scholarly journals Realist-informed review of motivational interviewing for adolescent health behaviors

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Erica Naccarato ◽  
Jen Rouse ◽  
Caitlin Davey ◽  
Kelly McShane
Keyword(s):  
Systematic Review ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Motivational Interviewing ◽  
Adolescent Health ◽  
School Setting ◽  
Health Behavior Change ◽  
Effective Intervention ◽  
Future Research

Background Clinical research investigating effective intervention strategies for adolescents to improve health behaviors has shifted to the application of motivational interviewing (MI). Evidence indicates that MI is an effective intervention for improving health behaviors as related to diet, exercise, and diabetes among adolescents. However, there is a lack of understanding about the mechanisms through which MI works and the contextual factors impacting MI effectiveness. The purpose of this review was to understand how, for whom, and under what circumstances MI works for adolescent health behavior change, which will inform future implementation of this intervention. To provide this in-depth understanding, a realist-informed systematic review was conducted in order to synthesize the evidence on the use of MI for health behaviors. Self-determination theory (SDT) was chosen as the candidate theory for testing in the present review. Methods Databases including PsycINFO, Healthstar, Cochrane, and PubMed were searched for articles published until March 2017. The search strategy included studies that examined or reviewed the effectiveness or efficacy of MI to change health behaviors among adolescent populations. The search identified 185 abstracts, of which 28 were included in the review. The literature was synthesized qualitatively (immersion/crystallization) and tested SDT as the candidate theory. Results Based on SDT, three mechanisms were found within reviewed studies, including competence, relatedness, and autonomy. The following contexts were found to impact mechanisms: school setting, clinician MI proficiency, parental involvement, and peer involvement. Conclusions This realist-informed systematic review provides advances in understanding the mechanisms involved in MI for adolescent health behavior change. Additionally, it provides important practical information as to which contexts create the conditions for these mechanisms to occur, leading to health behavior change. The results can inform future MI interventions for adolescent health behavior change. Future research should continue to test this realist theory and also examine mechanism variables not extensively documented in order to improve our understanding of MI in this population.

scholarly journals Realist-informed review of motivational interviewing for adolescent health behaviors

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Erica Naccarato ◽  
Jen Rouse ◽  
Caitlin Davey ◽  
Kelly McShane
Keyword(s):  
Systematic Review ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Motivational Interviewing ◽  
Adolescent Health ◽  
School Setting ◽  
Health Behavior Change ◽  
Effective Intervention ◽  
Future Research

Background Clinical research investigating effective intervention strategies for adolescents to improve health behaviors has shifted to the application of motivational interviewing (MI). Evidence indicates that MI is an effective intervention for improving health behaviors as related to diet, exercise, and diabetes among adolescents. However, there is a lack of understanding about the mechanisms through which MI works and the contextual factors impacting MI effectiveness. The purpose of this review was to understand how, for whom, and under what circumstances MI works for adolescent health behavior change, which will inform future implementation of this intervention. To provide this in-depth understanding, a realist-informed systematic review was conducted in order to synthesize the evidence on the use of MI for health behaviors. Self-determination theory (SDT) was chosen as the candidate theory for testing in the present review. Methods Databases including PsycINFO, Healthstar, Cochrane, and PubMed were searched for articles published until March 2017. The search strategy included studies that examined or reviewed the effectiveness or efficacy of MI to change health behaviors among adolescent populations. The search identified 185 abstracts, of which 28 were included in the review. The literature was synthesized qualitatively (immersion/crystallization) and tested SDT as the candidate theory. Results Based on SDT, three mechanisms were found within reviewed studies, including competence, relatedness, and autonomy. The following contexts were found to impact mechanisms: school setting, clinician MI proficiency, parental involvement, and peer involvement. Conclusions This realist-informed systematic review provides advances in understanding the mechanisms involved in MI for adolescent health behavior change. Additionally, it provides important practical information as to which contexts create the conditions for these mechanisms to occur, leading to health behavior change. The results can inform future MI interventions for adolescent health behavior change. Future research should continue to test this realist theory and also examine mechanism variables not extensively documented in order to improve our understanding of MI in this population.

