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 已将未上大学的年轻人确定为有针对性干预的关键人群，以减少酗酒和相关负面后果。基于动机访谈 (MI) 原则的简短干预措施已在大学生中显示出疗效，但对于非大学生中酗酒的年轻人的 MI 疗效、活性治疗成分以及行为改变机制知之甚少。目前的研究将测试一系列理论驱动的假设，这些假设涉及在这一未被充分研究的人群中有效的心肌梗死结果的疗程内预测因素。为此，本研究将从最近完成的临床试验（AA016000；PI：Colby）的录音会话文件中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）。该临床试验在过去一个月的未成年酗酒者（17-20 岁）样本（N=167）中将单次 MI 与时间匹配的冥想和放松训练 (REL) 对照进行了比较。与 REL 相比，MI 在 3 个月的随访中显着减少了饮酒和与酒精相关的负面后果，同时还影响了一系列理论驱动的认知和行为中间结果（改变饮酒的动机、感知饮酒规范、自我效能感）。改变饮酒行为；限制饮酒）。这些结果提供了一个独特的机会来研究负责治疗改善的会话内过程，而这些过程尚未得到充分研究，但需求很高的年轻成年人群。具体来说，本研究将纳入新颖的概念和统计考虑因素来检验：MI 功效的技术假设、动机构建的客户语言机制和 MI 过程的变更规划要素（MI 唤起、聚焦和规划）、具体的内部 -会议 MI 成分（探索饮酒的利弊，提供关于饮酒的个性化反馈，并规划限制饮酒的行为策略），预测客户的语言机制和具体条件（治疗师 MI 移情和精神，客户基线动机）变化），在此条件下因果模型得到最佳指定。此外，时间匹配控制条件的存在允许对会话内成分和机制进行条件间测试，这是迄今为止 MI 过程文献中很少实现的对比水平。从这项研究中获得的信息可以立即以 MI 传播指南的形式传达给服务机构，或者以经验支持的 MI 治疗实施原则的形式直接传达给提供者。这项研究还可以通过检查其关键因果模型在不同人群中的一致性来为 MI 文献提供信息，同时进一步扩展模型以识别因果链中的进一步链接。最后，MI 作为行为改变干预措施的成功可能是由于它能够利用以客户为中心的治疗的核心原则，这表明这一研究方向可能对更广泛的治疗促进行为研究产生影响。