MIA

Since online discussion platforms can limit the perception of social cues, effective collaboration over videochat requires additional attention to conversational skills. However, self-affirmation and defensive bias theories indicate that feedback may appear confrontational, especially when users are not motivated to incorporate them. We develop a feedback chatbot that employs Motivational Interviewing (MI), a directive counseling method that encourages commitment to behavior change, with the end goal of improving the user's conversational skills. We conduct a within-subject study with 21 participants in 8 teams to evaluate our MI-agent 'MIA' and a non-MI-agent 'Roboto'. After interacting with an agent, participants are tasked with conversing over videochat to evaluate candidate résumés for a job circular. Our quantitative evaluation shows that the MI-agent effectively motivates users, improves their conversational skills, and is likable. Through a qualitative lens, we present the strategies and the cautions needed to fulfill individual and team goals during group discussions. Our findings reveal the potential of the MI technique to improve collaboration and provide examples of conversational tactics important for optimal discussion outcomes.

Feasibility of using a General Health Promotion Approach to Helping Smokers with Non- Communicable Diseases Quit Smoking: A Randomized Controlled Trial

This randomized controlled trial aimed to evaluate the efficacy and ascertain the feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. A total of 60 participants who had medical follow-up in a special out-patient clinic were randomized into two groups, 30 in the intervention group received brief motivational interviewing to assist them with their chosen behavioral changes, and 30 in the control group received only a smoking cessation booklet. The primary outcome, by intention-to-treat, was biochemically validated abstinence at 12 months. The intervention group had a higher biochemically validated abstinence rate than the control group at 12 months (16.7% vs 6.7% P=.23) although the difference was not statistically significant (Adjusted OR 2.4, 95% CI 0.43–13.75; P=.32). In addition, the intervention group had a significantly higher self-reported reduction of at least 50% in daily cigarette consumption than the control group at 6 months (Adjusted OR 7.2, 95% CI 1.22–42.44; P=.03).This study demonstrated the potential efficacy and feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking.

The evaluation of a physical health promotion intervention for people with severe mental illness receiving community based accommodational support: a mixed-method pilot study

Background Unhealthy lifestyle constitutes a cause of increased morbidity and mortality in people with severe mental illness. The aim of this mixed-method pilot study was to investigate the feasibility and preliminary effectiveness of an intervention to promote a health-conscious lifestyle in comparison to care as usual among people with severe mental illness receiving accommodational support in community settings. Methods This was a prospective, quasi-experimental, controlled study over four six-month assessment points (t0, + 6 months, + 12 months, + 18 months) with 70 persons with severe mental illness receiving community based accommodational support. Mental health staff members of the housing facilities were trained in Motivational Interviewing and conducted a six-week health course with the intervention group participants in addition to care as usual. Next to the primary outcome - self-rated physical well-being (FEW 16) - anthropometric parameters and unhealthy behaviours (diet, physical activity, alcohol and tobacco consumption, and oral hygiene) were examined. Effectiveness analysis was conducted using mixed-effects regression models with propensity score adjustment to control for selection bias. One year after the end of the intervention, semi-standardized expert interviews were conducted with 12 of these employees and evaluated by content analysis. Results The qualitative interviews with mental health staff underline the intervention’s feasibility in people with severe mental illness in sheltered housing, and the acceptability of and satisfaction with the intervention among mental health workers. But in this pilot study no superiority of the HELPS intervention compared to routine care could be demonstrated in terms of the investigated outcomes. Conclusions The findings of this pilot study underscore the feasibility and acceptability of health promotion programmes based on Motivational Interviewing and highlight the need to further develop multi-modal programs according to the needs of the target group. Long-term and sustainable support for healthy lifestyles of people with severe mental illness receiving community mental health care requires multi-modal concepts and organisational change. Trial registration DRKS00011659, date of registration was 2017/02/15; retrospectively registered as date of first enrolment was 2017/01/24.

