Dissemination Of Motivational Interviewing Training: Use In Extension Outreach And School Health Programming

Abstract

PURPOSE: Motivational interviewing (MI) is a popular conversational strategy used to evoke intrinsic motivation for behavior change. Although a number of training programs have been described to build MI skills, there are few that evaluate the fidelity of training. The present study evaluated MI fidelity following a brief online training. METHODS: This study was conducted as an ancillary component of a school wellness training initiative (SWITCH) that focused on building capacity for schools to plan and lead school wellness programming. A quasi-experimental design was used to evaluate the impact of brief MI training on a sample of 16 extension field specialists (EFS) that facilitated the SWITCH implementation process. EFS were provided guidelines and suggestions for using MI to elicit change talk and promote goal setting by school leaders. A subsample of 8 EFS voluntarily agreed to participate in supplemental MI training prior to interacting with the schools. All EFS recorded phone calls with the schools as part of the standard practice in the SWITCH project, and a trained assistant blinded from group allocation coded them for MI proficiency levels using the Motivational Interviewing Treatment Integrity Coding Manual 4.2.1. RESULTS: A one-way ANOVA followed by Bonferroni post-hoc corrections were conducted to examine differences in MI techniques between trained and untrained EFS. No statistically significant results were found. However, differences between groups for technical global scores (F (1, 14) = 8.9, p = 0.05, d = 1.5) and reflection-to-question ratios (F (1, 14) = 5.3, p = 0.19, d = 1.15) were approaching statistical significance with large effect sizes. Relational global components (d = 0.76) and total adherence (d = 0.38) demonstrated moderate group differences. CONCLUSIONS: This study indicates that a brief MI training protocol is effective for teaching the spirit and relational components of MI. Although proficiency levels were not achieved by the majority of EFS, trained individuals were better at using technical and relational aspects of MI than untrained individuals. Future work should focus on ways to enhance skill acquisition with this type of distributed online training model as well as testing applications with other professionals and diverse settings.