Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Avenue de Beaumont 21bis - Pavillon 2, 1011 Lausanne, Switzerland.
Addict Behav. 2013 Nov;38(11):2718-23. doi: 10.1016/j.addbeh.2013.07.004. Epub 2013 Jul 20.
Assessing motivation for change is deemed an important step in the treatment process that allows further refinement of the intervention in motivational interviewing (MI) and brief MI (BMI) adaptations. During MI (and BMI) sessions, motivation for change is expressed by the client as "change talk", i.e. all statements inclined toward or away from change. We tested the predictive validity of the Change Questionnaire, a 12-item instrument assessing motivation to change, on hazardous tobacco and alcohol use.
As part of the baseline measurements for a randomized controlled trial on multi-substance BMI at the Lausanne recruitment center (army conscription is mandatory in Switzerland for males at age 20, and thus provides a unique opportunity to address a non-clinical and largely representative sample of young men), 213 participants completed the questionnaire on tobacco and 95 on alcohol and were followed-up six months later. The overall Change Questionnaire score and its six subscales (Desire, Ability, Reasons, Need, Commitment, and Taking steps) were used as predictors of hazardous tobacco use (defined as daily smoking) and hazardous alcohol use (defined as more than one occasion with six standard drinks or more per month, and/or more than 21 standard drinks per week) in bivariate logistic regression models at follow-up.
Higher overall Change scores were significant predictors of decreased risk for hazardous tobacco (odds ratio [OR] = 0.83, p = 0.046) and alcohol (OR = 0.76, p = 0.03) use. Several sub-dimensions were associated with the outcomes in bivariate analyses. Using a principal components analysis to reduce the number of predictors for multivariate models, we obtained two components. 'Ability to change' was strongly related to change in hazardous tobacco use (OR = 0.54, p < 0.001), the second we interpreted as 'Other change language dimensions' and which was significantly related to change in hazardous alcohol use (OR = 0.81, p = 0.05).
The present findings lend initial support for the predictive validity of the Change Questionnaire on hazardous tobacco and alcohol use, making it an interesting and potentially useful tool for assessing motivation to change among young males.
评估改变的动机被认为是治疗过程中的重要步骤，它可以进一步完善动机面谈（MI）和简短动机面谈（BMI）的干预措施。在 MI（和 BMI）过程中，客户通过“改变谈话”表达改变的动机，即所有倾向于或远离改变的陈述。我们测试了评估改变动机的 12 项工具《改变问卷》在危险烟草和酒精使用方面的预测有效性。
作为洛桑征兵中心多物质 BMI 随机对照试验的基线测量的一部分（在瑞士，男性在 20 岁时必须服兵役，因此这为解决非临床和具有代表性的年轻男性样本提供了独特的机会），213 名参与者完成了关于烟草的问卷，95 名参与者完成了关于酒精的问卷，并在六个月后进行了随访。总体《改变问卷》得分及其六个分量表（愿望、能力、理由、需要、承诺和采取措施）被用作随访时危险烟草使用（定义为每天吸烟）和危险酒精使用（定义为每月一次或以上六标准杯或以上，和/或每周超过 21 标准杯）的双变量逻辑回归模型的预测因子。
更高的总体改变分数是危险烟草（比值比[OR] = 0.83，p = 0.046）和酒精（OR = 0.76，p = 0.03）使用风险降低的显著预测因子。在双变量分析中，一些子维度与结果相关。使用主成分分析来减少多元模型的预测因子数量，我们得到了两个成分。“改变的能力”与危险烟草使用的改变密切相关（OR = 0.54，p < 0.001），我们解释的第二个成分是“其他改变语言维度”，与危险酒精使用的改变显著相关（OR = 0.81，p = 0.05）。
本研究结果初步支持《改变问卷》在危险烟草和酒精使用方面的预测有效性，使其成为评估年轻男性改变动机的一种有趣且潜在有用的工具。
