Motivational Techniques Research Articles

Healthy Me: A retrospective review of a pediatric resident run clinic for children and with overweight or obesity

Objective: Using motivational interview techniques, we aimed to encourage families to make healthy lifestyle choices with the goal of a decreased child’s body mass index percentile for age over time. Methods: We designated one afternoon each week to a special clinic focused on healthy lifestyle habits. Parents were referred to our clinic from private pediatricians in the area. During the initial visit which included the parent, the child and the resident, plus or minus a nutritionist or a family and marriage therapist, we focused discussion on assessment of current lifestyle habits and then on goal setting regarding lifestyle, exercise and diet. Patients and their families were seen every 1-3 months. During subsequent visits we focused discussion on reassessment of previously stated goals. Results: Over one half of our patients achieved a lower or steady body mass index percentile for age compared to their starting percentile. Conclusions: Simple and effective techniques can be incorporated into every pediatric visit to help educate and encourage families with a child with overweight or obesity.

The Role of Motivational Techniques and Strategies Used by Teachers to English Language Classroom at Secondary School Level

The purpose of this study is to examine the role of motivational techniques employed in secondary school classrooms by public and private school teachers to encourage students. A total of two hundred and forty (240) secondary school teachers from eight public and private schools participated in the study. The information was gathered using a simple sampling approach. A questionnaire was utilized to gather information from teachers to determine how these techniques were implemented in public and private schools. To assess if there was a difference in opinion between the two types of secondary schools, an independent sample t-test was used. The findings found that teachers in both types of schools used a variety of techniques, including cooperative instructional behavior and lesson structuring. Overall work, reading, and writing abilities of students. In addition, private school instructors were more appreciative of students' achievements to motivate them than public school teachers. Teachers at private schools were also found to be more active in encouraging and counseling students to read newspapers than teachers in public schools.

THE EFFECT OF MOTIVATION ON THE PRODUCTIVITY OF SKILLED WORKERS IN THE NIGERIAN CONSTRUCTION INDUSTRY

The Nigerian construction industry is extremely reliant on skilled workers to carry out complex projects. Motivating these workers is crucial for enhancing their productivity and achieving project success. This paper explores the effect of motivation on the productivity of skilled workers in the construction industry. The research methodology involves a review of existing literature on the subject, as well as a survey of professionals and skilled workers in the construction industry. One Hundred and fifty-six (156) copies of structured research questionnaires were administered to workers in eight (8) construction companies in Awka the Anambra state capital and staff in the School of Environmental design and Technology of the Federal Polytechnic Oko comprising Architecture, Building, Estate Management, Quantity Surveying, Surveying & Geoinformatics together with Urban & Regional Planning Departments. Out of the 156 copies distributed, 114 copies representing 73% of the questionnaires were duly completed and returned by the respondents. The data collected were analysed using inferential statistics. The result showed a high degree of correlation between motivation and the productivity levels of skilled operatives in the construction industry. The research also revealed the perception of construction industry employees on motivation and motivational techniques in the construction industry to be reasonably acceptable. Overall, the findings of this paper suggest that motivation is a crucial factor in enhancing the productivity of skilled workers in the construction industry. Financial incentives, recognition, job security, training and development, and job satisfaction are among the most important motivators that can be used to enhance worker productivity. The paper concludes by recommending strategies that construction firms can implement to motivate their skilled workers and improve productivity, ultimately leading to successful project outcomes. It is recommended that the welfare of workers and the identification of what motivates workers will go a long way in maintaining healthy relationship in the industry.

Applying TEC-VARIETY to Motivate and Engage Learners for Online Learning Success.

Learner motivation plays an essential role in overcoming barriers to achieve online learning success. Many health professions educators, however, are not familiar with evidence-based motivational principles and techniques that tap into learners' inner resources to promote online learning success. The TEC-VARIETY (T-Tone; E-Encouragement; C-Curiosity; V-Variety; A-Autonomy; R-Relevance; I-Interactivity; E-Engagement; T-Tension; and Y-Yielding products) framework provides evidence-based principles and techniques that motivate and engage learners. Health professions educators can identify and assemble appropriate activities to motivate and engage online learners. Educators are encouraged to use Design-Based Research to guide their adoption of TEC-VARIETY and evaluation of outcomes.

