Problem: Adolescent obesity has reached epidemic proportions globally. Motivational interviewing (MI) is an emerging intervention for adolescent health risk behavior that has promise. Despite its potential fit in primary health care contexts, primary care providers tend to express reticence in learning or adopting MI practices. This program evaluation project assessed the usefulness of Motivational Interviewing (MI) by primary care providers with adolescents in school based health centers that was implemented by a large randomized clinical trial (RCT) in southwest United States high schools.
Methods: As part of the RCT, the primary care providers were required to do MI sessions with 66, 45, 25, and 91 youth participants respectively at their School-based site. It was anticipated that providers would be increasingly comfortable with MI between their first and final participant and that youth would be increasingly satisfied as provider comfort increased. To evaluate this, as part of the RCT, a set of primary care providers working with youth in school based health centers were trained through didactic sessions, homework, and role-play. School-based providers were provided an introductory training in MI, MI reading materials, a study manual, and were required to participate in bimonthly tele-coaching to ensure treatment integrity and fidelity. Primary care provider and adolescent participant survey data from session 1 of the RCT was analyzed to determine provider comfort with MI and adolescent satisfaction with MI.
Summary of findings: Despite the standard training practices, providers showed a range of interest in comfort with the intervention. However, as anticipated, overall primary care providers became significantly more comfortable with MI on the final day of the MI sessions with increased use (p < 0.01). Adolescent participants overall were highly satisfied with MI regardless of time with no significant differences over time.
Implications for Practice: Primary care providers have not embraced MI as it is perceived as time consuming and challenging, yet over time the primary care providers in this project became significantly more comfortable with MI while youth were highly satisfied independent of provider comfort. Integrating MI into clinical practice has promising implications to get more effective treatment to high-need and underserved youth.
|School:||New Mexico State University|
|School Location:||United States -- New Mexico|
|Source:||DAI-B 76/10(E), Dissertation Abstracts International|
|Subjects:||Nursing, Public health|
|Keywords:||Adolescent engagement in healthcare, Adolescent primary care, Motivational interviewing, Overweight obese youth, Youth health behavior change|
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