Motivational Interviewing Techniques Research Articles

Enhancing Substance Use Disorder Recovery through Integrated Physical Activity and Behavioral Interventions: A Comprehensive Approach to Treatment and Prevention

The global issue of substance abuse demands ongoing initiatives aligned with the United Nations Sustainable Development Goals. With drug use remaining prevalent worldwide, interventions are critical to addressing the associated health challenges and societal implications. Exercise and physical activities have emerged as integral components of substance use disorder (SUD) treatment, offering promising avenues for prevention, intervention, and recovery. Recent research underscores the efficacy of exercise in reducing substance cravings, promoting abstinence, and improving overall well-being. However, integrating exercise into SUD recovery programs presents challenges such as dropout rates and cultural considerations. This paper synthesizes existing literature on exercise integration into SUD recovery, highlighting strategies for enhancing treatment outcomes and addressing barriers to exercise adherence. Drawing on cognitive–behavioral therapy, experiential learning, motivational interviewing, and goal-setting techniques, the holistic approach outlined in this paper aims to empower individuals both mentally and physically, fostering resilience and supporting long-term recovery. In conclusion, new initiatives need to be taken by advocating for inclusive policies, promoting community engagement, and fostering collaborations across sectors. By doing so, stakeholders can optimize the effectiveness of exercise programs and contribute to sustainable rehabilitation efforts for individuals with SUD.

Engaging Law Enforcement Employees in Mental Health Help-Seeking: Examining the Utilization of Interactive Screening Program and Motivational Interviewing Techniques.

The Interactive Screening Program (ISP) is an anonymous screening and dialogue platform used in workplaces to encourage mental health help-seeking. This study examined utilization of ISP among law enforcement workplaces and assessed how motivational interviewing techniques were associated with various help-seeking outcomes. This retrospective study used secondary ISP screening and dialogue data collected from 2013 to 2019 at four law enforcement workplaces or unions (N = 691). Independent variables include counselors' use of motivational interviewing techniques in their dialogue such as asking questions and showing empathy in their response. Help-seeking outcomes include requesting a referral, making a commitment to counseling services, decreased ambivalence about mental health services, and increased willingness to seek future services. Two-thirds of participants screened within the high distress level of ISP. Among them, 53% responded to the counselor's initial email and 50% of those who responded requested a referral for future services. Binary logistic regression models showed that counselors' use of confrontation in the dialogue was associated with improved willingness to seek services among ISP users (OR = 2.88, 95% CI = 1.24, 6.64). Further, ISP users who accessed ISP through their workplace peer support program, as compared to their employee assistance program (EAP), are more likely to show decreased ambivalence about seeking future services over time (OR = 0.28, 95% CI = 0.09, 0.80). This study demonstrates that the anonymous ISP program can successfully engage employees with high distress levels, including employees with suicidal ideation. Results highlight the importance of customizing ISP counselors' responses to be responsive for law enforcement employees.

Effectiveness of a School- and Primary Care–Based HPV Vaccination Intervention

The human papillomavirus (HPV) vaccine is safe and effective, yet vaccination coverage remains below public health objectives in many countries. To examine the effectiveness of a 3-component intervention on HPV vaccination coverage among adolescents aged 11 to 14 years 2 months after the intervention ended, each component being applied alone or in combination. A cluster randomized trial with incomplete factorial design (PrevHPV) was conducted between July 1, 2021, and April 30, 2022, in French municipalities receiving 0, 1, 2, or 3 components of the intervention. Randomization was stratified by school district and municipalities' socioeconomic level. Analyses were carried out on 11- to 14-year-old adolescents living in all participating municipalities, regardless of what had been implemented. The PrevHPV intervention had 3 components: (1) educating and motivating 11- to 14-year-old adolescents in middle schools, along with their parents; (2) training general practitioners (GPs) on up-to-date HPV information and motivational interviewing techniques; and (3) free HPV vaccination at school. The primary outcome was HPV vaccination coverage (≥1 dose) 2 months after the intervention ended among 11- to 14-year-old adolescents living in participating municipalities, based on the French national reimbursement database and data collected during the trial in groups randomized to implement at-school vaccination. A total of 91 municipalities comprising 30 739 adolescents aged 11 to 14 years (15 876 boys and 14 863 girls) were included and analyzed. Half the municipalities were in the 2 lowest socioeconomic quintiles and access to GPs was poor in more than two-thirds of the municipalities. Thirty-eight of 61 schools (62.3%) implemented actions and 26 of 45 municipalities (57.8%) had at least 1 trained GP. The median vaccination coverage increased by 4.0 percentage points (IQR, 2.0-7.3 percentage points) to 14.2 percentage points (IQR, 9.1-17.3 percentage points) at 2 months. At-school vaccination significantly increased vaccination coverage (5.50 percentage points [95% CI, 3.13-7.88 percentage points]) while no effect was observed for adolescents' education and motivation (-0.08 percentage points [95% CI, -2.54 to 2.39 percentage points]) and GPs' training (-1.46 percentage points [95% CI, -3.44 to 0.53 percentage points]). Subgroup analyses found a significant interaction between at-school vaccination and access to GPs, with a higher effect when access was poor (8.62 percentage points [95% CI, 5.37-11.86 percentage points] vs 2.13 percentage points [95% CI, -1.25 to 5.50 percentage points]; P = .007 for interaction). In this cluster randomized trial, within the context of the late COVID-19 pandemic period and limited school and GP participation, at-school HPV vaccination significantly increased vaccination coverage. The trial did not show a significant effect for training GPs and education and motivation, although it may be observed after more time has elapsed after the intervention. ClinicalTrials.gov Identifier: NCT04945655.

