Search

Pediatric obesity is a major public health epidemic with serious physical and psychological consequences. Difficulty engaging families in treatment is a significant obstacle in addressing pediatric obesity, especially among underserved populations. Motivational interviewing (MI) is a collaborative, person-centered communication style that has been shown to reduce attrition, increase attendance, and improve patient treatment adherence; however, little is known about the process of MI and how it improves treatment engagement. This study examined clinician and parent language in a pre-treatment MI session that increased initial engagement in a parent- focused pediatric obesity intervention (N= 81). Results showed that increased parent change talk, and preparatory language in particular, was positively related to the likelihood of initial attendance at baseline. Additionally, certain types of MI consistent clinician strategies were positively associated with parent change talk. Complex positive reflections were correlated with preparatory language and overall change talk, suggesting this might be a particularly important MI skill. Findings have implications for better understanding the process of MI and mechanisms through which MI can improve treatment engagement.

Motivational Interviewing (MI) is a counselling method used to strengthen and encourage behaviour change that is centered on an individual’s own intrinsic motivation to do so. Attempts have been made to measure skilfulness in Motivational Interviewing (MI), however the most valid and reliable current methods are resource demanding and difficult to administer and score. During MI, the practitioner listens for statements by the client that are directional towards or away from positive change in their behaviour, referred to as Change Talk (CT) and Sustain Talk (ST). Using two attention bias tasks, the present study was conducted to test if MI practitioners showed attentional bias to CT and ST as evidenced by slower response to CT in a modified Stroop task, and faster response towards CT and ST in a dot-probe task compared to individuals who had no MI training. If this were found to be true, then there would be the potential to develop a new means of measuring practitioner skilfulness in MI. Participants consisted of three groups, those with no MI training (N = 36), some MI training (N=22), and Motivational Interviewing Network of Trainers (MINT) members (N=15) with considerable training in MI. The Stroop task showed that MINT members were significantly slower in responding to all words regardless of their meaning compared to the control group (None). This difference no longer existed between groups when age was removed as a co-varying factor. It is recommended that an easier, user-friendly means to measure MI practitioner skill and fidelity and continue to be explored and tested. If the Stroop or dot-probe were to be utilized again to attempt to measure attentional bias towards CT and ST, using age matched participants, and the implementation of supraliminal exposure or priming may present more desirable findings.

<p dir="ltr">Motivational interviewing (MI) is effective for behavior change but faces delivery challenges. With current technological advances, many researchers have explored the possible applications of Artificial Intelligence in Motivational Interviewing. Using a Systematic Literature Review (SLR) methodology and adhering to the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) guidelines, this thesis provides insights into the current landscape of Artificial Intelligence applications in Motivational Interviewing. A co-occurrence map of author keywords and index keywords of 62 articles was created in VOSviewer software, which generated three key themes with 18 keywords. In addition, using the KeyBERT NLP technique, the top keywords of article abstracts were generated and grouped into five main themes. The dominant technologies were explored, and it revealed that because of the importance of including MI principles in communications, Chatbots and Conversational Agents could provide promising avenues for addressing the challenges of MI delivery.</p>

Purpose: Motivational interviewing (MI) is a client-centred counselling approach which supports an individual’s motivation to change behaviour. It has a substantial evidence base across various disciplines. This review synthesises existing evidence of the barriers and facilitators to MI implementation within service delivery.<br/>Design/methodology/approach: A systematic search of four databases retrieved 10 international studies, which were critically appraised and synthesised following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Framework synthesis was used to map findings onto existing MI implementation factors, with a descriptive commentary provided on barriers and facilitators.<br/>Findings: The review evidences the complexities of MI implementation within service delivery and outlines nine dimensions (leadership and management; workplace context; resources; therapist context; training; client context; documentation and outcomes gathering; and treatment fidelity) for consideration at all stages, if implementation is to be effective.<br/>Originality/value: As an outcome of this review, the empirically-derived framework may aid the planning and execution of MI implementation.

One of the leading causes of mental retardation, birth defects, and neurodevelopmental disorders in the United States is prenatal alcohol exposure leading to Fetal Alcohol Spectrum Disorders (Jacobs, Copperman, Jeffe, & Kulig, 2000).Although any alcohol consumption during pregnancy is unsafe (US DHHS, 2005), the percentage of women giving birth to alcohol exposed infants is 34.4% (Bobo, Klepinger, & Dong, 2006).Due to physical and psychological consequences of in utero alcohol exposure, it is imperative that caregivers have evidence-based interventions that lead to a decrease in alcohol use during pregnancy.The purpose of this study was to determine the effectiveness of a theoretically based motivational interviewing (MI) intervention in decreasing drinking during pregnancy.The influence of the MI intervention on the pregnant women's drinking behaviors as mediated by Self-Determination Theory's concepts of basic psychological needs and autonomous motivations was also explored.Pregnant women (N = 171) were screened for alcohol use in the previous year at three prenatal clinics.Of the 74 women eligible for the study, 67 women consented to participate with random assignment to an MI Intervention (MII) group or a No-MI Intervention Comparison (NIC) group.The MII group received the intervention and standard education regarding the risks of alcohol use during pregnancy.The NIC group received only standard education.Both groups were assessed for patterns of alcohol use, levels of basic psychological needs, and autonomous motivations at baseline and at 4-6 week follow-up.Fifty-six pregnant women completed all study procedures.Structural equation modeling was conducted to test the hypotheses of this study.Two models tested the effects of the MI intervention on (1) changes in the number of drink days per week from baseline to the 4-6 week follow-up and (2) changes in number of

