the outcomes of the MIMeRiC trial. This protocol also constitutes a contribution to the new field of process evaluations as made explicit in health services research and clinical trials of complex interventions.

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