Training Providers in Motivational Interviewing to Promote Behavior Change

Abstract

Motivational Interviewing (MI) is a highly specified behavior change communication approach to improve patient-provider relationships, provider communication, and patient health outcomes. Because MI is built on a foundation of patient autonomy support, a feature known to positively influence behavior change during adolescence and emerging adulthood, MI is an evidence-based framework that can inform interventions targeting improvements in health outcomes among youth. MI can be difficult to implement with adequate fidelity, because learning MI requires time and commitment from busy providers with competing priorities. This review addresses best practices for implementing MI within adolescent serving medical settings (eg, pediatrics, family practices, rural health clinics, community health organizations, and so forth), including an orientation to MI, examples of efficacious interventions that were developed leveraging MI, and consideration for the design of training programs that include ongoing support to maximize the likelihood of sustainment.

Keywords: Adolescents; Behavior change communication; Communication Science; Implementation Science; Motivational Interviewing; Training.

Figure 1.

Integrating communication science, implementation science, and Motivational Interviewing Adapted with permission.¹ 1. Naar SS, Mariann. Motivational Interviewing with Adolescents and Young Adults. Routledge; 2021.

Figure 2.

Motivational Interviewing communication strategies linked to patient change talk Note: Percentages represent the likelihood of producing change talk. “Provider questions phrased to elicit change talk were followed by a patient change talk statement more often than other provider communication strategies. Closed questions phrased to elicit change talk were followed by change talk 67% of the time and open questions were 58% of the time. In addition, reflections of patient change talk (43%), affirmations (28%), statements emphasizing the patient’s decision-making autonomy (15%), and information presented in a patient-centered manner (11%) were also more likely to elicit a patient change talk statement. All p ≤ .0001.” 1. Carcone AI, Naar S, Clark J, MacDonell K, Zhang L. Provider behaviors that predict motivational statements in adolescents and young adults with HIV: a study of clinical communication using the Motivational Interviewing framework. AIDS Care. 2020/09/01 2020;32(9):1069-1077. doi:10.1080/09540121.2019.1679709