IMPORTANCE: Chronic low back pain (CLBP) is a global health problem with significant clinical, social, and economic challenges. Over 80% of CLBP cases are non-specific (CNLBP), causing the highest number of years lived with disability. People with CNLBP often have comorbidities such as overweight or obesity, which negatively impact symptoms and treatment outcomes. OBJECTIVE: The objective is to evaluate whether a lifestyle intervention combining diet, physical activity, and evidence-based physical therapy can reduce pain in individuals with CNLBP and comorbid overweight or obesity. DESIGN: This is an international multicenter triple-blinded randomized controlled trial (RCT). SETTING: The trial will be conducted in Belgium and Switzerland, with interventions delivered in hospitals (ambulatory care) and outpatient private practices. PARTICIPANTS: In total, 252 adults will be included and randomly assigned to 1 of 2 treatment arms. INTERVENTIONS: The control intervention includes Pain Neuroscience Education and Cognition-Targeted Exercise Therapy. The experimental group receives the same intervention supplemented with a Behavioral Weight Reduction Program. MAIN OUTCOMES AND MEASURES: The primary outcome is pain intensity (assessed using the Brief Pain Inventory). Secondary outcomes include other pain-related outcomes, body composition measures, energy balance related behavior, medical consumption, indirect health-related costs, and quality of life. Assessments will occur at baseline, post-intervention, and at 3-, 6-, 9-, and 12-months follow-up. CONCLUSION: This study is the first international multicenter RCT integrating a lifestyle approach into evidence-based physical therapy for people with CNLBP and comorbid overweight or obesity. It will assess whether addressing comorbid overweight or obesity enhances pain reduction and other health outcomes in this population. RELEVANCE: The results will push the field forward, leading to new knowledge about the (cost-)effectiveness of this approach, which will provide key insights for different stakeholders, help optimizing therapy guidelines and individualized care for people with CNLBP and comorbid overweight or obesity.

In the process of disseminating motivational interviewing (MI) it is important to identify who benefits from initial workshops and which trainees would benefit from an extended training model that involves coaching and performance feedback, which has recently been advocated. Prior research attempting to determine who benefits from training has failed to show associations between baseline self-reported empathy and training outcomes. However, the use of an objective empathy task may address the shortcoming of prior research. The purpose of the present study was to predict competency in motivational interviewing skills following training using an objective empathy task. In addition, we investigated if self-report measures of empathy were more susceptible to social desirability than an objective empathy task. This study was a longitudinal design that is based on a pre-test objective empathy task and a post-test measure of MI skills/proficiency. Prior to a three-day training in motivational interviewing, participants completed a social desirability scale, self-reported empathy based on the empathy quotient and an objective empathy task based on the multifaceted empathy test. Following the training, participants interacted with a standardized patient which was audio recorded and subsequently scored on the motivational interviewing treatment integrity. Competency in motivational interviewing was based upon the average scores on the global measures of cultivating change talk, softening sustain talk, empathy, and partnership. It was anticipated that the empathy quotient would be more strongly correlated with social desirability than the multifaceted empathy test. In addition, we anticipated that the multifaceted empathy test would be a stronger predictor of competency than the empathy quotient.

Introduction In this article, we describe our creation of a machine-learning model that uses a combination of rule-based and natural language processing (NLP) algorithms. We show how this "Empathy Algorithm" was developed and how its results compare to three datasets of professional counseling and peer-led conversations. Methods These conversation datasets were rated by people with varying degrees of empathetic expertise (from counselors to student volunteers) and labeled as either low- or high-quality empathy. Our methodology involved running both these "low-empathy" and "high-empathy" conversations through our algorithm and then looking for a correlation between conversations labeled "high empathy" and an increased presence of six empathy skills flagged by our algorithm. Results We found positive correlations between four of the six skills that our algorithm measures (i.e., four empathizing skills showed up the same or more in each of the "high-empathy" conversations within the three datasets). This suggests that certain empathizing skills are not only consistently present in effective conversations but also quantifiable enough to be measured by today's machine-learning models. Conclusion While limitations of language, binary classifications, and non-verbal cues remain as opportunities for further development, using algorithms to objectively assess empathic skills represents an important step to improve client outcomes and refine communication practices for today's healthcare professionals.

Unhealthy behaviour is a key modifiable factor that underlies much of the South African (SA) burden of disease and primary care morbidity.Chronic diseases such as heart disease, type 2 diabetes, lung diseases and some cancers are linked to underlying behavioural issues such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy eating.Evidence shows that brief behaviour change counselling by primary care providers can be effective in helping patients to change risky lifestyle behaviours.However, the capacity of South African primary care providers to educate and counsel patients on lifestyle modification is generally poor.The need for primary care provider training in lifestyle counselling, is stated as a critical objective in 're-orientating' the primary health care system to effectively address NCDs in the National Strategic Plan for the Prevention and Control of NCDs and their risk factors in SA.The overall aim of this research was to develop, implement and evaluate the effectiveness of a training intervention for primary care providers in the South African setting, which is based on teaching best practice, behaviour change counselling (BBCC) methods that can be used for patients with risky lifestyle behaviours associated with non-communicable diseases (NCDs)."Effectiveness" relates to the effect of the training on PCPs adoption of a patient centred approach, and skills acquisition after the training, and not the effectiveness in changing, or improving patient outcomes.The sequence of the abstracts of the four articles that were published from this research, gives an overview of the process.