Counseling Style Research Articles

Breaking the cycle of reoccurring low back pain with integrated motivational interviewing and cognitive behavioural therapy to facilitate education and exercise advice: a superiority randomised controlled trial study protocol

BackgroundNon-specific low back pain is a common and costly global issue. Many people with low back pain live for years with ongoing symptom recurrence and disability, making it crucial to find effective prevention strategies. Motivational interviewing (MI) is an evidence-based patient-centred counselling style that helps motivate individuals to change their behaviours. In combination, MI and cognitive-behavioural therapy (MI-CBT) has the potential to yield long term improvements in pain and disability and reduce incidence of recurrence.MethodThis is a two-arm superiority randomised controlled trial comparing MI-CBT and Education (n = 83) with Education only (n = 83). Participants that have recovered from a recent episode of non-specific low back pain (7th consecutive day with pain ≤ 2 on a 0–10 numeric pain rating scale) will be eligible for inclusion into the study. Both groups will receive five 30-min sessions over a 10-week period as well as the Navigating Pain booklet, homework book and a standardised exercise programme. In the intervention group, MI-CBT techniques will be used to provide individualised support, identify beliefs, and increase engagement with the resources provided. Outcomes measures include pain (current and in the last 7 days) as rated on the numeric pain rating scale. This will be used to determine recurrence (number of participants who report back pain ≥ 3 out of 10 on the numeric pain rating scale). Furthermore, self-reported (1) pain intensity; (2) pain catastrophizing; (3) fear-avoidance beliefs; (4) pain self-efficacy; (5) depression and anxiety; (6) disability will be measured. All outcomes will be measured at baseline, and again at 3-, 6-, and 12-months post allocation.DiscussionThe effective delivery of self-management strategies to prevent recurrence of low back pain is an important aspect that requires urgent attention. This study will provide new information on the effectiveness of using an MI-CBT approach to facilitate self-management through education and exercise to improve low back pain outcomes. Evidence emerging from this trial has the potential to inform clinical practice and healthcare management of non-specific low back pain.Trial registrationProspectively registered with Australian New Zealand Clinical Trials Registry: ACTRN12623000746639 (10/07/2023).

Contraceptive counseling training experiences and behaviors among obstetrics and gynecology residents in California and Florida

ObjectiveTo describe experiences with contraception counseling training and provision of obstetrics and gynecology residents training in California and Florida. Study designWe conducted a mixed-methods study of obstetrics and gynecology residents training across 19 programs (with approximately 428 residents) in California and Florida from September 2022 through February 2023. We asked participants how often they use tiered-effectiveness counseling, their satisfaction with contraception counseling practices, and experiences with witnessing and recognizing contraception coercion. We asked about personal disappointment when patients decline long-acting reversible contraception (LARC) and pressure from faculty to prescribe LARC. To further explore resident contraception counseling education and behaviors, we conducted semi-structured telephone interviews with a subset of 20 survey volunteers. ResultsWe received survey responses from 155 (36.2%) participants. Most (n = 113 [76.4%]) often or always reported using tiered-effectiveness counseling. While few participants (n = 17 [11.3%]) reported feeling pressure from faculty to convince a patient to keep a LARC, some (n = 34 [22.1%]) reported they often or always feel disappointed when a patient chooses LARC removal, with more Florida participants reporting disappointment (n = 19 [37.3%]) compared to California (n = 15 [14.6%], p = 0.01). We identified two main themes from the telephone interviews. First, residents feel they have limited formal education on how to provide contraceptive counseling and commonly learn these practices by emulating supervising faculty or peer counseling styles. Second, residents are informally taught, through feedback and interactions with supervising faculty and peers, that successful contraception counseling is the ability to convince patients to use highly effective contraception. ConclusionWhen residents lack formalized contraception counseling education, they adopt counseling behaviors that may not be patient centered. ImplicationsWhen obstetrics and gynecology residents lack formalized contraception counseling education, they learn practices that may lead to coercive counseling behaviors during training. Resident education should include recognition and mitigation of contraception coercion and patient-centered counseling both through a formalized curriculum and socialization of trainees during their medical education.

