Development and Results of a Motivational Interviewing Program for Health Education to Facilitate Osteoporosis Self-Management
|Maura D Iversen1,2,3*, Laura R Rekedal3 and Daniel H Solomon3|
|1Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA|
|2Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden|
|3Department of Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA, USA|
|Corresponding Author :||Maura D Iversen
Professor and Chair
Department of Physical Therapy
Movement and Rehabilitation Sciences
School of Health Professions
Bouvé College of Health Sciences
Northeastern University, 6 Robinson Hall
Rm 301C,360 Huntington Avenue
Boston, MA, USA 02115
E-mail: [email protected]
|Received December 23, 2013, 2014; Accepted May 19, 2014; Published May 25, 2014|
|Citation: Iversen MD, Rekedal LR, Solomon DH (2014) Development and Results of a Motivational Interviewing Program for Health Education to Facilitate Osteoporosis Self-Management. J Osteopor Phys Act 2:116. doi:10.4172/2329-9509.1000116|
|Copyright: © 2014 Iversen MD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Introduction: Medication adherence is poor for many chronic conditions, including osteoporosis. Few proven interventions exist to improve Osteoporosis (OP) medication adherence. We report on methods to develop a telephonic motivational interviewing-based counseling program for health educators to promote osteoporosis medication adherence in elderly.
Methods: Five health educators participated in an initial day and a half education training session. Motivational Interviewing techniques were reinforced by a behavioral scientist via semi-monthly calls over one year. At trial midpoint, two 20-30 minute client conversations were recorded. A certified Motivational Interview trainer evaluated performance using the Motivational Interviewing Treatment Integrity code (MITI) and provided feedback (scale: 0=poor to 5=excellent) to determine the extent of motivational interviewing “spirit” incorporated by the health educators during interactions with clients.
Results: All health educators were female, mean age of 42 years. The range of health counseling experience was 7 to 15 years in varied healthcare areas. Scores across the five MITI domains suggest performance was strongest in providing direction and empathy. Domains needing improvement included evocation, collaboration, and autonomy/ support. On average, the total reflection to question ratio was 1.3, suggesting the need for more client reflections.
Conclusion: Among health educators without substantial prior motivational interviewing experience, a year-long, multi-faceted motivational interviewing training program resulted in suboptimal competence in use of motivational interviewing counseling behaviors. This program serves as a novel, instructive model to inform the development and maintenance of MI intervention integrity among health educators using telephonic counseling.