Motivational interviewing and outcomes in adults with type 2 diabetes: A systematic review

Ekong, Gladys; Kavookjian, Jan

doi:10.1016/j.pec.2015.11.022

Cited by 156 publications

(101 citation statements)

References 41 publications

Supporting

Mentioning

100

Contrasting

Order By: Relevance

“…Five key techniques have been identified: 1) prompt focus on past success, 2) barrier identification/problemsolving, 3) use of follow-up prompts, 4) provision of information on where/ when to perform the behavior, and 5) prompt review of behavioral goals (175). However, motivational interviewing is not significantly better than usual care (176), and other intervention factors associated with weight loss, such as number and duration of contacts, have been inconsistent or not associated with greater participation (177).…”

Section: Behavior-change Strategiesmentioning

confidence: 99%

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

et al. 2016

View full text Add to dashboard Cite

The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes and prediabetes. Recommendations and precautions vary depending on individual characteristics and health status. In this Position Statement, we provide a clinically oriented review and evidencebased recommendations regarding physical activity and exercise in people with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, and prediabetes.Physical activity includes all movement that increases energy use, whereas exercise is planned, structured physical activity. Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and improves well-being (1,2). Regular exercise may prevent or delay type 2 diabetes development (3). Regular exercise also has considerable health benefits for people with type 1 diabetes (e.g., improved cardiovascular fitness, muscle strength, insulin sensitivity, etc.) (4). The challenges related to blood glucose management vary with diabetes type, activity type, and presence of diabetes-related complications (5,6). Physical activity and exercise recommendations, therefore, should be tailored to meet the specific needs of each individual. TYPES AND CLASSIFICATIONS OF DIABETES AND PREDIABETESPhysical activity recommendations and precautions may vary by diabetes type. The primary types of diabetes are type 1 and type 2. Type 1 diabetes (5%-10% of cases) results from cellular-mediated autoimmune destruction of the pancreatic b-cells, producing insulin deficiency (7). Although it can occur at any age, b-cell destruction rates vary, typically occurring more rapidly in youth than in adults. Type 2 diabetes (90%-95% of cases) results from a progressive loss of insulin secretion, usually also with insulin resistance. Gestational diabetes mellitus occurs during pregnancy, with screening typically occurring at 24-28 weeks of gestation in pregnant women not previously known to have diabetes. Prediabetes is diagnosed when blood glucose levels are above the normal range but not high enough to be classified as diabetes; affected individuals have a heightened risk of developing type 2 diabetes (7) but may prevent/delay its onset with physical activity and other lifestyle changes (8). TYPES OF EXERCISE AND PHYSICAL ACTIVITYAerobic exercise involves repeated and continuous movement of large muscle groups (9). Activities such as walking, cycling, jogging, and swimming rely primarily on aerobic energy-producing systems. Resistance (strength) training includes exercises with free weights, weight machines, body weight, or elastic resistance bands. Flexibility exercises improve range of motion around joints (10). Balance exercises benefit gait and prevent falls (11). Activities like tai chi and yoga combine flexibility, balance, and resistance activities.

show abstract

Section: Behavior-change Strategiesmentioning

confidence: 99%

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Moreover, they generally do not receive formal or rigorous training in behavioral counseling techniques such as Motivational Interviewing [30] to guide their outreach to adults with diabetes and other NCDs that require high levels of patient self-management to improve outcomes. There is strong evidence on the effectiveness of Motivational Interviewing-based brief counseling to improve healthy behaviors and outcomes among adults with type 2 diabetes [31, 32]. Yet, to date there is little rigorous evidence on the feasibility, acceptability, and effectiveness of training CHAs in Brazil’s Basic Health Units (UBSs) in these evidence-based behavioral counseling skills for chronic disease self-management.…”

Section: Introductionmentioning

confidence: 99%

A pilot study of a Community Health Agent-led type 2 diabetes self-management program using Motivational Interviewing-based approaches in a public primary care center in São Paulo, Brazil

