Developing the Moti-4 intervention, assessing its feasibility and pilot testing its effectiveness

Abstract

BackgroundThe Moti-4 intervention was developed to prevent addiction and other health problems among vulnerable adolescent cannabis users. The aims of Moti-4 are to reduce the use of cannabis among adolescents and to encourage their motivation to change their behavior.MethodsIntervention Mapping, a systematic approach to developing theory- and evidence-based interventions, was used to develop a protocol for the intervention. The process of developing the intervention also used the method of responsive evaluation to explore the opinions of the immediate target group and intermediaries (N = 31). Feasibility was assessed in 9 interviews and analyzed in grids.A quantitative pilot analysis involving a pre- and post-assessment in 31 subjects assessed whether the intervention was able to reduce drug use and would change intentions to change drug use behavior.ResultsUsing Intervention Mapping resulted in the development of a substantial four-session intervention with a clear manual and training for prevention workers. The choice of 12 consecutive steps was based on the Trans Theoretical Model of Behavior Change, Motivational Interviewing, Theory of Planned Behavior and the Self Determination Theory.Positive aspects of working with Moti-4 were assessed in a feasibility study. Criticism by users has led to improvements to the manual.In the pilot study, the average weekly amount spent on cannabis decreased significantly from an average €17.77 to €11,95 in the period after the intervention, with a medium effect size (d = 0.36). Likewise, a significant decrease was found in the frequency of use during the past week, from 4.3 to 2.4 (d = .52). As to motivation to change, a statistically significant increase was found in planning (d = .44) and a large increase in the desire to stop (d = .76). The change in the motivation to smoke less cannabis was small.ConclusionIntervention Mapping proved to be a useful approach for the development of the intervention, using a productive combination of theory and community knowledge. The pre- and post-test pilot study showed that the intervention generally brought about a considerable positive change in the two principle targets, cannabis use and motivation. There is a need for further (controlled) research into its effectiveness and implementation as a standard method in addiction prevention services.

Assessing the Efficacy of MOTI-4 for Reducing the Use of Cannabis Among Youth in the Netherlands: A Randomized Controlled Trial

“…These trained professionals then recruited participants (N = 31), which were referred by their parents, by agencies for youth care and drop-out, field workers and by student counselors. A pilot study was undertaken with pre-and post-test assessments (Dupont et al, 2015). The results of our pilot study showed that after the intervention, the average weekly amount of money spent on cannabis had decreased by 47%.…”

“…Since 1995, various kinds of targeted prevention initiatives have been applied in the Netherlands including Hasj en weedweek, CIA, Wietcheck and ABC-gesprek (Spits et al, 2014). In the Moti-4 intervention, the most effective elements of these best practices, such as motivational interviewing, self-monitoring, and strengthening behavioral control, were used, mixed and compressed into a protocol (Dupont et al, 2015). The goals of Moti-4 are to reduce the use of cannabis in the target group and to increase their motivation to change their behavior.…”

“…The protocol for the intervention was developed using intervention mapping (Bartholomew, Parcel, Kok, Gottlieb, & Fernandez, 2011), a systematic approach for developing theory-and evidence-based interventions that provides a method for the process of health promotion program development. The development of the Moti-4 program followed the six consecutive steps of intervention mapping (Dupont et al, 2015): 1) needs assessment; 2) behavioral and learning outcomes; 3) selecting methods of behavior change and translating methods into intervention strategies and materials; 4) producing the program components; 5) program adoption and implementation; and 6) planning of program evaluation.…”

“…In the sessions a social climate was created in which the stakeholders and target group members would feel free to express their commitment to, but also concerns about the proposed intervention. These information sessions resulted in the design of a four-session intervention that included a manual and a training course for prevention workers (Dupont et al, 2015). The manual and training course clearly expressed that the Moti-4 intervention was designed with the aim to stimulate targeted youth to critically examine and adjust their own cannabis use.…”

“…In order to create an intervention that was suitable for the Dutch situation, we developed Moti-4 (Dupont, Lemmens, Adriana, van de Mheen, & de Vries, 2015), a brief motivational enhancement intervention designed for young vulnerable non-treatment-seeking cannabis users. The existing practice as usual of the last 20 years in Dutch cannabis prevention was the important starting point for Moti-4.…”