Artificial intelligence-based personalized serious game for enhancing the physical and cognitive abilities of the elderly

Recently, therapeutic exercise serious games have been successfully conducted to enhance cognitive decline in dementia and to aid physical rehabilitation. However, these promising results are only possible based on the premise that the elderly players can keep on playing the game with high motivation until they can see the clinical effects. In line with this, this study was conducted to design a digital healthcare application aiming at improving the elderly’s physical and cognitive functions. This study designed the exercise serious game Farming with Artificial Intelligence-(AI-) based personalized systems of difficulty level adjustment and relative scoring to motivate the user to keep playing the game with pleasure while applying a set of gratification and motivation technique. This study also designed a three-month empirical assessment on user satisfaction and performance test. Results of the study showed that all three aspects of immersion, satisfaction, and performance records become higher than other existing games in the market, which proved the suitability and utility of the proposed serious game as a digital healthcare application. Thus, the personalized and playful elements for the exercise games is expected to provide a more motivating and entertaining environment for the elderly users for further practical and wider usage of emerging digital healthcare applications.

The competence of a coach in sports: How does it correlate with athlete motivation?

Sports coaches hold integral roles in sports organizations. As important figures for athletes, coaches are responsible for maintaining athletes’ motivation which will drive their performances in matches. To motivate athletes, coaches must possess good competence which reflect their quality as coaches. This study analyzes the effect of coach competency on athlete motivation. Coach competency in this study is represented by four indicators: Motivation Competency, Game-strategy Competency, Technique Competency, and Character-building Competency. Each and every indicator’s effect on athlete motivation was investigated. The instrument in this study used a questionnaire with 42 question items. This study is an explanatory research conducted on 114 student basketball athletes in Indonesia as respondents. Data analysis was conducted using SEM-PLS on the WARP-PLS 7 software. The results of this research show that overall, motivation competency, technique competency, character building competency, and game-strategy competency which represents the coach competency variable have a positive effect on athlete motivation (p<0.05), while motivation competency has no effect on athlete motivation (p>0.05). Game strategy competency, technique competency, and character building competency has positive effects on athlete motivation (p<0.05). This research contributes to increasing scientific knowledge among coaches and athletes about the importance of competence for the motivational aspect. The limitation in this study is that the sample used only comes from basketball athletes so it is not yet known whether there is a similar relationship between the competence and motivation of other sports coaches. Therefore, future research can examine the relationship between the competence and motivation of coaches in sports such as football, volleyball, and handball.

Change talk: developing a therapeutic relationship with your patients

Building trust and a relationship with patients is the foundation for loyalty, which leads to repeat bookings and recommendations. In this article, Jason Ratcliffe discusses how to break the ice and get a conversation started with your patients. In some cases, understanding motivational interviewing techniques can help practitioners to guide patients to develop their strategies themselves to deal with problems they may discuss with in confidence

Strategies for Implementing an Oral Medication Adherence Intervention in Academic and Community Cancer Settings

