Intervention Fidelity of Telephone Motivational Interviewing On Physical Activity, Fruit Intake, and Vegetable Consumption in Dutch Outpatients With and Without Hypertension

Abstract

Background In theory, Motivational Interviewing (MI) fidelity should be associated with client outcomes. Nevertheless, this fidelity-effectiveness association is rarely investigated. This study evaluated the extent to which Telephone Motivational Interviewing (TMI) fidelity is associated with change in self-reported physical activity (PA), fruit intake, and vegetable consumption. Method Adults in primary care (45–70 years) participated in a study that compared the effect of tailor print communication, telephone motivational interviewing (TMI), and a combination of the two on PA, fruit intake, and vegetable consumption. MI fidelity was assessed using the behavioral coding method “Motivational Interviewing Treatment Integrity Code (MITI)” in 409 randomly selected audio-recorded sessions, representing 232 participants of the TMI group. The associations between MI fidelity scores and the behavioral changes from baseline to 47-week follow-up were examined using backward multiple linear regression analyses (adjusted for covariates). Results A significant and positive association between the percentage of MI adherent responses and improvements in PA and fruit consumption was found with respectively a small and medium effect size. The global rating “Spirit” (which resembles an all-at-once appraisal of the interviewer’s MI competence) was significantly, but inversely associated with progress in vegetable intake with a medium effect size. Conclusion The finding that relatively lower MI competency was associated with higher vegetable consumption went against our expectations. Findings suggest that practicing MI-consistent skills was beneficial in promoting PA and fruit consumption, but moderated vegetable intake. This study contributes to the scientific confidence that TMI enables change in PA and fruit intake.

Effect of motivational interviewing on lifestyle modification among patients with hypertension attending the family medicine clinics of Irrua Specialist Teaching Hospital, Irrua, Nigeria – A randomized controlled trial (MILMAPH Study)

“…34 An intervention study using Telephone MI conducted among the Dutch population found a significant relationship between the percentage of MI adherent expressions and change in the level of PA from baseline to 47-week follow-up, with a small effect size (p<0.05). 37…”

“…However, the research did not identify a significant correlation between the utilization of motivational interviewing and vegetable intake. 37…”

“…34–38 It has been used to effect changes in health behaviour through self-reflection thereby helping individuals prevent unhealthy behaviours and promoting healthy behaviours. 35,37 This has resulted in weight loss in overweight or obese patients and, a reduction in triglyceride levels, waist circumference, and systolic blood pressure. 34…”

Motivational interviewing—an evidence-based, collaborative, goal-oriented communication approach in lifestyle medicine: A comprehensive review of the literature

“…The use of technology, such as mobile, telephone, or web-based approaches in MI, has been demonstrated to provide satisfactory outcomes. 36 , 37 The investigators of the BEHOLD-16 RCT have pilot tested the feasibility and acceptability of a 16-week telephone-based combined positive psychology-MI intervention to promote PA in patients with T2DM. An average of 11 (of 14) sessions were completed by the participants, and a satisfactory composite mean score of ease/utility (8.6/10) was found.…”