Intervention Ingredients and Mechanisms of an Efficacious Motivational Interview

有效动机访谈的干预成分和机制

基本信息

批准号：
9087106
负责人：
Molly Magill
金额：
$ 27.63万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9087106
关键词：
20 year old Accounting Adult Alcohol abuse Alcohol consumption Alcoholic beverage heavy drinker Alcohols Area Behavior Therapy Behavioral Behavioral Research Binding Client Clinical Clinical Trials Code Cognitive Complex Data Distal Elements Empathy Feedback Goals Guidelines Health Heavy Drinking Individual Intervention Knowledge Language Lead Link Literature Mediating Mediation Meditation Modeling Motivation National Institute on Alcohol Abuse and Alcoholism Nondirective Therapy Outcome Parents Pathway interactions Patient Self-Report Patients Performance Population Process Provider Public Health Relaxation Therapy Research Rosa Sampling Self Efficacy Series Services Specific qualifier value Strategic Planning Study models Target Populations Testing Therapeutic Time Training Treatment Efficacy Validation active method alcohol use disorder base behavior change behavioral outcome brief intervention causal model college computerized data processing coping cost efficient drinking follow-up improved interest intervention effect motivational enhancement therapy motivational intervention novel outcome prediction personalized care randomized trial reduced alcohol use skills success theories trial comparing university student young adult

项目摘要

DESCRIPTION (provided by applicant): NIAAA has identified non-college bound young adults as a key population for targeted intervention to reduce heavy alcohol use and related negative consequences. Brief interventions, based in the principles of Motivational Interviewing (MI), have demonstrated efficacy among college students, but very little is known about MI efficacy, active treatment ingredients, and mechanisms of behavior change with heavy drinking young adults categorized as non-college. The current study will test a series of theory-driven hypotheses regarding the within-session predictors of outcome in an efficacious MI with this understudied population. To do so, this study will collect observationally-rated process data (Motivational Interviewing Skill Code 2.5; Client Language Assessment - Proximal/Distal) from audio-recorded session files derived from a recently completed clinical trial (AA016000; PI: Colby). The clinical trial compared a single session MI to a time-matched control of meditation and relaxation training (REL) in a sample (N=167) of underage, past-month heavy drinkers (17-20 years old). Compared to REL, MI significantly reduced alcohol use and alcohol-related negative consequences at 3-month follow-up while additionally impacting a series of theory-driven cognitive and behavioral intermediate outcomes (motivation to change drinking; perceived drinking norms; self-efficacy to change drinking; behavioral strategies to limit drinking). These results present a unique opportunity to investigate the within-session processes responsible for therapeutic improvement with an understudied, yet high need young adult population. Specifically, this research will incorporate novel conceptual and statistical considerations to examine: the Technical Hypothesis of MI efficacy, the client language mechanisms of the motivation building and change planning elements of MI process (MI Evoking, Focusing, and Planning), the specific within-session MI ingredients (exploring the Pros and Cons of Alcohol Use, providing Personalized Feedback on Alcohol Use, and planning for Behavioral Strategies to Limit Drinking) that predict client language mechanisms and the specific conditions (therapist MI Empathy and Spirit, client baseline motivation to change) under which causal models are optimally specified. Moreover, the presence of the time-matched control condition allows for between-condition tests of within-session ingredients and mechanisms, which is a level of contrast rarely achieved in the MI process literature to date. Information derived from this study can be immediately communicated to service settings in the form of MI dissemination guidelines or directly to providers in the form of empirically-supported principles of MI treatment delivery. This research can also inform the MI literature by examining the consistency of its key causal model across populations while additionally extending the model to identify further links in the causal chain. Finally, the success of MI as a behavior change intervention may be due to its capacity to harness core principles of client-centered therapy, which suggest this line of research may have implications for treatment-facilitated behavioral research more broadly.

描述（由申请人提供）：NIAAA已确定非大学的年轻人是针对性干预措施的关键人群，以减少大量饮酒和相关的负面后果。基于动机访谈原则（MI）的简短干预措施已经证明了大学生的功效，但对MI功效，积极的治疗成分以及行为变化的机制知之甚少，重量饮用的年轻人被分类为非哥伦比尔大学。当前的研究将检验一系列关于理论驱动的假设，这些假设涉及在有效的MI中与该研究的人群中的结果预测指标。为此，这项研究将收集观察评级的过程数据（动机访谈技能代码2.5；客户语言评估 - 近端/远端），从最近完成的临床试验（AA016000; PI：COLBY）中得出的音频记录的会话文件。该临床试验将单个会话MI与未成年人（n = 167）的冥想和放松训练（RER）的时间匹配的控制（n = 167）进行了比较。与REL相比，MI在3个月的随访中显着降低了酒精使用和与酒精相关的负面后果，同时还影响了一系列与理论驱动的认知和行为中间结果（改变饮酒的动机；感知到饮酒规范；自我效率；改变饮酒；行为策略以限制饮酒）。这些结果提供了一个独特的机会，以调查负责治疗改善的会议内过程，但研究不足但需求高的年轻人人口。具体而言，这项研究将结合新颖的概念和统计考虑来检查：MI功效的技术假设，动机建设和变化计划要素的客户语言机制（MI唤起，集中和计划），特定的经验内部MI内部的MI成分（探索饮酒的专业化和规划）的特定机制，并预测了饮酒的饮酒行为，该策略是饮酒行为，并提供了饮酒行为，该策略是饮酒行为，并提供了饮酒的行为，并提供了饮酒的行为。（治疗师MI同理心和精神，客户基准改变的动机）在该因果模型最佳指定。此外，时间匹配的控制条件的存在允许对课程内部成分和机制进行条件测试，这是迄今为止在MI过程文献中很少实现的对比度。可以立即以MI传播指南的形式或直接以经验支持MI治疗交付的原则形式传达从本研究中获得的信息。这项研究还可以通过检查其在人群之间的关键因果模型的一致性，同时还扩展该模型以确定因果链中的进一步联系，从而为MI文献提供了信息。最后，MI作为行为改变干预措施的成功可能是由于其利用以客户为中心的疗法的核心原则的能力，这表明这一研究可能会更广泛地对治疗促进的行为研究产生影响。