The state of motivational interviewing training in school counseling graduate programs

AbstractMotivational interviewing (MI) is a brief, evidence‐based counseling style that helps people make positive behavior changes. Scholars have advocated for MI's use by school counselors (SCs), and research lends evidence to MI's effectiveness in schools. However, there are little data focused on how SCs are trained to utilize MI. Researchers investigated MI training in school counseling graduate programs from the perspective of SCs and counselor educators (CEs). The article presents two qualitative studies that discussed the importance of MI training in graduate programs. Researchers identified six themes and discussed their implications for graduate programs.

Process Evaluation of a Motivational Interviewing Intervention in a Social Security Setting: A Qualitative Study among Work-Disabled Patients.

Purpose Return to work (RTW) may be facilitated by motivational interviewing (MI), a counseling style designed to increase motivation towards behavior change. MI's relevance in a RTW context remains however unclear. Exploring how, for whom and in what circumstances MI works is therefore necessary. Methods Eighteen people (29-60years; sick leave > 12weeks) with low back pain (LBP) or medically unexplained symptoms (MUS) participated in a semi-structured interview after one MI consultation. We conducted a realist-informed process evaluation to explore MI's mechanisms of impact, its outcomes and how external factors may influence these. Data were coded using thematic analysis. ResultsMain mechanisms were supporting autonomy, communicating with empathy and respect, facilitating feelings of competence and focusing on RTW solutions instead of hindrances. Competence support was more salient among LBP patients, whereas MUS patients benefited more from empathy and understanding. External factors were mentioned to have impacted MI's effectiveness and/or the further RTW process, being personal (e.g. acceptance of the condition), work-related (e.g. supervisor support) and societal (e.g. possibility of gradual RTW). Conclusions These results stress the importance of self-determination theory's support for autonomy, relatedness and competence, together with a solution-focused approach when stimulating patients' engagement regarding RTW. These mechanisms' instalment during RTW counseling and their long-term impact depends on both personal and system-like external factors. Belgium's social security system's premise, based on control, might actually hinder RTW instead of facilitating it. Further longitudinal research could explore MI's long-term effects as well as its complex interaction with external factors.

Analyzing User-Generated Web-Based Posts of Adolescents’ Emotional, Behavioral, and Symptom Responses to Beliefs About Depression: Qualitative Thematic Analysis

Depression is common during adolescence. Early intervention can prevent it from developing into more progressive mental disorders. Combining information technology and clinical psychoeducation is a promising way to intervene at an earlier stage. However, data-driven research on the cognitive response to health information targeting adolescents with symptoms of depression is lacking. This study aimed to fill this knowledge gap through a new understanding of adolescents' cognitive response to health information about depression. This knowledge can help to develop population-specific information technology, such as chatbots, in addition to clinical therapeutic tools for use in general practice. The data set consists of 1870 depression-related questions posted by adolescents on a public web-based information service. Most of the posts contain descriptions of events that lead to depression. On a sample of 100 posts, we conducted a qualitative thematic analysis based on cognitive behavioral theory investigating behavioral, emotional, and symptom responses to beliefs associated with depression. Results were organized into four themes. (1) Hopelessness, appearing as a set of negative beliefs about the future, possibly results from erroneous beliefs about the causal link between risk factors and the course of depression. We found beliefs about establishing a sturdy therapy alliance as a responsibility resting on the patient. (2) Therapy hesitancy seemed to be associated with negative beliefs about therapy prognosis and doubts about confidentiality. (3) Social shame appeared as a consequence of impaired daily function when the cause is not acknowledged. (4) Failing to attain social interaction appeared to be associated with a negative symptom response. In contrast, actively obtaining social support reduces symptoms and suicidal thoughts. These results could be used to meet the clinical aims stated by earlier psychoeducation development, such as instilling hope through direct reattribution of beliefs about the future; challenging causal attributions, thereby lowering therapy hesitancy; reducing shame through the mechanisms of externalization by providing a tentative diagnosis despite the risk of stigmatizing; and providing initial symptom relief by giving advice on how to open up and reveal themselves to friends and family and balance the message of self-management to fit coping capabilities. An active counseling style advises the patient to approach the social environment, demonstrating an attitude toward self-action.

