A CONTENT ANALYSIS OF BRIEF INTERVENTION SESSIONS FOR HEALTH PROMOTION AND REDUCTION OF ALCOHOL CONS - PowerPoint PPT Presentation

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A CONTENT ANALYSIS OF BRIEF INTERVENTION SESSIONS FOR HEALTH PROMOTION AND REDUCTION OF ALCOHOL CONS

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Title: A CONTENT ANALYSIS OF BRIEF INTERVENTION SESSIONS FOR HEALTH PROMOTION AND REDUCTION OF ALCOHOL CONS


1
A CONTENT ANALYSIS OF BRIEF INTERVENTION SESSIONS
FOR HEALTH PROMOTION AND REDUCTION OF ALCOHOL
CONSUMPTION IN COLLEGE STUDENTS
  • Elizabeth M. Rash PhD, ARNP, FNP-C
  • James Schauss M.D., Michael Diechen, M.D.,
    Michael Dunn PhD, Mary Lou Sole PhD, Laura Riddle
    LFMT, Natalie Mullett, M.Ed.
  • University of Central Florida
  • Orlando, Florida
  • Study funded by grants from Sigma Theta Tau
    (Theta Epsilon Chapter), Florida Nurses
    Foundation, and AANP Foundation. Large study
    funded by NIAAA (U18 xxx)

2
Background
  • High rate of negative alcohol behaviors among
    college students (NIAAA, 2002).
  • Brief interventions using Motivational
    Interviewing (MI) successfully reduce negative
    behaviors (Miller Rollnick, 2002).
  • Limited analyses of fidelity with MI principles
    (Miller Rollnick).

3
MI Principles (Miller and Rollnick)
  • Client Centered
  • Collaborative
  • Dancing vs. wrestling
  • Rolling with Resistance
  • Empathy
  • Developing discrepancy
  • Values vs. behaviors

4
Background
  • NIAAA funded study of college students with
    evidence of negative alcohol behaviors
  • Control Grp. received routine care
  • Expt. Grp. Received 2 brief intervention sessions
    with health care providers trained in MI using
    NIAAA BASICS (Fleming, Cotter Talboy, 1997).

5
Purpose
  • Determine if the brief intervention sessions
    demonstrated fidelity with motivational
    interviewing principles

6
Methodology
  • Content analysis of randomly selected brief
    intervention session audio-taped transcripts
    using the Motivational Interviewing Skill Code
    (MISC) (Miller, 2000) participant and provider
    session feedback forms

The MISC offers good to excellent intra-class
correlations and inter-rater reliability on
global ratings (Moyer, Martin, Catley, Harris,
Ahluwalia, 2003).
7
MISC
  • 1st Pass global rating
  • spirit
  • 2nd Pass behavior counts
  • principles
  • 3rd Pass computation of talk time
  • client centered
  • Summary scoring
  • MI proficiency
  • Not proficient (0-1.9) Proficient (2-2.9 )
    Expert (3)

8
Data Analysis
Rater1 Rater2 Inter-rater reliability
9
Discussion
  • Less talk time correlates with greater
    proficiency (albeit still not proficient).
  • Feedback forms reveal positive student
    perceptions providers felt they were consistent
    with MI principles.
  • Comparisons (Wilcoxon Signed Ranks Test) of
    available pre- 3 mos. post (1-mos. average) BAC
    (p0.394) pre- 3 mos. post (1-mos. average)
    peak BAC (p0.478) demonstrated no significant
    differences among experimental group. Subset too
    small to generalize to entire study.
  • Design produced artificial setting (consider
    blinding providers?)

10
Recommendations Future Research
  • Reassess MI training protocols and needs
  • Reassess design
  • Determine influence of unintended extraneous
    variables
  • Re-analyze using criteria for a Behavior Change
    Counseling model

11
References
  • Moyer, T., Martin, T., Catley, D., Harris, K. J.,
    Ahluwalia, J. S. (2003). Assessing the
    integrity of motivational interviewing
    interventions Reliability of the motivational
    interviewing skills code. Behavioral and
    Cognitive Psychotherapy 31, (2), 177-184.
  • National Institute on Alcohol Abuse and
    Alcoholism. (2002). A call to action Challenging
    the culture of drinking at U.S. Colleges. NIH
    Pub. No. 02-5010. Bethesda, M.D. NIAAA.
  • Miller, W. R. (2000). Motivational Interviewing
    Skill Code (MISC) Coders Manual. University of
    New Mexico
  • Miller, W. R. Rollnick, S. (2002). Motivational
    interviewing (2nd ed.). New York The Guilford
    Press.
  • National Institute on Alcohol Abuse and
    Alcoholism. (2002). A call to action Challenging
    the culture of drinking at U.S. Colleges. NIH
    Pub. No. 02-5010. Bethesda, M.D. NIAAA.
  • Thank you to Rater2 Ruchi Gandhi Shah BSN, FNP
    resident
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