Enhancing medication management in hemodialysis patients: Exploring the impact of patient-centered pharmacist care and motivational interviewing.

Patients on hemodialysis (HD) often uses several medications, making them highly susceptible to medication-related problems (MRP) thereby leading to medication nonadherence. Therefore, an innovative pharmaceutical care strategy incorporating drug therapy optimization (DTO) and motivational interviewing (MI) can mitigate medication-related problems and optimize patient care. The objective of this study is to assess the efficacy of pharmacist led interventions in utilizing DTO and MI techniques in managing medication related problems among patients undergoing hemodialysis. A12-months, cross sectional prospective study was conducted among 63 End Stage Renal Disease (ESRD) patients on HD. DTO was conducted by the pharmacist to identify the MRP by reviewing complete medication list gathered from patient interview and medical records. All MRPs was classified using the PCNE classification version 9.00 and medication issues, that require patient involvement were categorized as patient-related, while those that necessitate physician intervention were classified as physician-related. The DTO was performed at the baseline, 6-month and at the final month of the study. Identified medication issues were communicated to the site nephrologist and was tracked during next follow up. Whereas MI was conducted physically at Month-3 and via telephone on month-6 and month-9 to address patient related medication issues. Mean age of the study population was 48.5±14 years. While the mean number of prescribed medications was 8.1±2 with 57% of the patients taking more than 5 types of medication. After 12 months of pharmacist intervention using DTO and MI, a mean reduction in MRP was observed for both patient-related and physician-related MRPs across three time series. However, further analysis using repeated measure ANOVA revealed that the reduction in patient-related MRPs was statistically significant [F(1.491, 92.412) = 60.921, p < 0.05], while no statistically significant difference was detected in physician-related MRPs [F(2, 124) = 2.216, P = 0.113]. Pharmaceutical care service through DTO and MI can effectively reduce and prevent drug-related issues to optimize medication therapy among HD patients.

My Partner Is My Family: Engaging and Advocating for Lesbian, Gay, Bisexual, Transgender, Queer+ Patients in Goals of Care Conversations.

In goals of care conversations and through the care trajectory, to avoid insensitive or discriminatory care, it is vital clinicians recognize lesbian, gay, bisexual, transgender, queer+ patients' values and wishes. In clinical settings, implicit bias operating within unconscious awareness may challenge the commitment to equitable care, negatively affecting patient outcomes. In this composite case, during a conversation with a social worker/nurse team, a cisgender woman repeatedly expressed her wishes for her female partner to be her decision maker instead of her biological family. The conversation stalled during the patient's attempts to identify her partner as her most valued and trusted person. Interviewer follow-up responses based on motivational interviewing techniques, which do not include strategies for lesbian, gay, bisexual, transgender, queer+ interactions, inaccurately reflected the patient's needs. Two ethical issues emerged, (1) autonomy and (2) beneficence. Clinicians should approach all patients using nongendered language, and allow patients to self-identify and decide which people are in their support system. Lack of inclusivity training has significant potential to affect the patient experience and decrease clinician/patient trust. Clinicians should not assume the decision maker is a cisgender, heterosexual partner or a biological family member. When patients speak about their partners, it is imperative clinicians use the patient's language and not avoid or redirect responses.

Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia.

HIV-positive people who inject drugs (PWID) experience challenges in initiating and adhering to antiretroviral treatment (ART). Counselling using motivational interviewing (MI) techniques may help them formulate individualised strategies, and execute actions to address these challenges collaboratively with their providers. We evaluated the acceptability of MI from a pilot implementation at three public health facilities in Indonesia. Adapting the acceptability constructs developed by Sekhon (2017) we assessed the acceptability to HIV-positive PWID clients (n = 12) and providers (n = 10) in four synthesised constructs: motivation (attributes that inspire engagement); cost consideration (sacrifices made to engage in MI); learned understanding (mechanism of action); and outcomes (ability to effect change with engagement). We included all providers and clients who completed ≥ 2 MI encounters. Qualitative analysis with an interpretive paradigm was used to extract and categorise themes by these constructs. In motivation, clients valued the open communication style of MI, while providers appreciated its novelty in offering coherent structure with clear boundaries. In cost consideration, both groups faced a challenge in meeting MI encounters due to access or engagement in other health care areas. In learned understanding, clients understood that MI worked to identify problematic areas of life amenable to change to support long-term ART, with reconciliation in family life being the most targeted change. By contrast, providers preferred targeting tangible health outcomes to such behavioural proxies. In outcomes, clients were confident in their ability to develop behaviours to sustain ART uptakes, whereas providers doubted the outcome of MI on younger PWID or those with severe dependence. There is broad acceptability of MI in motivating engagement for both actors. Relative to providers, clients were more acceptable in its mechanism and had greater confidence to perform behaviours conducive to ART engagement. Design innovations to improve the acceptability of MI for both actors are needed.

“I Don’t Want to Compete Anymore”: Using Self-Determination Theory and Motivational Interviewing to Help an Athlete Figure out What’s Next

Using a strong framework to help athletes undergoing a sport transition is important to ensure the process is as smooth and supportive as possible. Self-determination theory (SDT) and motivational interviewing (MI) are complementary paradigms that can help athletes navigate complex situations, like a sport transition, by taking a person-centered approach and focusing on autonomously selected goals. Theoretical elements and techniques of SDT and MI are reviewed, and used to illustrate how a mental performance consultant can help an athlete experiencing a sport-transition clearly define and work toward a goal that reflects their needs.

Pilot Study to Assess the Effectiveness of the Sustainable Culturally Adaptive Nutrition Program (SCAN) to Improve Adherence to the National Diabetes Prevention Program.

The Sustainable Culturally Adapted Nutrition Program (SCAN) is a novel adaptation to the National Diabetes Prevention Program (NDPP) that aims to improve attendance and effectiveness. This paper presents its feasibility and impact through the initial 6-month outcomes. A pragmatic quasi-experimental pilot study with intervention (DPP plus SCAN) and control (DPP only) groups. Sustainable Culturally Adapted Nutrition Program participants were recruited from federally qualified health center (FQHC) clinic patients enrolled in a NDPP in Houston, Texas. Participants needed to be (1) ≥18years old, (2) body mass index >25, (3) no prior diagnosis of diabetes, and (4) not pregnant. Sustainable Culturally Adapted Nutrition Program cooking classes were designed to teach skills to prepare fresh produce, and utilized Motivational Interviewing (MI) techniques to encourage participants to adapt these skills for foods that were culturally important to them. (1) National Diabetes Prevention Program attendance, (2) BMI and (3) percent weight loss. We used linear mixed models to test the association between weights and NDPP attendance. 22 intervention and 15 control participants completed the program to the 6-month point. Intervention participants had increased DPP attendance over controls (7.14 vs 6.87 session). Intervention participants also demonstrated on average, 1.5% weight loss for each additional SCAN class attended (P = .144). The SCAN adaptation shows promising results for effectively increasing both NDPP attendance and weight loss.

Testing the efficacy of narrator empathy, self-disclosure, gender, and use of brief motivational interviewing techniques in a brief internet-based intervention for alcohol use.

