Learning & motivational talk in smoking cessation interventions: An examination of session language in two randomized trials.

OBJECTIVES

Motivational Interviewing (MI), a client-centered approach that seeks to evoke and resolve ambivalence, and health education (HE), which provides health information and advice, may both provide some benefit to unmotivated smokers. In HE, it is possible that client language reflective of new learning, or "learning talk" (LT), and rejection of health advice, or "rejection talk," (RT), may uniquely reflect intent of subsequent behavior change.

METHODS

This project utilized MI and HE sessions from two randomized clinical trials (RCTs), one in a low-income, diverse community civilian sample of 255 unmotivated smokers, and the other in a sample of Veterans with mental illness who were unmotivated smokers (n = 55). Mixed methods approaches were utilized to reliably code sessions using the Motivational Interviewing Skill Code 2.5 (MISC 2.5) and a refined Learning Talk coding system.

RESULTS

Reliability of LT and RT codes ranged from fair to excellent (ICCs from 0.43-0.93).

CONCLUSION

LT appears to be a unique construct and its impact on post-session changes in smoking is warranted.

PRACTICE IMPLICATIONS

This system can be used in a study to code existing interventions for smokers using both MI and HE techniques and relate in-session client LT to subsequent smoking behaviors.