Adapted motivational interviewing for brief healthcare consultations: A systematic review and meta-analysis of treatment fidelity in real-world evaluations of behaviour change counselling

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology Pub Date : 2023-05-04 DOI:10.1111/bjhp.12664

Alison K. Beck, Amanda L. Baker, Ben Britton, Alistair Lum, Sonja Pohlman, Erin Forbes, Lyndell Moore, Ditte Barnoth, Sarah J. Perkes, Chris Oldmeadow, Gregory Carter

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引用次数: 0

Abstract

Background

Behaviour change counselling (BCC) is an adaptation of motivational interviewing (MI) designed to maximize the effectiveness of time-limited health behaviour change consultations. To improve intervention quality and understanding of treatment effects, it is recommended that evaluations of health behaviour change interventions incorporate existing fidelity frameworks (e.g. The National Institutes of Health [NIH] Behaviour Change Consortium) and ensure that treatment fidelity is assessed and reported.

Purpose

This systematic review was designed to examine (a) adherence to NIH fidelity recommendations, (b) provider fidelity to BCC and (c) impact of these variables on the real-world effectiveness of BCC for adult health behaviours and outcomes.

Methods and Results

Searches of 10 electronic databases yielded 110 eligible publications describing 58 unique studies examining BCC delivered within real-world healthcare settings by existing providers. Mean study adherence to NIH fidelity recommendations was 63.31% (Range 26.83%–96.23%). Pooled effect size (Hedges g) for short-term and long-term outcomes was .19 (95% CI [.11, .27]) and .09 (95% CI [.04, .13]), respectively. In separate, random-effects meta-regressions, neither short-term nor long-term effect sizes were significantly modified by adherence to NIH fidelity recommendations. For the subgroup of short-term alcohol studies (n = 10), a significant inverse relationship was detected (Coefficient = −.0114, 95% CI [−.0187, −.0041], p = .0021). Inadequate and inconsistent reporting within the included studies precluded planned meta-regression between provider fidelity and BCC effect size.

Conclusions

Further evidence is needed to clarify whether adherence to fidelity recommendations modifies intervention effects. Efforts to promote transparent consideration, evaluation and reporting of fidelity are urgently needed. Research and clinical implications are discussed.

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简短医疗咨询的适应性动机访谈：行为改变咨询真实世界评估中治疗忠诚度的系统综述和荟萃分析。

背景：行为改变咨询（BCC）是对动机访谈（MI）的改编，旨在最大限度地提高限时健康行为改变咨询的有效性。为了提高干预质量和对治疗效果的理解，建议对健康行为改变干预措施的评估纳入现有的保真度框架（例如美国国立卫生研究院[NIH]行为改变联盟），并确保评估和报告治疗保真度。目的：本系统综述旨在检查（a）对NIH保真度建议的遵守情况，（b）提供者对BCC的保真度，以及（c）这些变量对BCC对成人健康行为和结果的真实有效性的影响。方法和结果：对10个电子数据库的搜索产生了110份符合条件的出版物，描述了58项独特的研究，这些研究检查了现有提供者在现实世界医疗环境中提供的BCC。对NIH保真度建议的平均研究依从性为63.31%（范围26.83%-96.23%）。短期和长期结果的综合效应大小（Hedges g）分别为.19（95%CI[.11，.27]）和.09（95%CI[0.04，.13]）。在单独的随机效应元回归中，短期和长期效应大小都没有因遵守NIH保真度建议而显著改变。对于短期酒精研究的亚组（n = 10），检测到显著的反比关系（系数 = -.0114，95%置信区间[-.0187，-.0041]，p = .0021）。纳入研究中的报告不充分且不一致，排除了提供者保真度和BCC效应大小之间的计划元回归。结论：需要进一步的证据来阐明遵守保真度建议是否会改变干预效果。迫切需要努力促进对忠诚度的透明审议、评估和报告。讨论了研究和临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.