Nonspecific relational factors, such as therapist empathy, play an important role in therapy effectiveness. Building on this literature, some researchers have attempted to incorporate relational factors into electronic brief interventions (e-BIs) by using interactive narrators to guide participants through the intervention. However, few studies have examined which characteristics of these interactive narrators increase intervention acceptability and efficacy. The present study sought to systematically manipulate animated narrator characteristics in an e-BI and to examine their effects on respondents' alcohol use and subjective reactions. Participants (N = 348) were randomly assigned to 1-16 possible combinations of four narrator-level characteristics in a 2 × 2 × 2 × 2 factorial trial evaluating narrator empathy, self-disclosure, gender, and the use of brief motivational interviewing (BMI) techniques. We measured main and interaction effects of these characteristics on the primary outcome of typical drinks per week at 1-month follow-up. Secondary outcomes included maximum drinks, alcohol consequences, and subjective reactions to the intervention, with additional secondary analyses evaluating moderation by participant gender. Participants showed reductions in all alcohol outcomes. These reductions were stronger for participants exposed to either narrator disclosure or BMI techniques (vs. neither). Participants in the high empathy condition rated the intervention as more supportive, while those exposed to BMI techniques reported feeling more criticized by the intervention. Specific narrator-level characteristics, such as narrator self-disclosure and empathy, may improve the efficacy or acceptability of e-BIs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluation of an early childhood caries preventive programme starting during pregnancy-Results after 3 and 6 years.

Early childhood caries (ECC) has been found to be up to five times more common among children living in areas of low socio-economic status (SES) than among children in areas of higher SES. To evaluate an ECC prevention programme from pregnancy to 3 and 6 years of age. A prospective, controlled, intervention cohort study was initiated in 2013 in a low-SES area in Sweden. The intervention group received an individual interdisciplinary ECC prevention programme starting pre-birth, consisting of supportive oral health-promoting talks using motivational interviewing techniques and individual ECC preventive actions. A control group, consisting of pregnant women living in a comparable area, received ordinary routines. Of the 336 pregnant women, 64 mothers (with 64 children) completed the programme, and 394 children were born in the control group. At the sixth year examination, the proportion of children with no caries was similar between the groups (53% resp. 52%, p = .976), whereas the proportion with decayed, missed, filled primary teeth (dmft = 1-5) was slightly lower (23% resp. 36%, p = .063), and the proportion with severe caries disease (dmft > 5) was higher (p = .013) in the intervention group (25%) than in the control group (12%). No preventive effect regarding caries can be demonstrated at sixth year of age. Maternal behavioural change in dental care was not sufficient to even out inequalities in oral health in children, eventually due to difficulties in reaching the target group and the lack of effects among the families reached.

A multi-component intervention increased access to smoking cessation treatment after hospitalization for atherosclerotic cardiovascular disease: a randomized trial.

To evaluate the effects of a multi-component intervention for smokers hospitalized for atherosclerotic cardiovascular disease (ASCVD) on the participation rate in community-based cessation programmes and the use of cessation drugs. Additionally, to explore the impact on the cessation rates at 6 months. A randomized parallel-group study was conducted at a Norwegian secondary care hospital in 2021. The intervention group was: (i) counselled using motivational interviewing techniques during hospitalization; (ii) given an information leaflet, detailing the cessation programme; and (iii) referred to the community-based smoking cessation treatment including a post-discharge pro-active telephone invitation. The control group received usual care and the same information leaflet containing clear contact details for initiating participation. Data were collected at baseline, 1, 3, and 6 months. Among 99 smokers hospitalized with ASCVD, 40 were excluded. Of 59 randomized patients, 4 were lost to follow-up and 55 completed the study. The mean age was 65.1 (standard deviation 9.3) years, 35% were female, and 88% had smoked >20 years. Co-morbidity was prevalent (mean Charlson score 4.8). The intervention group was more likely to participate in the smoking cessation treatment {48 vs. 7%, difference: 41% [95% confidence interval (CI): 14%, 63%]} and used cessation drugs more frequently [59 vs. 21%, difference: 38% (95% CI: 17%, 59%)]. At the 6 months point prevalence, we observed notable between-group differences in self-reported cessation rate (48 vs. 25%). The intervention significantly increased the participation rate at community-based smoking cessation programmes and the use of cessation drugs among multi-morbid smokers hospitalized for ASCVD.

Effectiveness of a health communication intervention on health literacy in the first year following kidney transplantation – A randomized controlled study

ObjectiveThis study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation. MethodsWe randomized 195 patients during 2020–2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©). ResultsResults showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the “ability to appraise health information” Domain 5, (p-value = 0.002) and the “ability to navigate the healthcare system” Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points. ConclusionsThis study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients. Practical implicationsCurrent patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.