Background: Oral anticancer (OAC) agents revolutionized the treatment of once-fatal chronic leukemias by extending survival and delaying progression; however, this requires a medication adherence rate >90%. Innovative models to improve patient knowledge and adherence to OACs exist. A critical limitation of these previous models is a lack of clear strategies to improve their adoption, implementation, and maintenance. Previously, we identified barriers and facilitators to the implementation and maintenance of a medication adherence intervention for OACs. Here, we use focus group discussions with clinical teams, administrators, and patients to design practical strategies for the program's adoption, implementation, and maintenance. Methods: We assembled an advisory panel with clinicians (n=9), administrators (n=7), and patients (n=2) in two settings (an academic and a community cancer center) to design practical strategies for the adoption, implementation, and maintenance of a structured adherence intervention using a 5-step systematic approach called implementation mapping. We report findings from the first three steps. In step 1 (needs assessment), we conducted a consensus building discussion followed by a survey to identify perceived importance and changeability of predetermined barriers to implementation of adherence interventions (from literature review and qualitative interviews). In step 2 (determine outcomes/objectives), we identified agreeability with predetermined performance outcomes and objectives associated with the adoption, implementation, and maintenance of the program. Both surveys consisted of questions measured using a 5-point Likert scale response, ranging from 1 (not at all important/extremely difficult) to 5 (Extremely important/extremely easy). Results from these surveys were used to select and produce implementation strategies (steps 3-5) using the CFIR-ERIC Strategy Matching Tool (https://cfirguide.org/choosing-strategies/ which helps match evidence-based strategies to identified barriers) to address previously identified barriers to program implementation. Implementation strategies were further refined through focus group discussions with health care practitioners. Results: Three sets of consensus-building sessions followed by surveys were conducted with the advisory panel. In the first set, after the qualitative focus group discussion, 14 participants completed a survey (Figure 1), where 4 barriers to adherence were assessed. Survey participants found all barriers surveyed to be important to address, with >70% of survey respondents selecting 4 or 5 for every barrier. However, all but one barrier was perceived as difficult to change, with low awareness of the evidence behind the adherence intervention perceived as neither easy nor difficult. In the second set, a consensus-building discussion was held with the advisory panel followed by a survey aimed at selecting program outcomes and objectives. Seven participants completed the survey (Table 1) and 10 performance outcomes and 18 performance objectives were assessed. There was moderate to high agreement (range: 4.0 to 5) on all 28 items, with >85% of participants selecting 4 or 5 on 25 of the 28 items. In the third set (focus group and survey), we aimed to identify and refine implementation strategies. Nine participants completed a survey, and 21 strategies were proposed (8 for adoption; 11 for implementation; 2 for maintenance) with moderate to high levels of agreement (range: 3.78 to 5) for all strategies. After a final focus group discussion with the advisory panel, four strategies were reached for final production: 1) Development of a standard operating procedure; 2) Creation of a short course on implementing motivational interviewing techniques to improve adherence; 3) Defining measurable performance indicators and metrics; and 4) Scheduling quarterly meetings with clinical teams. Conclusions: Using a systematic approach and an interprofessional advisory panel, our team confirmed known and modifiable barriers to the adoption, implementation, and maintenance of a structured adherence intervention. Through quantitative surveys and qualitative focus group discussions, we built consensus program outcomes and objectives as well as practical implementation strategies. Using these results, we plan to pilot and evaluate an oral chemotherapy adherence program. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Modeling Motivational Interviewing Strategies on an Online Peer-to-Peer Counseling Platform

Millions of people participate in online peer-to-peer support sessions, yet there has been little prior research on systematic psychology-based evaluations of fine-grained peer-counselor behavior in relation to client satisfaction. This paper seeks to bridge this gap by mapping peer-counselor chat-messages to motivational interviewing (MI) techniques. We annotate 14,797 utterances from 734 chat conversations using 17 MI techniques and introduce four new interviewing codes such as ''chit-chat'' and ''inappropriate'' to account for the unique conversational patterns observed on online platforms. We automate the process of labeling peer-counselor responses to MI techniques by fine-tuning large domain-specific language models and then use these automated measures to investigate the behavior of the peer counselors via correlational studies. Specifically, we study the impact of MI techniques on the conversation ratings to investigate the techniques that predict clients' satisfaction with their counseling sessions. When counselors use techniques such as reflection and affirmation, clients are more satisfied. Examining volunteer counselors' change in usage of techniques suggest that counselors learn to use more introduction and open questions as they gain experience. This work provides a deeper understanding of the use of motivational interviewing techniques on peer-to-peer counselor platforms and sheds light on how to build better training programs for volunteer counselors on online platforms.