The Disconnected Values Model: Intervention Strategies for Exercise Behavior Change

2008 ◽  
Vol 2 (4) ◽  
pp. 357-380 ◽  
Author(s):  
Mark H. Anshel
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Exercise Program ◽  
Health Behavior Change ◽  
Exercise Behavior ◽  
Future Research ◽  
Behavioral Strategies ◽  
Values And Beliefs ◽  
Long Term Consequences

This article proposes a new approach to health behavior change, the disconnected values (intervention) model (DVM). The DVM consists of predetermined cognitive-behavioral strategies for initiating and maintaining changes in health behavior, such as the implementation of an exercise program. The model consists of helping clients (a) examine the benefits, in contrast to the costs and long-term consequences, of the habit they most want to change; (b) identify their deepest values and beliefs (e.g., health, family, faith, integrity); (c) detect a “disconnect” between the negative habit and the identified values; and (d) conclude whether the disconnect is acceptable, given its costs and long-term consequences. The client’s conclusion that the disconnect is unacceptable creates incentive and commitment for health behavior change. The theoretical foundations of the DVM are explained, and its specific application for exercise behavior change is described. Three outcome studies also are reported, as well as a brief case study. Implications for practitioners and suggestions for future research are provided.

Heat-Health Behavior Change During Summer 2020 in African American Alabama Residents

2021 ◽  
Vol 111 (8) ◽  
pp. 1443-1447
Author(s):  
Suwei Wang ◽  
Ethel Johnson ◽  
Sheila Tyson ◽  
Julia M. Gohlke
Keyword(s):  
African American ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Health Behavior Change ◽  
Public Spaces ◽  
Police Brutality ◽  
Telephone Surveys ◽  
Safety Concerns

To investigate how heat-health behaviors changed in summer 2020 compared with previous summers, our community–academic partnership conducted telephone surveys to collect data on cooling behaviors, safety concerns, and preferences for cooling alternatives for 101 participants living in Alabama. Participants indicating they would visit cooling centers declined from 23% in previous summers to 10% in summer 2020. The use of cooling centers and other public spaces may be less effective in reducing heat-related illness because of safety concerns amid the COVID-19 pandemic and police brutality.

scholarly journals Therapeutic Alliance Between Dietitians and Patients With Head and Neck Cancer: The Effect of Training in a Health Behavior Change Intervention

2018 ◽  
Vol 53 (8) ◽  
pp. 756-768
Author(s):  
Rebecca Murray ◽  
Amanda Baker ◽  
Sean Halpin ◽  
Ben Britton ◽  
Kristen McCarter ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Health Behavior ◽  
Behavior Change ◽  
Therapeutic Alliance ◽  
Motivational Interviewing ◽  
Head And Neck ◽  
Neck Cancer ◽  
Health Behavior Change ◽  
Behavior Change Intervention ◽  
Interviewing Techniques

Abstract Background The relationship between a clinician and their client—the “therapeutic alliance” is a robust predictor of outcome in healthcare settings; yet, few interventions to improve alliance have been tested. Motivational interviewing is a client-centered approach that embodies many principles and strategies consistent with a strong therapeutic alliance. Purpose To examine whether alliance is enhanced by training dietitians to deliver a motivational interviewing informed health behavior change intervention (“Eating as Treatment”; EAT) as part of routine consultations with patients with head and neck cancer. The predictive ability of motivational interviewing techniques was also assessed. Methods A secondary analysis of the EAT stepped-wedge cluster-randomized controlled trial was conducted. Patients with head and neck cancer undergoing radiotherapy (n = 307) were treated by radiotherapy dietitians (n = 29) during the control (Treatment as Usual) or intervention (EAT) phase. Alliance was rated during the first and final weeks of radiotherapy, and again 4 and 12 weeks post-radiotherapy. Dietetic sessions were audiotaped. Week one sessions were objectively rated for dietitians’ use of motivational interviewing techniques. Results Generalized linear-mixed effects regressions found no effect of EAT on dietitian-rated alliance (p = .237). After excluding outliers, patient-rated alliance was 0.29 points lower after EAT training (p = .016). Post hoc analyses revealed lower patient ratings on perceived support and dietitian confidence. Hierarchical multiple regressions found that no specific motivational interviewing techniques predicted patient-rated alliance. Dietitian acknowledgment of patient challenges was related to dietitian-rated alliance (β =.15, p =.035). Conclusions Patient and dietitian ratings of alliance were high after EAT training, but not significantly improved. Further research is needed to better understand the differential impact of intervention training and delivery on patient and clinician ratings of therapeutic alliance. Clinical Trial information Trial registration number ACTRN12613000320752

scholarly journals Triggers and Their Influence on Health Behaviors

2017 ◽  
Vol 23 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Christine S. Gipson
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Health Behavior Change ◽  
Concept Analysis ◽  
Healthy Behaviors ◽  
Conceptual Definition ◽  
Optimal Health ◽  
Definition Of ◽  
Significant Health