Cognitive Behavioral Counseling Vs Family Counseling: Which Motivational Interviewing Is More Effective to Reduce Game Addiction in Adolescents?

&#x0D; &#x0D; &#x0D; &#x0D; Game addiction is a phenomenon that can interfere with adolescents' social relationships, leading to emotional, behavioral or mental disorders. The COVID-19 pandemic has contributed to an increase in game addiction behavior, largely due to feelings of loneliness. The consequences faced by adolescents as a result of game addiction can significantly impact their personal, social, learning, and career aspects. Therefore, it is crucial to employ appropriate counseling techniques to effectively reduce this addiction. Empirical and practical evidence showed that Family Counseling and Motivational Interviewing Techniques were effective in addressing game addiction. This study aimed to show the effectiveness of the Family Counseling Motivational Interviewing (FCMI) technique in reducing game addiction, as compared to Cognitive Behavioral Counseling (CBC). A quantitative approach was utilized, with a randomized controlled trial as the study design. The hypothesis was analyzed using the Wilcoxon and Mann-Whitney Tests. A total of 90 adult students participated in this study and were classified into FCMI as the experimental group and the CBC as the control. The results showed that the FCMI technique was more effective in reducing game addiction than CBC. Significant improvements were also observed in the aspects of tolerance and mood modification, which experienced a notable decrease.&#x0D; &#x0D; &#x0D; &#x0D;

Physical activity counseling within the «KiKli Fit»-project: Development and first implementation

Introduction Increasing physical activity (PA) levels in children and adolescents with cancer holds promise for enhancing outcomes both during treatment and into survivorship (Stout et al., 2017). Despite this potential, the promotion of PA within Swiss pediatric oncology units remains largely overlooked. To address this gap, the “KiKli Fit” project has been initiated. This program features personalized training sessions during acute care, accompanied by PA counseling during the transition to the post-acute phase. Importantly, it engages not only the patients but also their families, since they play a crucial role in shaping youth’s PA behavior (Cheung et al., 2021). The PA counseling is designed to enhance motivation, volition, enjoyment, family health-climate, and ultimately, foster an active lifestyle (Schorno et al., 2022). This study aims to outline the theoretical development of the counseling approach and present initial findings from its implementation. Methods We plan a two-arm multicenter crossover-controlled trial to investigate the effects of the whole PA program. The trial will compare the PA program (intervention group in Bern, n = 40) with standard treatment (control group in Basel, n = 40). Participants will be aged 6-18, newly diagnosed with cancer and undergoing neurotoxic treatment for at least six weeks. The PA counseling comprises four sessions involving the child or adolescent and their parents. These sessions cover various topics, including parental concerns about their child performing PA, individual preferences in exercise and sports, and ways to be physically active as a whole family. Motivational interviewing techniques are applied across all sessions. The study will start in early 2024. Outcomes will be measured three times (once at admission, after twelve weeks of intervention and for follow-up after six months). Discussion The “KiKli Fit”-project is a complex program that aims to promote PA in and after acute care by combining personalized training sessions with PA counseling. The scalability of the PA counseling is a key advantage, allowing it to reach a wide demographic, including those who have completed treatment. Fostering PA in young cancer patients seems to particularly important because it can set a foundation for a healthier lifestyle as they transition into adulthood.

Motivational Interviewing as a Tool to Increase Motivation and Adherence to a Long COVID Telerehabilitation Intervention: Secondary Data Analysis from a Randomized Clinical Trial.

Although motivational interviewing was originally developed to address abuse disorders, scientific evidence confirms that it is an increasingly used and effective approach in a wide range of therapeutic interventions. To date, however, no studies have analyzed the use of this tool in patients with persistent symptoms following coronavirus disease 2019, a condition known as Long COVID. To analyze the effectiveness of motivational interviewing with regard to the adherence to telerehabilitation for Long COVID using a mobile application. As a secondary objective, factors related to greater motivation before and after the motivational interviewing techniques were analyzed. This longitudinal design substudy used a sample of 52 adult patients with Long COVID participating in the intervention group of a randomized clinical trial. This trial examined the effectiveness of a telerehabilitation program for this population using a mobile application. This program included three motivational interviews to achieve maximum treatment adherence. In this study, the main variables were motivation and adherence to application use. Sociodemographic and clinical data, personal constructs, and affective state were also collected. Subsequently, a descriptive, correlational, and regression statistical analysis was performed using the SPSS Statistics program. The median motivation prior to the first motivational interview was 8 (IQR 2), the median at the end of the last motivational interview was 8.5 (IQR 2.75), and the change in motivation levels after the three motivational interviews was 0.5 (IQR 1). Affective state and final motivation scores were predictors of greater adherence to telerehabilitation treatment. A high level of motivation after participating in motivational interviewing appears to be related to higher levels of adherence to telerehabilitation in patients with Long COVID. This suggests that motivational interviewing may be an effective tool in the treatment of this disease.