Effect of the e-health supported INTER-ACT lifestyle intervention on postpartum weight retention and body composition, and associations with lifestyle behavior: A randomized controlled trial

We investigated whether a postpartum lifestyle intervention reduced postpartum weight retention (PPWR) and improved body composition, and whether improved lifestyle was associated with less PPWR and improved body composition. A total of 1075 women with excessive gestational weight gain were randomized into the intervention (N = 551) or control (N = 524) group. A completion rate of 76% was reached. Anthropometrics and lifestyle data were collected at 6 weeks and 6 months postpartum. The e-health supported intervention consisted of 4 face-to-face coaching's, focusing on nutrition, exercise and mental wellbeing and using motivational interviewing and behavior change techniques. In the intervention group we observed; larger decrease in weight in women who reduced their energy intake (mean ± SD: 3.1 ± 4.2 kg vs. 2.2 ± 3.8 kg, P = 0.05) and decreased uncontrolled eating (3.5 ± 4.2 kg vs. 1.9 ± 3.7 kg, P ≤0.001) by the end of the intervention; larger decrease in fat percentage in women who reduced energy intake (2.3% ± 2.9 vs. 1.4% ± 2.7, P = 0.01), enhanced restrained eating (2.2% ± 3 vs. 1.4% ± 2.6, P = 0.02) and decreased uncontrolled eating (2.3% ± 2.9 vs. 1.5% ± 2.7, P = 0.01) and larger decrease in waist circumference in women who reduced energy intake (4.6 cm ± 4.8 vs. 3.3 cm ± 4.7, P = 0.01), enhanced restrained eating (4.5 cm ± 4.8 vs. 3.4 cm ± 4.8, P = 0.05) and decreased uncontrolled eating (4.7 cm ± 4.8 vs. 3.3 cm ± 4.8, P = 0.006), compared to those who did not. Improved energy intake, restrained eating and uncontrolled eating behavior were associated with more favorable outcomes in weight and body composition.ClinicalTrials.gov identifier:NCT02989142.

Patriotism as a conduit to employee environmental engagement in a post‐Soviet economy in transition

AbstractThis paper investigates the way in which first‐line managers in Belarusian chemical companies used environmental framings of the notion of homeland and linked these to Soviet‐legacy organisational practices in order to encourage members of staff to engage in proenvironmental behaviour at work. Participants presented three different framings of homeland: Rodina (the motherland), small Rodina (one's more immediate surroundings), and Katorga (“a country with forced labour”) to show how a sense of environmental responsibility could (or could not) be linked to them. Different Soviet‐legacy motivational and mobilisation techniques could be used by front‐line managers to encourage and reward proenvironmental engagement in employees who were amenable to different framings of homeland. The paper contributes to the limited literature on patriotism as a conduit to environmental virtue and engagement, and to the equally scarce literature on proenvironmental attitudes and behaviours in post‐Soviet economies in transition. Through rich, qualitative descriptions of emotionally coloured framings of homeland as constitutive of environmental responsibility, we show how notions of patriotism linked to specific organisational practices provide front‐line managers with a language and motivational techniques to address employees' environmental engagement—or lack thereof.

Assessing the impact of the COVID-19 infodemic on older people in the region of Crete

Abstract The COVID-19 pandemic has been accompanied by an unprecedented infodemic, a key global public health challenge. Older people are more susceptible to COVID-19 and to misinformation, with WHO indicating the need for research on how people process and manage information in physical and digital environments to better understand how this phenomenon affects individuals. A qualitative study was developed in to explore the infodemic impact on elderly groups (eligible beneficiaries, aged 60-75 y, users of social services in the Heraklion Regional Unit, Crete Greece). Preliminary results indicate low trust levels for information delivered online and through media. Physicians remain the most trusted and preferred source of information, yet participants questioned their expertise level given the various issues emerging during the pandemic. Most of them report poor quality, incomplete information and point out the misleading role of media pluralism. Key topics of concern include the origin of SARS-CoV-2 and the safety and effectiveness of COVID-19 vaccines. The majority strongly believes that coronavirus is of lab origin, as they have read on the Internet. They are also susceptible to fake news and myths surrounding COVID-19 vaccines. Many of them also suffer from “pandemic fatigue”, i.e., information overload, preferring not to further follow COVID-19 updates. Fear about their vulnerability was the major factor mentioned regarding scientific evidence, stating they prefer information to be conveyed clearly and in an understandable manner. Some exchange information with relatives and friends whilst others prefer not to discuss COVID-19, unless they consider the other person knows more than they do. Nevertheless, they all believe they make the best choices on how to protect their health, whilst having mixed feelings about the manner and content of communication received both in physical and digital environments. Key messages • COVID-19 care for the elderly should encompass infodemic management elements, incl. information presented using simple terms, from updated and regularly verified sources, ideally in printed form. • Health and social care professionals’ training should include media discourse, compassionate care, and motivational communication techniques rather than directional speeches of coercion and fear.