How expectations and therapeutic style influence counselling outcome

AbstractObjectiveWith a lack of experimental designs in psychotherapy/counselling process research, evidence is limited regarding which therapeutic style is helpful for which patient and the role of expectations. Therefore, the aim of this experimental study was to manipulate the therapeutic style and clients' expectations towards psychological counselling and investigate their effects on counselling outcome.MethodEighty healthy participants (74% female, Mage = 31.2 years, SDage = 12.21) received a single counselling session focussing on interpersonal conflicts. We defined two therapeutic styles (relationship‐focussed vs. problem‐focussed) based on the interpersonal circumplex, and participants were led to believe they would receive one of the two styles. In the actual counselling session, they received either the expected or the contrary, resulting in a 2 x 2 design. Primary outcome rated by participants was subjective impairment caused by the conflict 2 weeks after the session; secondary outcomes were satisfaction with the session and perceived working alliance.ResultsThe successful implementation of the proposed therapeutic styles was confirmed by adherence ratings (U = 25.50, p < 0.001) and ratings of counsellors’ behaviour in the circumplex model (p < 0.001) for the friendly and hostile dimensions. Impairment was significantly reduced 2 weeks after the counselling session, but this effect was dependent on neither the therapeutic style, clients' expectations, nor their interaction.DiscussionThe study provides the first evidence that a single counselling session appears to be effective in alleviating impairment caused by an interpersonal conflict, independent of the counselling style and client expectations. The novel experimental design provides a basis for further process research in psychological counselling and psychotherapy.

Description and Demonstration Signals as Complements and Substitutes in an Online Market for Mental Health Care

Online markets for mental health care (OMMH) allow clients to connect remotely with counselors to receive psychological therapy. Rooted in signaling theory and in the specific context of an OMMH, we theorize relative credibility of signals as the boundary condition that determines whether the demonstration signal of responsiveness to client questions substitutes or complements the two description signals of professional qualifications and counseling style in predicting market demand for counselors from new clients in an OMMH. Based on a panel dataset of 823 observations from 309 counselors participating on YiXinLi, a leading OMMH in China, we tested our hypotheses using linguistic and sentiment analysis methods and zero-inflated negative binomial models. We found broad support for nine out of ten hypotheses. Findings are robust with respect to different measures of variables, potential endogeneity from the simultaneity of responsiveness and counselor demand, and potential selection bias from both observable and endogenous covariates. Our study extends the literature on signaling in online markets in the unique context of OMMH by showing that: (1) relative credibility of signals is the boundary condition that determines when a demonstration signal will complement and when it will substitute for a description signal, (2) previous clients’ feedback on counselors’ empathy and warmth was deemed not credible by new clients in the context of online counseling, and (3) responsiveness to client questions is the most influential predictor of market demand from new clients in an OMMH.

Fidelity and maintenance of motivational interviewing skills in diabetes prevention program coaches: a pilot study