Alcoholmisuse/dependence carepathway in and outside the general hospital. Detecting, motivating and treating the whole person.

Problematic alcoholuse is a common problem, frequently missed , as somatic medicine and mental health services are seperated/siloed. Patients admitted to a general hospital have an increased probability of a comorbid alcoholproblem (and other mental health problems like depression and anxiety) which is not adressed due to the separation of mind and body, which leads to greater costs for society , poor patient experience and discomfort with the somatic team.&#x0D; Comorbidity within the general hospital is largest for the patient with gastrointestinal (GI) problems, which is why we opted to roll out our approach here, gradually expanding to other patient groups in a later stage.&#x0D; To tackle this problem, the mental health department of the hospital contacted the GI-team (i.e. nurses, doctors, social services), the psychological services, management, general practitioners and service users (AA).&#x0D; After consultation of the existing literature, we chose a collaborative care approach mixed with population based screening and a proactive approach. In the past, a care pathway for alcohol was developed with first line actors (general practitioners, social services, psychologists, AA and mental health services), which was used to determine the level of care in the hospital and after discharge. The team comprises a fulltime psychiatric nurse and 0.3 full time employee (FTE) psychiatrist (trainee) embedded in the somatic GI team.&#x0D; Patients are screened for alcohol and psychiatric issues within 48 hours. If necessary, the appropriate detoxification scheme is started and followed up by the somatic team, aided by the mental health team. The patient is assessed and encouraged to stop drinking, depending on the stage they are in. Motivational interviewing techniques are used, along with psycho-education and other (pharmacological) interventions. A care plan is developed together with the patient and is then communicated with the primary care provider. &#x0D; After discharge, psychiatric follow-up is scheduled with the primary care provider, mobile crisis team or psychiatric nurse when pt comes for follow-up visits to the ambulatory GI service if needed.&#x0D; Teammembers are trained in mental health issues so they become able to recognice and handle mental health issues, making them much more comfortable with comorbid psychiatric problems and optimizing workflows.&#x0D; &#x0D; We have since expanded to the AE department and planned surgery. &#x0D; Since the program started there were fewer cases of delirium tremens. Due to a merger with an other hospital while the pathway started we have no exact data. Over a period of 1 year 235 patients were included in the project and 143 were followed-up after testing positive on intake for planned surgery.&#x0D; We want to further expand to the entire hospital and develop a digital care support plan which follows the patient after discharge, with all the information about the patient for future care-givers, with their care plan , controlled by the patient.&#x0D; Due to COVID, involvement of partners outside the hospital was delayed. This is now top of the agenda.&#x0D; As a proof of concept this integrated pathway was well received and initiated a new pathway , integrating mental health into perinatal care.

Effects of Near-Peer Motivational Interviewing Teaching on Greek Medical Students