Fostering Need-Supportive Behaviors in Physical Education Teachers and Parents: A Cluster Randomized Controlled Trial Study Protocol of a Web-Based Intervention on Secondary School Students' Physical Activity.

Despite various benefits of physical activity, children are increasingly inactive. Both school physical education classes and support from parents are important determinants of physical activity level of children and adolescents. We aim to develop a web-based intervention for physical education teachers and parents to teach them to be more need-supportive towards children when discussing physical activity and thus increase children’s autonomous motivation towards it. The study will adopt a waitlist-control design with cluster randomization by schools. The intervention content is based on self-determination theory. Specifically, the teachers and parents will be introduced to a series of motivation and behavior change techniques to help them satisfy the children’s psychological needs for autonomy, competence, and relatedness in physical activity. The targeted group in the six-week intervention is comprised of students aged 12–14 years. The primary outcome variable, physical activity of students, will be assessed via self-report questionnaires at baseline, post-intervention, one-month and six-month follow-up. Web-based intervention programs are cost-effective, allow self-paced learning and enable reaching larger audiences. If this project proves to be effective, a highly valuable web-based solution would be available for PE teachers and parents to help increase students’ physical activity levels.

Sustainable Innovation and Creative Behavior: the Mediating Effect of Technology Application from Early Adopters

Innovation adoption and technology application models have revolutionized the hospitality and food sectors. Innovation is very important to the sustainable development of enterprises. However, current knowledge on whether and how sustainable innovation and innovation adoption can be understood from the perspective of technology application behavior has not been examined empirically. Based on decision-making levels derived from the attitude-implementation-confirmation (A-I-C) framework and following rule conditions on front- and back-of-house processes, the aim of this study is to provide practical recommendations for the establishment of a pattern of green innovation action that influences the implementation of innovation among early adopters in the restaurant industry. Using 499 questionnaire responses and diverse statistical methods, we verify that the effect of innovation adoption is significant and positive on sustainable innovation, and the effects of innovation adoption and sustainability are both significant and positive on technology application and behavior, respectively. Moreover, the effects of technology application are significant and positive on behavior and mediate the link between innovation adoption and behavior. Finally, technology application is modestly moderated by green resource motivation techniques (GrRMT) to influence behavior. The empirical results proved that innovation adoption, sustainable innovation, technology application and GrRMT improve the mechanism of creative behavior in the food/ hospitality sector.

Factors Contributing to Poor Academic Achievement Among Low Performing Pupils: A Case Study

: Despite numerous efforts by the Malaysian Ministry of Education to raise educational quality especially in the wake of the Covid 19 pandemic, the number of low-performing pupils in Malaysian schools remains a serious concern. Additionally, the number of pupils’ dropping out has increased during the period of online facilitation. This qualitative case study examines factors contributing to poor academic achievement among low performing pupils. Also, it explored the strategies to overcome those factors. Sampling was purposeful as this study required the views of both those who were directly part of the low-performing group either as students or educators. Five teachers and five low academic performing pupils were chosen as participants from a Malaysian primary school. Data was gathered through scheduled semi-structured interviews with teachers and pupils. The study sought to explore the factors that contribute to poor academic achievement, and those which are frequently overlooked. The findings revealed that the main factors related to pupils with low academic performance, were lack of family or parental support, financial issues, motivation, learning facilities, interaction, equality and teaching techniques. These findings will help teachers, school administrators, curriculum designers and developers to plan new teaching and learning strategies in their classrooms.