ABSTRACT Motivational interviewing (MI) is an effective counseling style for changing lifestyle behaviors. The purpose of this study was to pilot a brief MI workshop on non-healthcare practitioners to deliver a community-based diabetes prevention program. Participants (n = 5) attended a two-day MI workshop, shadowed an expert coach delivering the diabetes prevention program, and finally, were shadowed by the expert coach and received feedback. Participants pre- and post-workshop MI skills were assessed, participants’ satisfaction with the workshop was recorded, and their delivery of the program using MI was assessed using a random selection of participants’ audio recordings of interactions with client. The primary outcome was whether coaches were able to maintain a level of client-centered MI skills for the six months post-training, as assessed by the Motivational Interviewing Competency Assessment (MICA). One session with one client per month for coaches’ first six months post-training was coded. Counseling scores were generated using the MICA. In general, coaches showed improvements from pre- to post-workshop, were satisfied with the training, and were using client-centered care over the six-month study period. The majority (80%) of all sessions were client-centered for all the MICA categories. This pilot study offers preliminary evidence that non-healthcare practitioners attending a brief MI training were able to deliver client-centered coaching in a community-based diabetes prevention program up to six months post-training without the use of any booster training sessions. This suggests that the training used within this study may be sufficient to train future non-healthcare practitioner diabetes prevention program coaches in the community.

Arab First-Generation Immigrants’ Wishes and Attitudes Toward Marital Counseling in Canada

ABSTRACT A mixed method study explored the attitudes and wishes of Arab first-generation immigrants (n = 86) in Canada regarding marital therapy. Results suggested positive attitudes toward seeking marital therapy, and overall attitudes significantly related to the likelihood of seeking marital therapy. Orientation to Canadian or Arab culture was associated with positive or negative attitudes toward marital therapy. Thematic analysis suggested participants wished counselors understood cultural norms and its impact on marriage, religious beliefs, native language, and shame and stigma toward counseling, while using a straightforward counseling style. Participants wished to improve communication, resolve marital conflict, have a supportive third-party, and acculturation support. Recommendations from this study for clinicians include building foundational understanding of the Arab culture, challenging bias, updating knowledge, assessing couple’s acculturation, and connecting with communities and religious leaders to inform them of counseling services.

Counselling for Testosterone Therapy in Mid Life Men.

Testosterone is frequently used for the optimization of mid-life health. This therapy is effective and safe if accompanied by adequate counseling, before prescription, and during administration. In this opinion piece, we discuss the style and substance of medication counseling for testosterone therapy. The role and scope of counseling are highlighted, with a focus on screening, diagnosis, medication counseling, sexual counseling, and monitoring. This article should prove useful for all health care professionals.

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

Introduction: Motivational interviewing is an evidence-based, collaborative style of counselling which addresses ambivalence by strengthening a person’s own motivation and commitment to change. This is achieved by utilising motivational interviewing spirit (partnership, autonomy, collaboration, and evocation) and skills (open questions, affirmations, reflections, and summaries). Since motivational interviewing is not trademarked, many practitioners claim to implement it while missing these key elements.

PATTERNS OF EXTENSION, INCENTIVES, LEADERSHIP STYLES, AND THEIR EFFECT ON EMPLOYEE PERFORMANCE

This paper aims to explain the effect of counseling patterns, incentives and leadership styles on the performance of the brown sugar micro-small industry Clushter in Blitar Regency. The results of the preliminary research show that the problems at this Clushter are the low performance of employees, the pattern of counseling given by the technical coach tends to be generalized, and the provision of incentives is less transparent. There has been no integration between leadership styles and individual abilities of employees which include talents, interests, and personality, skills of employees so that they have not been able to improve employee performance. The research model with hypothesis development was derived based on the literature. To provide empirical evidence, this study conducted a survey, primary data was collected using a list of questionnaires, and saturated sampling of 33 employees. The results showed that the pattern of counseling, incentives and leadership styles had a direct positive and significant effect on employee performance. The implication of the research is to examine the perceptions of 33 employees at the Clushter for Micro Small Brown Sugar Industry in Blitar Regency. The analytical technique used is multiple linear regression. This paper contributes to the theory of organizational behavior by explaining the effect of counseling patterns, incentives and leadership styles on employee performance.

Psychologically empowered during the job search: How empowering counseling affects job search process quality.