BACKGROUND: Obesity presents as a significant and increasingly prevalent public health problem globally. Greece reported an adult obesity rate of 17% in 2016 (OECD) and a more alarming paediatric overweight/obesity rate of 1 in 3 children (WHO). However, weight management can be difficult to negotiate and implement successfully with patients. Previous studies have reported positive results when utilising Motivational Interviewing (MI) techniques in these consultations. To ensure that healthcare systems are well-equipped to deal with increasing obesity rates, it is important to develop MI skills in medical students. Near-peer teaching has been reported as an effective method to improve student learning, and a gap in the literature exists regarding this type of teaching initiative for MI skills. AIM: To introduce and assess the effects of near-peer MI teaching, with the focus on weight management, on the knowledge and skills of medical students with limited previous exposure to the topic. To evaluate and compare how different methods of delivering near-peer teaching material between in-person and online sessions affect teaching efficacy. METHODS: An interactive seminar was delivered in English/Greek, both in-person and online, for Aristotle University of Thessaloniki (AUTh) students in years 3-6 and year 6 respectively. Materials were adapted to the local context from curriculum and literature, and delivered by final year AUTh and KCL medical students based at AUTh. Each seminar consisted of a theoretical section and a practical section. First, a teaching sheet was handed out to the participants that accompanied a PowerPoint presentation. The latter included information on MI for the Overweight/Obese Population, as well as demonstration video clips on certain concepts. Following the presentation, participants were split into small groups to apply MI in a Role-Playing environment. Scenarios were handed out and practiced by two participants in each group, as well as Examiners’ checklists for the observers. This process was repeated three times with different scenarios and participants, and each turn was followed by a short discussion to provide feedback. Anonymous pre- and post-teaching evaluation surveys were also distributed and returned immediately before and after teaching with both cohorts. RESULTS: There were 88 total participants, with 10 in the in-person and 78 in the online cohort. A significant improvement (p&lt;0.001) was seen for both in-person and online cohorts in 5-point Likert confidence ratings for using MI skills whilst consulting both simulated (95%CI, i-p[1.83,3.37];o[1.64,2.05]) and real (95%CI, i–p[1.71,3.09];o[1.56,2.00]) overweight/obese patients. The in-person cohort showed greater positive change across all question domains assessing confidence on session content compared to the online cohort, beginning with skills such as motivational interviewing. CONCLUSION: Near-peer education is an effective method to improve medical student confidence in MI skills, and suggests the potential success of a long-term student-led clinical communication skills course run alongside the core curriculum.

Application of motivational interviewing to group: Teaching advance care planning via group visits for clinical professionals

ObjectiveAdvance Care Planning (ACP) via Group Visits (ACP-GV) is an innovative patient-centered intervention used in the United States Department of Veterans Affairs (VA) healthcare system. The goal of ACP-GV is to spread ACP to veterans and caregivers in medically underserved rural areas. Veterans, caregivers and those they trust participate in a group led by clinicians in Veterans Health Administration healthcare and/or community-based settings. To learn how to facilitate ACP-GV, clinicians attend ACP-GV training. The training teaches the ACP-GV group model and the theoretical components of Motivational Interviewing (MI) (Rollnick & Miller, 1995), which are used to empower participants to have conversations about their healthcare values and preferences. Therefore, the aim is to describe the specific MI techniques utilized by group facilitators in the innovative ACP-GV intervention. DiscussionWe provide exemplars for how group facilitators apply the MI techniques to the group discussion with participants. Lastly, we provide a scripted case example of a coded MI-concordant session of ACP-GV delivered with veterans in a healthcare setting that can be used in future training and education for clinicians interested in facilitating ACP using a group modality. ConclusionMI is a key aspect of delivering ACP-GV, a high-quality, patient-centered intervention for veterans, caregivers and those they trust.

A STUDY OF COMMUNICATIVE STRATEGIES AND TACTICS IN MEDICAL COLLEGIAL DISCOURSE

The research deals with the study of communicative strategies and tactics in medical collegial discourse. The speech strategies of communicators have been studied based on audio recordings of dialogues between students/doctors and patients, and typical macro intentions of student-doctors ("support", "prohibition", "ignoring") were identified, according to this was suggested the classification of communication strategies and tactics: cognitive reframing, persuasive Communication strategy, motivational interviewing techniques, feedback tactics, information strategy. The analysis showed that the appropriateness of the selected approach depends on the context of the situation and affects the achievement of mutual understanding with the patient. The problem of studying communicative strategies and tactics of professional discourse is widely presented in the research of foreign authors such as J. Heritage, D.W. Maynard, S. Fleischman, N. Ainsworth-Vaughn, et al. Communication between a doctor and a patient is at the center of researchers' attention as a phenomenon that acts as a multifaceted construct and is considered in modern linguistics from pragmalinguistic, dialogic, culturological, and sociolinguistic positions. Reforms carried out in the healthcare system over the past years have led to the need to change the paradigm of doctor-patient communicative interaction models: the paternalistic model is replaced by a collegial model, which has led to the analysis of the effectiveness of the doctor-patient communication models, the study of the specifics of the linguistic implementation of their cognitive and speech strategies, comparing the results obtained and determining the reasons for the success or failure of specific speech strategies and tactics.

Are primary care providers able to effectively use motivational interviewing techniques in clinic?

Are primary care providers able to effectively use motivational interviewing techniques in clinic?