Nascimento

Resnicow

Nery

et al. 2017

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundRates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil.MethodsNineteen salaried CHAs participated in 32 h of training in MI and behavioral action planning. With support from booster training sessions, they used these skills in their regular monthly home visits over a 6 month period with 57 diabetes patients with baseline HbA1cs > 7.0%. The primary outcome was patients’ reports of the quality of diabetes care as measured by the Portuguese version of the Patient Assessment of Chronic Illness Care (PACIC) scale. Secondary outcomes included changes in patients’ reported diabetes self-management behaviors and in A1c, blood pressure, cholesterol and triglycerides. We also examined CHAs’ fidelity to and experiences with the intervention.ResultsPatients reported improvements over the 6 month period in quality of diabetes care received (PACIC score improved 33 (+/−19) to 68 (+/−21) (p < .001)). They reported increases in physical activity (p = .001), consumption of fruits and vegetables (p < .001) and medication adherence (p = .002), but no decreases in consumption of high-fat foods (p = .402) or sweets (p = .436). Participants had mean 6-month A1c levels 0.34% points lower than at baseline (p = .08) and improved mean LDL (−16.1 mg/dL, p = .005) and triglyceride levels (−38.725 mg/dL, p = .002). Of the 16 CHAs observed in fidelity assessments, 13 were categorized as medium- or high-performing on MI skills, while 3 were low-performing. CHAs expressed enthusiasm about learning new skills, and many described a shift from advice-giving to encouraging patients to define their own goals.ConclusionIn resource-scarce settings, it is essential to fully utilize existing primary care resources to stem the epidemic of diabetes and other NCDs. Our pilot results support the potential of training CHAs to incorporate effective diabetes self-management support into their routine patient encounters.Trial registration NCT02994095 12/14/2016 Registered retrospectively.

show abstract

“…10 Furthermore, expressing early empathy in health care encounters is a fundamental principle of Motivational Interviewing (MI), which is a patient-centered communication skillset with evidence base for promoting health behavior change. [11][12][13] Pharmacy education has gradually embraced MI as a communication tool box that pharmacists can use to engage patients in health behavior change decision-making. [14][15][16][17] The utility and effectiveness of MI has been explored in various health behaviors for more than 30 years.…”

Section: Introductionmentioning

confidence: 99%

Predisposition for Empathy, Intercultural Sensitivity, and Intentions for Using Motivational Interviewing in First Year Pharmacy Students

Ekong

Kavookjian

Hutchison

2017

American Journal of Pharmaceutical Education

Self Cite

View full text Add to dashboard Cite

Objective. To assess first-year pharmacy (P1) students' predispositions (eg, perceptions for empathy, intercultural sensitivity, and motivational interviewing (MI) as a patient-centered communication skillset) and identify potential curricula content/communication skills training needs. Methods. A cross-sectional survey was used to collect students' self-reported perceptions for empathy, intercultural sensitivity, counseling contexts, and projected future MI use. Relationships between variables were explored and logistic regression was used to evaluate intention for using MI in future patient encounters.Results. There were 134 students who participated. Higher predisposition for empathy and for intercultural sensitivity were significantly correlated. Significant predictors for applying MI in future patient encounters were sex, confidence with counseling skills, and current use of MI. Conclusion. Results suggest the need to incorporate innovative training strategies in communication skills curricula. Potential areas include empathy, intercultural sensitivity and significant predictor variables for future MI use. Further investigation in other schools is needed.

show abstract

Motivational interviewing and outcomes in adults with type 2 diabetes: A systematic review

Cited by 156 publications

References 41 publications

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

A pilot study of a Community Health Agent-led type 2 diabetes self-management program using Motivational Interviewing-based approaches in a public primary care center in São Paulo, Brazil

Predisposition for Empathy, Intercultural Sensitivity, and Intentions for Using Motivational Interviewing in First Year Pharmacy Students

Contact Info

Product

Resources

About