Computerization, environmental challenges, and the economic slowdown related to COVID-19 are expected to result in an increased number of job seekers in the near future. Although the quality of the job search process has been theoretically and empirically linked to job search success and employment quality, research on the determinants of job search process quality has been scarce. The present study uses the self-regulatory model of job search process quality to propose empowering counseling and psychological empowerment during the job search as promoting factors of job search process quality. Data was collected in a sample of clients at an outplacement agency at two separate points in time, 12 weeks apart. In total, 128 clients completed both questionnaires. The results of a moderated mediation analysis suggest that empowering counseling had a positive, indirect effect on job search process quality through psychological empowerment. This indirect effect was moderated by the bond with the counselor, such that the effect was stronger when the bond with the counselor was stronger. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement What's It Mean? Implications for Consulting Psychology -This research considers career counselors to be sources of instrumental and emotional social support for job seekers. An empowering counseling style is shown to be positively associated with psychological empowerment during the job search. Through psychological empowerment, empowering counseling is indirectly associated with the quality of the job search process. Counselors are advised to invest in relationships with their clients to enhance the indirect effect of empowering counseling on job search process quality. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Coronary risk reduction intervention for siblings and offspring of patients with premature coronary heart disease: the CRISO study protocol for a randomised controlled pilot study

BackgroundResearch has consistently demonstrated that preventive cardiology programs have limited success, and healthy practices among high-risk individuals remain suboptimal. Furthermore, there are no current programmes in Malta that offer support to first-degree relatives of patients with premature coronary heart disease. This internal pilot study will determine the feasibility, acceptability, and potential effectiveness of a preventative intervention.Methods/designWe are conducting a 12-month single-centre, two-armed group randomised controlled trial (RCT), recruiting a sample of 100 asymptomatic first-degree relatives of patients with premature coronary heart disease (CHD). The study seeks to test an evidence-based intervention to reduce modifiable risk and determine its feasibility and acceptability. The Intervention will be delivered at an outpatient office based in a large acute academic hospital. It will comprise risk communication using an online risk calculator, a counselling style adapted from motivational interviewing, and 12 weekly telephone goal reinforcement calls (3 months). Control subjects will receive verbal lifestyle advice only. Feasibility will be assessed through recruitment and retention. Qualitative evaluation interviews will be conducted with a subsample of 24 purposefully selected participants at 12 months. Assessment for risk factor changes will be measured at pre-intervention and 6 and 12 months. Associations between variables will also be assessed descriptively.DiscussionPreventive cardiology guidelines highlighted the importance of lifestyle interventions, and lifestyle intervention adherence was proven to reduce atherosclerotic cardiovascular disease (ASCVD) risk, regardless of the individual's genetic risk. Preventive cardiology programmes may fail to adequately support persons in modifying risky behaviours, and research demonstrates that healthy practices among high-risk individuals can remain suboptimal.Siblings and offspring of patients with premature CHD are at increased risk of ASCVD. Despite this, there is no process in place for routine screening and support to modify risk. It is hypothesised that participants assigned to the intervention arm will show more cardio-protective lifestyle-related improvement from the baseline than those in the control group. To date, this is the first trial being conducted amongst Maltese first-degree relatives. This study addresses the needed research, and the results will inform a definitive trial.The funding institution is the University of Malta.Trial registrationISRCTN, ISRCTN21559170; Registered 06/08/2020,

Career Guidance Services : Trait and Factor Career Theory Analysis

The future challenge in life for students is self-preparation in choosing a career. Career choice is a determination in decision making as a process where a person makes his choice based on the abilities and qualifications of the students themselves, according to the characteristics of each major, interests, talents, and knowing plans for future career prospects. Trait and Factor can be interpreted as a directive-counseling or counselor- centered approach, having the basic view that human personality is a system of interdependent traits and factors. Trait and factor is a counseling style that emphasizes individual understanding through psychological testing and the application of that understanding in solving various problems faced, especially those concerning career choices. This article is a literature review that will explain career guidance and counseling services in terms of Trait and Factor Career Theory Analysis. Data in this study sourced by books and journals that are credible and reputable.

