Vallabhan Monique K, Kong Alberta S, Jimenez Elizabeth Yakes, Summers Linda C, DeBlieck Conni J, Feldstein Ewing Sarah W
Res Theory Nurs Pract. 2017 Aug 1;31(3):219-232. doi: 10.1891/1541-6577.31.3.219.
Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express discomfort with learning and adopting MI practices and with addressing patient weight issues. PCP proficiency in using MI to discuss body mass index, health screening results, and nutrition and physical activity behaviors after receiving training and coaching from an MI expert and practicing the technique was evaluated. We hypothesized that comfort with MI would increase consistently over time.
Self-assessment surveys in MI proficiency were administered to PCPs after every youth participant MI session. MI comfort as determined by proficiency was categorized into low, medium, and high comfort according to survey Likert scale responses. Data were analyzed using analysis of variance (ANOVA) and Fisher's exact tests.
Two hundred twenty-seven youth were seen for MI-based discussions by 4 PCPs. Two hundred twenty-six surveys had complete data for analysis. As anticipated, overall PCPs reported significantly more comfort with MI from the first to the final MI session over a 2- to 3-month period (p< .001). Comfort scores did not increase linearly over time for all PCPs. Despite standard training practices, overall MI proficiency as measured by comfort scores varied by PCP (p< .01).
This type of MI training program should be considered for clinical nurses and nurse practitioners during their nursing education training to facilitate their ability to consistently and effectively support youth behavior change for conditions such as obesity (ClinicalTrials.gov Number NCT02502383).
青少年肥胖是一种全球性的流行病。动机性访谈（MI）是应对青少年肥胖风险行为的一种有前景的策略。然而，初级保健提供者（PCP）往往对学习和采用MI实践以及处理患者体重问题表示不适。评估了初级保健提供者在接受MI专家的培训和指导并练习该技术后，使用MI讨论体重指数、健康筛查结果以及营养和身体活动行为的能力。我们假设对MI的舒适度会随着时间的推移持续增加。
在每次青少年参与者的MI会议后，对初级保健提供者进行MI能力的自我评估调查。根据调查的李克特量表回答，将由能力确定的MI舒适度分为低、中、高舒适度。使用方差分析（ANOVA）和费舍尔精确检验对数据进行分析。
4名初级保健提供者对227名青少年进行了基于MI的讨论。226份调查问卷有完整的数据可供分析。正如预期的那样，在2至3个月的时间里，总体上初级保健提供者报告说从第一次到最后一次MI会议对MI的舒适度明显更高（p<0.001）。并非所有初级保健提供者的舒适度得分都随时间呈线性增加。尽管有标准的培训做法，但根据舒适度得分衡量的总体MI能力因初级保健提供者而异（p<0.01）。
在临床护士和执业护士的护理教育培训期间，应考虑这种类型的MI培训计划，以促进他们持续有效地支持青少年行为改变以应对肥胖等情况的能力（ClinicalTrials.gov编号NCT02502383）。