This article provides a conceptual definition of the concept trigger within the context of health behaviors and applies it to the highly significant health issue of obesity. Healthy behaviors are essential to life and happiness, but they do not just happen. They are triggered, and an inner drive keeps them alive. To help patients gain and retain optimal health, nurses must understand the triggers of healthy behaviors. Walker and Avant’s (2011) method of concept analysis is used as the basis for defining the concept of trigger. The antecedents, defining attributes, and consequences of trigger are identified. Findings suggest that nurses can play a role in triggering health behavior change through simple motivational efforts.

scholarly journals Interdisciplinary Perspectives on Maintenance of Health Behavior Change

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 817-817
Author(s):  
Jaime Hughes ◽  
Janet Bettger ◽  
Susan Hughes ◽  
Mina Raj
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Chronic Conditions ◽  
Intervention Development ◽  
Health Behavior Change ◽  
Cognitive Capacity ◽  
Multiple Chronic Conditions ◽  
Intervention Science ◽  
Behavior Maintenance

Abstract Modifying health behaviors can be difficult, especially for older adults who are challenged by multiple chronic conditions, reduced functional and/or cognitive capacity, and limited social support. Although much attention has been given to the theories, skills, and resources behind initiating and achieving behavior change, less work has focused on maintenance of health behaviors over time. This presentation will showcase pilot research inspired by RCCN’s first workshop, Achieving and Sustaining Behavior Change. Specifically, this pilot brings together an interdisciplinary team of behavioral scientists and health services researchers working at the intersection of intervention science and implementation science to better understand the construct of maintenance and discuss emerging methods for intervention development and evaluation. The presentation will utilize physical activity as an example behavior to demonstrate the value of interdisciplinary research, including recommendations on how some of the six NIA research centers can make unique contributions to understanding health behavior maintenance.

scholarly journals Fear of Cancer Recurrence: A Model Examination of Physical Symptoms, Emotional Distress, and Health Behavior Change

2019 ◽  
Vol 15 (9) ◽  
pp. e787-e797 ◽  
Author(s):  
Daniel L. Hall ◽  
Rachel B. Jimenez ◽  
Giselle K. Perez ◽  
Julia Rabin ◽  
Katharine Quain ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Behaviors ◽  
Emotional Distress ◽  
Cancer Recurrence ◽  
Health Behavior Change ◽  
Physical Symptoms ◽  
Fear Of Cancer Recurrence ◽  
Fear Of Cancer

PURPOSE: Fear of cancer recurrence is highly prevalent among adult survivors of cancer. The role of fear of recurrence in the emotional distress of survivors of cancer, as well as health behaviors that may directly affect their health, remains unclear. To advance oncology practice, this study sought to examine the extent to which fear of recurrence stemming from physical symptoms accounts for emotional distress in a large sample of adult survivors of cancer and to extend the model to explain postdiagnosis self-reported health behavior change. METHODS: In 2016, 258 survivors of cancer at an academic hospital completed a survey of psychosocial needs. Items assessed physical symptoms (checklist), fear of cancer recurrence (Assessment of Survivor Concerns), emotional distress (anxiety and depressed mood), and health behaviors (current alcohol use, physical activity, diet, and sunscreen use, as well as changes after cancer diagnosis) informed by National Comprehensive Cancer Network survivorship guidelines. Indirect effects regression models accounting for relevant covariates (age and treatment history) used 5,000-iteration bootstrapping. RESULTS: Higher fear of cancer recurrence was associated with greater number of physical symptoms ( P < .001), greater emotional distress ( P < .05), lower moderate or vigorous physical activity ( P < .05), higher sunscreen use ( P < .05), and postdiagnosis increases in alcohol use ( P < .01) and reductions in physical activity ( P < .01). Fear of cancer recurrence models accounted for almost half of the variance in distress of survivors of cancer ( R2 = 0.44, P < .001) and, to a lesser yet significant extent, changes in alcohol consumption ( R2 = 0.09, P < .001) and physical activity ( R2 = 0.06, P = .003). CONCLUSION: Fear of cancer recurrence plays a central role in the emotional distress and key health behaviors of survivors of cancer. These findings support fear of cancer recurrence as a potential target for emotional health and health behavior change interventions.

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