Polygenic risk in familial breast cancer: Changing the dynamics of communicating genetic risk.

Hereditary breast cancer is associated with known genetic changes: either variants that affect function in a few rare genes or an ever-increasing number of common genomic risk variants, which combine to produce a cumulative effect, known as a polygenic risk (PR) score. While the clinical validity and utility of PR scores are still being determined, the communication of PR is a new challenge for genetic health professionals. This study investigated how PR scores are discussed in the familial cancer clinic compared with a previous study assessing the communication of monogenic risk (MR) for breast cancer. Sixty-five PR consultations between genetic health professionals and women at familial risk of breast cancer were audiotaped, transcribed, and coded using a methodology adapted from the MR study. Analysis of consultations shows that while there were similarities in communicating MR and PR, the complexity and novelty of the polygenic information influenced the style of counseling used by genetic health professionals toward a teaching model of genetic counseling, rather than a patient-centered approach. In particular, compared to MR consultations, in PR consultations significantly fewer counselees (a) were asked about their reasons for attending genetic counseling; or (b) had their information preferences, decision-making style, medical knowledge, understanding, or concerns checked. In conclusion, it is anticipated that PR scores will become part of standard clinical practice. Thus, it will be important for all genetic health professionals to be appropriately educated so that they can tailor their communication to meet patient needs.

Facebook Users' Interactions, Organic Reach, and Engagement in a Smoking Cessation Intervention: Content Analysis.

BackgroundFacebook can be a suitable platform for public health interventions. Facebook users can express their reaction to the given social media content in many ways using interaction buttons. The analysis of these interactions can be advantageous in increasing reach and engagement of public health interventions.ObjectiveThis research aimed at understanding how Facebook users’ interactions correlate with organic reach and engagement regarding the same smoking cessation support contents.MethodsThe study population consisted of Facebook users who were reached by a public smoking cessation support page without advertising. We included 1025 nonpaid Facebook posts (N=1025) which used smoking cessation strategies based on a motivational interviewing counseling style. The following data were collected from the “Post Details”: the number of people who saw the given nonpaid content (organic reach) which consisted of fan and nonfan reach according to previous “page like” activity; each rate of “engagement indicators” (such as the symbols of “like,” “love,” “haha,” “wow,” “sad,” “angry”; or other interactions: “shares,” “comments,” “clicks”); and the rate of negative Facebook interactions (eg, “post hides” or “unlike of page”). Overall, these data were analyzed with the Spearman correlation method.ResultsSurprisingly, we found a significant negative correlation between organic reach and the “like” reaction (rs=–0.418; P<.001). The strongest significant positive correlations of organic reach were observed with the “haha” reaction (rs=0.396; P<.001), comments (rs=0.368; P<.001), and the “love” reaction (rs=0.264; P<.001). Furthermore, nonfan reach correlated positively with “shares” (rs=0.388; P<.001) and clicks (rs=0.135; P<.001), while fan reach correlated positively with the “haha” reaction (rs=0.457; P<.001), comments (rs=0.393; P<.001), and the “love” reaction (rs=0.310; P<.001). Contrary to expectations, the “like” reaction was sharply separated by significant negative correlations from “wow” (rs=–0.077; P=.013), “sad” (rs=–0.120; P<.001), “angry” reactions (rs=–0.136; P<.001), and comments (rs=–0.130; P<.001). Additionally, a high rate of negative Facebook interactions was significantly associated with “wow” (rs=0.076; P=.016) and “sad” reactions (rs=0.091; P=.003).ConclusionsThis study has shown that it is possible to hypothesize a disadvantage of the “like” reaction and advantages of other interactions (eg, the “haha” reaction or “comments”) in content algorithmic ranking on Facebook. In addition, the correlational analysis revealed a need of a further categorization to fan-specific interactions (eg, “haha” or “love” reactions) and nonfan-specific interactions (eg, “shares” and “clicks”). Regarding the direction of the correlations, these findings suggest that some interactions (eg, negative Facebook interactions, “wow,” “sad,” and “angry” reactions) may decrease the engagement, while other interactions (“like,” “love,” “haha” reactions, “shares,” and “clicks”) may increase the engagement during Facebook-based smoking cessation interventions. This hypothesis-generating research offers an important insight into the relationship between organic reach, engagement, and Facebook users’ interactions for public health professionals who design Facebook-based interventions.

