Cushing Christopher C, Jensen Chad D, Miller Mary B, Leffingwell Thad R
Department of Psychology.
Department of Psychology, Brigham Young University.
J Consult Clin Psychol. 2014 Dec;82(6):1212-8. doi: 10.1037/a0036912. Epub 2014 May 19.
We sought to systematically review and meta-analyze the literature comparing motivational interviewing (MI) with a control condition for adolescent health behavior change. In the current article, we reviewed only studies targeting health behaviors other than substance use (e.g., sexual risk behavior, physical activity, diet).
Systematic literature searches of PsycINFO, PubMed/Medline, and ERIC were conducted through June 2013. Databases were combined, and studies were screened for inclusion or exclusion. To be included in the current review, studies were required to (a) compare the efficacy of at least 1 session of MI intervention with a control condition using a between-groups design and (b) examine a non-substance-use health behavior in adolescents. Fifteen studies met criteria for inclusion and were described qualitatively and quantitatively.
Using a fixed-effects model, we found that MI interventions produced a small, but significant, aggregate effect size for short-term postintervention effects-g = .16; 95% confidence interval (CI) [.05, .27]-compared with control conditions. Moreover, this effect was sustained at follow-up assessments averaging 33.6 weeks postintervention, n = 8, g = .18, 95% CI [.05, .32].
MI interventions for adolescent health behavior appear to be effective. In addition, the magnitude of the aggregate effect size does not appear to differ meaningfully from reports of interventions targeting only substance use in adolescents. However, significant lack of clarity exists regarding interventionist training requirements necessary to ensure intervention effectiveness.
我们试图系统回顾并荟萃分析将动机性访谈(MI)与对照条件相比较以促进青少年健康行为改变的文献。在本文中,我们仅回顾了针对除物质使用之外的健康行为(如性风险行为、体育活动、饮食)的研究。
截至2013年6月,对PsycINFO、PubMed/Medline和教育资源信息中心(ERIC)进行了系统的文献检索。将数据库合并,并筛选研究以确定纳入或排除标准。要纳入本综述,研究需满足以下条件:(a)采用组间设计比较至少1次MI干预与对照条件的疗效;(b)研究青少年的非物质使用健康行为。15项研究符合纳入标准,并进行了定性和定量描述。
使用固定效应模型,我们发现与对照条件相比,MI干预在干预后短期内产生了小但显著的总体效应量——g = 0.16;95%置信区间(CI)[0.05, 0.27]。此外,在干预后平均33.6周的随访评估中,该效应持续存在,n = 8,g = 0.18,95% CI [0.05, 0.32]。
针对青少年健康行为的MI干预似乎是有效的。此外,总体效应量的大小与仅针对青少年物质使用的干预报告相比,似乎没有显著差异。然而,在确保干预有效性所需的干预者培训要求方面,仍存在明显的不明确之处。