alexa Development and Results of a Motivational Interviewing Program for Health Education to Facilitate Osteoporosis Self-Management
ISSN: 2329-9509

Journal of Osteoporosis and Physical Activity
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Research Article

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
Tel: 617-373-5996
Fax: 617-373-3161
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.


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