A medication adherence–enhancing simulation intervention in pediatric cystic fibrosis

Adherence to chronic pulmonary drugs in cystic fibrosis (CF) is suboptimal. We studied the feasibility and effectiveness of a multistep medication adherence-enhancing simulation intervention for pediatric CF, which was embedded in motivational interviewing and education. Product simulation experiments were performed by the children themselves, and they addressed adherence to mucolytics/hydrators and antibiotics. Dornase alfa-treated patients aged 7-13 years were included. We invited each patient and their parents to attend an interview. PowerPoint slides were presented and discussed. The final slide invited the patient to perform the simulation experiments, and, in so doing, they experienced what happens when they either do or do not take their medication. An educational film was applied as a summary tool. A patient-centered empathic counseling style was used. Two months later, the child and their parents each completed a different anonymous questionnaire. Overall, 21 patients were included. Parents rated the means of communication and improvement in their child's motivation as very satisfactory. Children highly appreciated the experiments they performed. They often answered two questions on dornase alfa correctly and associated knowledge with adherence. Our results suggest that experiential simulation-based learning is extremely appropriate, and that this multistep intervention is feasible and effective in pediatric CF.

Exercise and COVID‐19: reasons individuals sought coaching support to assist them to increase physical activity during COVID‐19

ObjectiveThis paper explores the experiences of individuals who reported substantially decreasing physical activity (PA) as a result of COVID‐19 and sought coaching support to increase PA. MethodsA qualitative study using phenomenological analysis. Eight individuals participated in semi‐structured interviews that focused on their experiences of decreasing PA as a result of physical distancing measures, and why they sought PA coaching to overcome these issues. Responses were analysed thematically. ResultsThe participants reported markedly decreasing their PA following the enactment of physical distancing measures. The inability to subsequently engage in regular PA was a source of frustration for participants. Interview analysis revealed two themes that contributed to the understanding of why these individuals felt they needed PA coaching to increase PA; namely, a desire for both listening support and PA self‐regulation support. ConclusionThe individuals who decreased PA due to COVID‐19 desired an autonomy‐supportive counselling style, centred on listening support and self‐regulatory support. Online PA interventions were not highlighted as strategies to overcome PA barriers. Implications for public healthThe effect of physical distancing measures on the determinants of overall PA is important, particularly if prolonged physical distancing is required.

Motivational Interviewing Training for Advanced Practice Nursing Students to Address Prescription Opioid Use Disorder: A Mixed Methods Approach.

Prescription opioid use disorder in the United States has increased to epidemic proportions and poses a challenging problem to health care providers. Motivational interviewing (MI) is a patient-centered counseling style that can effectively reduce substance abuse, but MI training has not been well incorporated into advanced practice nursing curricula. Standardized patient (SP) simulation is an educational tool that is growing in popularity because of its success in improving nursing skills. Medical students and residents who underwent a formalized MI training with an SP simulation showed positive results. This study aimed to determine whether an MI training with an SP simulation improved NP students' knowledge, confidence, and skills in MI. A one-group pretest-posttest repeated measures design was used. Quantitative data were analyzed using descriptive statistics and repeated measures analysis of variance, and qualitative data were analyzed using content analysis. Results indicated that the MI training showed a significant impact on students' confidence in MI and promising impacts on students' MI knowledge and skills. Students valued the training, favoring the SP component, and plan to use MI in future practice. An MI training can be effectively incorporated into an advanced practice nursing program and would better prepare students to address prescription opioid use disorder and effectively encourage behavior change among their patients.