Integration of Motivational Interviewing and Behavioral Economics Theories to Enhance Measurement of Client Language as a Mechanism of Behavior Change

动机访谈与行为经济学理论相结合，加强对客户语言作为行为改变机制的测量

• 批准号: 9887048
• 负责人: Benjamin O. Ladd
• 金额: $ 39.66万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-10 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9887048
• 关键词: Addictive Behavior; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Alternative Health; Area; Behavior; Behavioral; Behavioral Mechanisms; Categories; Characteristics; Client; Clinical; Code; Complement; Costs and Benefits; Data; Data Set; Decision Making; Demographic Factors; Development; Future; Gender; Goals; Health; Health behavior; Intervention; Language; Lead; Maintenance; Measurement; Measures; Mediating; Mediator of activation protein; Modeling; Motivation; Movement; Outcome; Perception; Physical Exercise; Population; Prediction of Response to Therapy; Process; Psychological reinforcement; Randomized Controlled Trials; Research; Rewards; Severities; Structure; System; Testing; Theoretical model; Time; Training; Validity and Reliability; alcohol behavior; alcohol demand; alcohol response; behavior change; behavioral economics; brief intervention; clinical application; clinical practice; clinically relevant; college; college drinking; cost; design; discounting; drinking; economic indicator; follow-up; free behavior; high risk drinking; improved; innovation; motivational enhancement therapy; novel; predicting response; psychologic; rate of change; reduced substance use; reinforcer; skills; theories; treatment response; trial comparing; university student; young adult; young adult alcohol use

Project Summary Motivational interviewing (MI) theory posits certain measures of client language serve as key mechanisms of behavior change. Specifically, increased change talk, or statements supporting movement toward healthy behavior, and decreased sustain talk, or statement supporting maintenance of unhealthy behavior, should lead to reductions in risky alcohol use. While findings support aspects of this technical hypothesis of MI, there are a number of limitations to the current study of client language. Of note, large amounts of in-session language go unexamined and the current MI model lacks a theory guiding session content, particularly in contexts where clients are not ready to discuss changes in drinking. Behavioral economics (BE) theory assumes the reinforcing value of a substance is a function of the benefit/cost ratio of substance use in relation to the benefit/cost of other available activities; thus BE provides a structure by which to understand the value of alcohol and other reinforcing behaviors. BE also identifies delayed reward discounting as a critical factor associated with value appraisal of behavior. The proposed research aims to integrate cutting-edge MI process research with BE theory with the goal of developing an innovative, theoretically-driven conceptualization of client language associated with college alcohol use and response to brief intervention. Comprised of BE and MI experts, the proposed research team will develop and test an enhanced coding system that uses a parallel decision-making process involving multiple independent choices for each client language utterance: one for motivational state, another for behavioral target (e.g., talking about an alternative substance-free behavior such as spending more time studying vs. the identified target behavior of alcohol use reduction), and a third related to temporal orientation (e.g., discussing future goals vs. present circumstances). During the initial development stage, MI session recordings from three completed randomized controlled trials will be coded using the novel client language variables and compared to conventional definitions of change talk and sustain talk to examine convergent, divergent, and incremental validity. Next, using recordings from another two completed randomized controlled trials, the novel coding system will examine client language as a predictor of response to an innovative BE clinical application compared to a traditional MI intervention. Finally, using data from all five original trials, we will examine conditional models of client language as predictors of treatment response. The current study has significant potential to enhance efforts to reduce risky young adult drinking and inform clinical training and practice.

项目摘要 动机访谈（MI）理论认为，客户语言的某些度量是 行为改变。具体而言，变更谈话增加或支持健康运动的陈述 行为，减少维持谈话或支持维持不健康行为的声明，应领导 减少风险的饮酒。尽管发现支持了MI的技术假设的各个方面，但有一个 当前对客户语言研究的局限性数量。值得注意的是，大量的课内语言 未经检查，当前的MI模型缺乏指导会话内容的理论，尤其是在环境中 客户还没有准备好讨论饮酒的变化。行为经济学（BE）理论假设 物质的增强价值是与物质使用的利益/成本比率相关的函数 其他可用活动的收益/成本；因此，BE提供了一种理解价值的结构 酒精和其他加强行为。也可以将延迟的奖励折扣视为关键因素 与行为的价值评估有关。拟议的研究旨在整合尖端的MI过程 具有理论的研究，目的是开发一种创新的，理论上驱动的概念化 与大学酒精使用和对短暂干预的反应相关的客户语言。由BE和 MI专家，拟议的研究团队将开发和测试使用平行的增强的编码系统 决策过程涉及每种客户语言的多个独立选择：一种 动机状态，行为目标的另一个动机（例如，谈论一种无物质的行为 由于花费更多的时间学习与降低酒精饮酒的目标行为）和第三个相关的 到时间取向（例如，讨论未来目标与当前情况）。在最初的开发期间 阶段，将使用小说编码三个完整的随机对照试验的MI会话记录 客户语言变量，并将变化谈话和维持对话的传统定义进行比较 收敛，发散和增量有效性。接下来，使用另外两个完成的录音 随机对照试验，新颖的编码系统将检查客户语言作为响应的预测指标 与传统的MI干预相比，具有创新的临床应用。最后，使用所有五个数据 原始试验，我们将研究客户语言的条件模型作为治疗反应的预测指标。这 当前的研究具有增强努力减少风险的年轻饮酒并为临床告知的巨大潜力 培训和实践。