社区为基础的物质使用治疗环境中提供者能力的有效和高效测量：动机性访谈教练评定量表（MI-CRS）的表现。
Efficient and effective measurement of provider competence in community-based substance use treatment settings: Performance of the Motivational Interviewing Coach Rating Scale (MI-CRS).
机构信息
Florida State University, United States of America.
Oregon Social Learning Center, United States of America.
出版信息
J Subst Use Addict Treat. 2023 Jul;150:209027. doi: 10.1016/j.josat.2023.209027. Epub 2023 Mar 29.
OBJECTIVE
Efficient and effective fidelity measurement is necessary to improve rigor and reduce burden of motivational interviewing (MI) implementation studies for both fidelity outcomes and quality improvement strategies. This article reports on such a measure developed with rigorous methodology and tested in community-based substance abuse treatment settings.
METHODS
This scale development study analyzed data from a National Institute on Drug Abuse study testing the Leadership and Organizational Change for Implementation (LOCI) strategy. Utilizing item response theory (IRT) methods and Rasch modeling, we analyzed coded recordings (N = 1089) of intervention sessions of 238 providers from 60 substance use treatment clinics across nine agencies in an implementation trial focusing on MI.
RESULTS
These methods yielded a reliable and valid 12-item scale representing single construct dimensionality, strong item-session maps, good rating scale functionality, and item fit. Separation reliability and absolute agreement for adjacent categories was high. No items were significantly misfitting, though one was borderline. The LOCI community providers were less likely to be scored in the advanced competence range and items were more difficult compared to the original development sample.
CONCLUSIONS
The 12-item Motivational Interviewing Coach Rating Scale (MI-CRS) showed excellent performance in a large sample of community-based substance use treatment providers using real recordings. The MI-CRS is the first efficient and effective fidelity measure appropriate for diverse ethnic groups, with interventions that are MI only or interventions that integrate MI with other treatments, and with adolescents and adults. Follow-up coaching by trained supervisors may be needed for community-based providers to achieve the highest level of MI competence.
目的
为了提高动机访谈（MI）实施研究的严谨性并减少其负担，无论是针对保真度结果还是质量改进策略，都需要高效且有效的保真度测量。本文报告了一种使用严格方法开发并在基于社区的药物滥用治疗环境中进行测试的此类度量标准。
方法
这项量表发展研究分析了美国国立药物滥用研究所（National Institute on Drug Abuse）一项测试领导力和组织变革实施策略（Leadership and Organizational Change for Implementation，LOCI）的研究数据。利用项目反应理论（item response theory，IRT）方法和 Rasch 建模，我们分析了一项实施试验中 60 个药物使用治疗诊所的 238 名提供者的干预会话的编码记录（N=1089），该试验的重点是 MI。
结果
这些方法产生了一个可靠且有效的 12 项量表，代表单一的构念维度、强大的项目-会话映射、良好的评分量表功能和项目拟合度。相邻类别之间的分离可靠性和绝对一致性很高。没有项目明显拟合不良，尽管有一个项目接近拟合不良。与原始开发样本相比，LOCI 社区提供者更不可能在高级能力范围内被评分，而且项目更难。
结论
在一个基于社区的药物使用治疗提供者的大样本中，使用真实记录，12 项动机访谈教练评分量表（Motivational Interviewing Coach Rating Scale，MI-CRS）表现出了极好的性能。MI-CRS 是第一个适合不同种族群体的高效且有效的保真度度量标准，适用于仅采用 MI 的干预措施或将 MI 与其他治疗方法相结合的干预措施，以及适用于青少年和成年人。可能需要接受过培训的主管进行后续辅导，以帮助社区提供者达到最高水平的 MI 能力。
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