Virtual patient simulation to improve nurses’ relational skills in a continuing education context: a convergent mixed methods study

Background Effective provider-patient communication is crucial to the delivery of high-quality care. Communication roadblock such as righting reflex is widely observed among providers and can lead to relational disengagement. In previous work, nurses felt ill-equipped to communicate effectively with HIV-positive patients to support medication adherence. Providing nurses with continuing education opportunities to improve their relational skills is a major target for optimizing the quality of care. Virtual patient simulation is one promising strategy that needs to be evaluated among graduate nurses. This study aimed to assess the acceptability of a virtual patient simulation to improve nurses’ relational skills in a continuing education context. Methods We conducted a convergent mixed methods study by combining a quantitative pre-experimental, one-group post-test design and a qualitative exploratory study. We used convenience and snowball sampling approaches to select registered nurses (n = 49) working in Quebec, Canada. Participants completed an online sociodemographic questionnaire, consulted the automated virtual patient simulation (informed by motivational interviewing), and filled out an online post-test survey. Descriptive statistics (mean, SD, median, interquartile range) were used to present quantitative findings. From the 27 participants who completed the simulation and post-test survey, five participated in a focus group to explore their learning experience. The discussion transcript was subjected to thematic analysis. At the final stage of the study, we used a comparison strategy for the purpose of integrating the quantitative and qualitative results. Results Nurses perceived the simulation to be highly acceptable. They rated the global system quality and the technology acceptance with high scores. They reported having enjoyed the simulation and recommended other providers use it. Four qualitative themes were identified: motivations to engage in the simulation-based research; learning in a realistic, immersive, and non-judgmental environment; perceived utility of the simulation; and perceived difficulty in engaging in the simulation-based research. Conclusions The simulation contributed to knowledge and skills development on motivational interviewing and enhanced nurses’ self-confidence in applying relational skills. Simulation holds the potential to change practice, as nurses become more self-reflective and aware of the impact of their relational skills on patient care. Trial registration ISRCTN18243005, retrospectively registered on July 3 2020.

Impact of motivational interviewing as a follow-up to an exercise intervention among women with or at risk for metabolic syndrome: A randomized controlled trial

Objectives: Women have a higher prevalence of metabolic syndrome than their male counterparts, and interventions should target women with or at risk for metabolic syndrome. The objective of this study was to compare two intervention strategies on long-term outcomes following the completion of an exercise intervention. Methods: Twenty-six women ( M age = 43.35 ± 9.03) with at least one risk factor for metabolic syndrome were randomized into either a motivational interviewing group ( n = 10) or self-regulation-based mobile messaging control group ( n = 16) as a 12-week follow-up to a 10-week, 30-session exercise intervention. Outcomes of interest were body fat percentage, bone mineral density, waist circumference, systolic blood pressure, diastolic blood pressure, triglycerides, high-density cholesterol, and fasting blood glucose. Results: Mixed ANOVAs revealed a significant effect for group × time for body fat percentage F(1, 24) = 8.30, p = 0.01, [Formula: see text] = 0.26, bone mineral density F(1, 24) = 6.68, p = 0.02, [Formula: see text] = 0.22, waist circumference F(1, 24) = 10.35, p = 0.01, [Formula: see text] = 0.30, triglycerides F(1, 24) = 5.06, p = 0.03, [Formula: see text] = 0.17, and systolic blood pressure F(1, 24) = 5.39, p = 0.03, [Formula: see text] = 0.18 all in favor of the motivational interviewing group after 12 weeks when compared to the self-regulation-based mobile messaging group. No significant effect for group × time was noted for diastolic blood pressure p = 0.36, [Formula: see text] = 0.04, high-density cholesterol p = 0.08, [Formula: see text] = 0.12, or fasting blood glucose p = 0.85, [Formula: see text] = 0.01 when comparing the motivational interviewing and self-regulation-based mobile messaging groups. Conclusions: Motivational interviewing may be a more impactful solution to extend the effects of exercise intervention studies compared to a self-regulation-based mobile messaging control group. Future interventions should focus on increasing sample size, utilizing more objective measures of body composition, utilizing booster sessions, and increasing the length of follow-up periods.