Effect of in-hospital nurse-led smoking cessation intervention for patients with atherosclerotic cardiovascular disease: a randomised pilot study

Abstract Background Smoking remains prevalent after cardiovascular disease (CVD) events and knowledge on how to facilitate effective cessation in clinical practice is needed. Purpose To test the effect of an in-hospital nurse-led intervention on the participation rate at municipal Healthy Life Centres (HLC) and the use of smoking cessation drugs. Secondary, to determine long-term effects on cessation rates. Methods A prospective, randomized, open-label, parallel-group intervention pilot-study was conducted at a Norwegian secondary care hospital in 2021. Patients with atherosclerotic CVD who smoked at least one cigarette daily when admitted with an acute CVD event were consecutively included. The nurse-led intervention included cessation counselling utilizing motivational interview technique, information and guidance in proper use of cessation drugs and direct referral to a 12-weeks digital (video ± phone) HLC program where patients received free cessation drugs. The low-threshold intervention included written information about the offer in the HLC with free cessation drugs. The primary endpoints were between-group differences in attendance rates at the HLC program and the use of cessation drugs. Results Of 99 potential participants, 24 did not meet the entry criteria whereas 17 declined to participate. Of 58 randomised patients, three died during follow-up and 55 completed the study. Mean age was 65.7 (SD 9.2) years, 35% were female, 88% had low education, 88% had smoked >20 years, and motivation for quitting smoking was high (mean 8.5 on a 0 [no motivation] to 10 [high motivation] Likert scale). Comorbidity was common (mean Charlson score 5.1) and 40% had symptoms of anxiety and/or depression. The nurse-led intervention resulted in significantly higher participation rate at the HLC (48% vs. 4%, difference: 44% [95% CI: 24%, 65%], P<0.0001) and more frequent use of cessation drugs (48% vs. 11%, difference: 37% [95% CI: 15%, 60%], P=0.002) compared to the low-threshold intervention (Figure A). All participants in the intervention group who attended the HLC program were offered follow-up within 21 days following randomisation. In the intervention group 15% used varenicline and 33% used a combination of short and long-acting nicotine replacements. Clinically significant differences in cessation rates after six months were observed between the groups (Figure B). Concomitant carbon monoxide measurements were obtained of 5 participants in the intervention group and 4 in the control group who reported cessation and all confirmed non-smoking. Conclusion Among multi-morbid patients hospitalised for a CVD event, a nurse-led intervention resulted in substantially higher participation rate at a municipal HLC program and higher use of smoking cessation drugs compared to written information. We also found clinically significant long-term effects on cessation rates which needs to be confirmed in a large-scale study. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Dam Foundation

The Future Positive micro-intervention protocol: A program aiming to increase a healthy life-style among employees with a low socio-economic position.

This paper describes the development of a Dutch micro-intervention, Future Positive, that aims to increase health behaviors among employees with a low socio-economic position (SEP), with the ultimate aim to decrease socio-economic health inequalities. Intervention Mapping (IM) was used to adapt previously developed psychological capital interventions into a micro-intervention suitable to be delivered in the work context for employees with a low socio-economic position. The first 4 steps of IM including the results of pre-testing the developed intervention program are described. Step 1 consists of the needs assessment, and investigated (a) the individual determinants of health behavior and health inequalities, and (b) the needs of employees with a low SEP and their employers regarding the implementation of the intervention at the worksite. Matrices-of-change were produced in Step 2, and relevant methods and applications were selected in step 3. Step 4 involved the intervention development, resulting in a brief micro-intervention that will be delivered in small groups, guided by trained facilitators using motivational interviewing techniques. Program materials include informative video-clips and active and cooperative learning exercises. The intervention was pre-tested among three groups of employees. The IM process, as well as the pre-testing, revealed that emphasizing autonomy and using easy to understand and mostly visual materials offered in chunks is essential for a well-tailored intervention that is suitable for people with low SEP. Also, participation should be facilitated by employers: It should be free of costs, offered during working hours, and take place at the job site. Results showed that the Future Positive micro-intervention is substantiated by theory, applicable in a work setting (high reach), and tailored to the needs of employees with a low SEP. We therefore fill the gap in this existing range of interventions aimed to improve life-style behaviors and contribute to theory-based interventions aimed to decrease the SEP-Health gradient.

