Ingersoll Karen S, Banton Thomas, Gorlin Eugenia, Vajda Karen, Singh Harsimran, Peterson Ninoska, Gonder-Frederick Linda, Cox Daniel J
University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
Internet Interv. 2015 May 1;2(2):103-109. doi: 10.1016/j.invent.2015.02.001.
While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI) intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized to vs. . The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t= -2.25; p<.03) and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t= -1.69; p<. 10) or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data.
虽然互联网干预措施可以改善健康行为，但其效果受到项目依从性的限制。通过电话咨询来支持项目依从性可能会有所帮助，但很少有对这种支持效果的直接测试。我们描述了一种电话动机性访谈（MI）干预措施，目标是提高1型糖尿病患者对互联网干预项目DD.com的依从性，并比较随机分配到接受与未接受该干预措施的参与者完成干预基准的情况。干预前MI环节的目标是增强参与者完成互联网干预及其所有任务的动机，而治疗后MI环节的目标是规划如何维持干预期间所取得的改变。访谈环节采用半结构化并部分编写了脚本，以最大限度地保证一致性。MI保真度使用标准编码系统MITI进行编码。我们研究了MI支持与无支持对从注册到达到项目基准的天数的影响。结果显示，MI访谈环节的实施具有较高的保真度。接受MI支持的用户显著更快地完成了一些项目基准，如核心4（t = -2.25；p <.03）以及12份月度驾驶日记中的11份，但支持措施对干预完成时间（t = -1.69；p <.10）或完成率没有显著影响。这些数据表明，对于包括自动电子邮件提示和其他自动最小支持在内的互联网干预措施，治疗师指导几乎没有益处，但强化MI环节可能会提高后续数据的收集。
