Motivational interviewing and colorectal cancer screening: A peek from the inside out

Abstract

Objective-This article focuses on design, training, and delivery of MI in a longitudinal randomized controlled trial intended to assess the efficacy of two separate interventions designed to increase colorectal screening when compared to a usual care, control group. One intervention was a singlesession, telephone-based motivational interview (MI), created to increase colorectal cancer screening within primary care populations. The other was tailored health counseling. We present the rationale, design, and process discussions of the one-time motivational interview telephone intervention. We discuss in this paper the training and supervision of study interventionists, in order to enhance practice and research knowledge concerned with fidelity issues in motivational interview interventions.Methods-To improve motivational interview proficiency and effectiveness, we developed a prescribed training program adapting MI to a telephone counseling session.Results-The four interventionists trained in MI demonstrate some MI proficiency assessed by the Motivational Interviewing Treatment Integrity Scale. In the post-intervention interview, 20.5% of the MI participants reported having had a CRC screening test, and another 19.75% (n = 16) had scheduled a screening test. Almost half of the participants (43%) indicated that the phone conversation helped them to overcome the reasons why they had not had a screening test.Conclusions-Ongoing supervision and training (post MI workshop) are crucial to supporting MI fidelity. The trajectory of learning MI demonstrated by the interventionists is consistent with the eight stages of learning MI. The MI roadmap created for the interventionists has shown to be more of a distraction than a facilitator in the delivery of the telephone intervention. MI can, however, be considered a useful tool for health education and warrants further study.Practice Implications-MI training should include consistent training and process evaluation. MI can, however, be considered a useful tool for health education and warrants further study. MI can also be adapted to diverse health promotion scenarios.

Improving Colorectal Cancer Screening in Family Medicine: An Oklahoma Physicians Resource/Research Network (OKPRN) Study

“…33 When patients were ambivalent, PCPs explored the causes of the ambivalence and attempted to address them, frequently with an anecdote. They "rolled with resistance," avoiding direct arguments, and were respectful and supportive of patient autonomy.…”

Barrier-focused intervention to increase colonoscopy attendance among nonadherent high-risk populations

“…In previous studies on CRC screening intervention, higher attendance was achieved by some intervention practices such as health-care-provider-directed intervention [19] , telephone support [20,21] , psychoeducational intervention [22,23] , tailored guidance [24,25] , patient-physician communication [26] , motivational interviewing [27] , physician reminder [28,29] , community volunteers [30] , and mailed brochure [31] . However, one-sided intervention methods may not achieve a satisfactory effect among nonadherent high-risk subjects.…”

Improving colorectal cancer screening rates using motivational interviewing

“…[20] There is growing literature surrounding telephone counseling for disease prevention in a variety of settings, however, no studies were found to directly correlate a telephone based motivational interview with FOBT/FIT return rates. [13,21,22] Few studies have focused on the effects of MI and CRC screening, however MI has been used to explore behaviors surrounding primary prevention and cancer screening. [13,22] Baker et al designed an intervention to address reasons for unsuccessful CRC screening in those whom had previously completed a FIT.…”

“…[13,21,22] Few studies have focused on the effects of MI and CRC screening, however MI has been used to explore behaviors surrounding primary prevention and cancer screening. [13,22] Baker et al designed an intervention to address reasons for unsuccessful CRC screening in those whom had previously completed a FIT. [23] The intervention group received a mailed reminder letter, a free FIT with low literacy instructions and a postage paid return envelope.…”

“…[25] Published by Sciedu Press For this project, a MI roadmap was developed based on the roadmap created by Wahab et al for MI telephone intervention. [22] The road map allows the encounter to be authentic, yet aids the interventionist with the skills and techniques needed to navigate the conversation. The details of the adapted road map used for this project can be seen in Figure 1.…”