Effects of Monetary Motivational Techniques on Organizational Performance of St. Benedict's Ndanda Referral Hospital – Ndanda Mission Masasi, Tanzania

The study is on assessment of the monetary motivational techniques on organizational performance of St. Benedict's Ndanda Referral Hospital in Mtwara Tanzania. The study was guided by the Two Factor Theory. A concurrent research design was used whereas the research approach was mixed involving quantitative and qualitative data collection. A sample of 177 respondents was determined using Yamane (1964) from a target population of 316 employees of the Hospital. Content validity was ensured through discussion with specialists at the University and supervisors while reliability of the instruments was tested through Cronbach alpha coefficient. Data was collected through a self-administered questionnaire and key informant interviews using an interview guide. Quantitative data was analyzed using descriptive statistics where mean scores, frequencies and percentage were used to present results. Study findings indicated that salary, overtime, staff loans and health insurance with mean scores of 3.704, 3.654, 3,542 and 3.429 respectively as the highly rated monetary motivational factors used in the study area. Likewise, bonuses, transport allowances and gratuity were the least rated monetary techniques used with mean scores of 0.002, 0.003 and 0.001 respectively. From the study findings; it is concluded that there are monetary techniques that work effectively as indicated. It is thus recommended that the management of the hospital should look critically to other monetary motivation techniques in order to enhance the motivation of employees towards organizational performance of the hospital.

Utilizing SBIRT as a Framework for Transforming How We Think About Prevention and Early Intervention for Youth and Young Adults

Utilizing SBIRT as a Framework for Transforming How We Think About Prevention and Early Intervention for Youth and Young Adults

Lessons Learned From Clinicians and Stroke Survivors About Using Telerehabilitation Combined With Exergames: Multiple Case Study.

BackgroundIn Canada, stroke survivors have difficulty accessing community-based rehabilitation services because of a lack of resources. VirTele, a personalized remote rehabilitation program combining virtual reality exergames and telerehabilitation, was developed to provide stroke survivors an opportunity to pursue rehabilitation of their chronic upper extremity (UE) deficits at home while receiving ongoing follow-up from a clinician.ObjectiveWe aimed to identify the behavioral and motivational techniques used by clinicians during the VirTele intervention, explore the indicators of empowerment among stroke survivors, and investigate the determinants of VirTele use among stroke survivors and clinicians.MethodsThis multiple case study involved 3 stroke survivors with chronic UE deficits and their respective clinicians (physiotherapists) who participated in the VirTele intervention, a 2-month remote rehabilitation intervention that uses nonimmersive virtual reality exergames and telerehabilitation aimed at improving UE deficits in stroke survivors. Study participants had autonomous access to Jintronix exergames and were asked to use them for 30 minutes, 5 times a week. The VirTele intervention included 1-hour videoconference sessions with a clinician 1 to 3 times a week, during which the clinician engaged in motivational interviewing, supervised the stroke survivors’ use of the exergames, and monitored their use of the affected UE through activities of daily living. Semidirected interviews were conducted with the clinicians and stroke survivors 4 to 5 weeks after the end of the VirTele intervention. All interviews were audiorecorded and transcribed verbatim. An abductive thematic analysis was conducted to generate new ideas through a dynamic interaction between data and theory.ResultsThree stroke survivors (n=2, 67%, women and n=1, 33%, man), with a mean age of 58.8 (SD 19.4) years, and 2 physiotherapists participated in the study. Five major determinants of VirTele use emerged from the qualitative analyses, namely technology performance (usefulness and perception of exergames), effort (ease of use), family support (encouragement), facilitators (considerations of the stroke survivors’ safety as well as trust and understanding of instructions), and challenges (miscommunication and exergame limits). During the VirTele intervention, both clinicians used motivational and behavioral techniques to support autonomy, competence, and connectivity. All these attributes were reflected as empowerment indicators in the stroke survivors. Lessons learned from using telerehabilitation combined with exergames are provided, which will be relevant to other researchers and contexts.ConclusionsThis multiple case study provides a first glimpse into the impact that motivational interviewing can have on adherence to exergames and changes in behavior in the use of the affected UE in stroke survivors. Lessons learned regarding the supportive role caregivers play and the new responsibilities clinicians have when using the VirTele intervention may inform the use of exergames via telerehabilitation. These lessons will also serve as a model to guide the implementation of similar interventions.International Registered Report Identifier (IRRID)RR2-10.2196/14629