RESUMO
BACKGROUND: Motivational interviewing (MI) is an evidence-based practice that has been successfully applied to at-risk youth. Well-validated measures that track MI integrity may not be used in practice settings due to the time to complete them, recording requirements and training involved. A simpler, less resource-intensive instrument may encourage programs and providers to attend more to the quality of MI use during implementation. PURPOSE: To validate a method involving two measures, Youth and Provider Logs, to assist in monitoring MI use. METHODS: Clients and providers reported on provider behaviors consistent and inconsistent with MI during the session. Factor analyses were conducted to examine whether measures showed clear scales assessing MI use and analyses were conducted to assess validity of these measures. RESULTS: Both Youth and Provider Logs showed a clear and consistent 3-factor structure assessing MI-consistent behavior, MI-inconsistent behavior, and alcohol-related topics. Significant correlations were found between Youth Logs and youth reports of rapport with providers, and satisfaction with services. Provider MI-inconsistent scores were significantly inversely predictive of observer fidelity scores over time. CONCLUSION: This study offers provider and client measures for tracking use of MI in sessions, which are a simpler, less resource-intensive method for monitoring MI, and may encourage fidelity during implementation.
Assuntos
Entrevista Motivacional , Humanos , Entrevista Motivacional/métodos , Adolescente , Masculino , FemininoRESUMO
Background: This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII) designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. Methods: A mixed-method cluster randomized design was used to randomize 21 sites to early- or delayed-start within 9 research centers. Parent study protocol was reviewed to develop fidelity constructs (i.e., responsiveness, dose, quality, adherence). Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percent goals achieved). Correlations, analyses of covariance, regressions and moderation analyses were performed. Qualitative interviews assessed facilitators/barriers to implementation. Results: Fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness (i.e., engagement in the OPII) related to poorer outcome. Conclusions: It is important to consider contextual factors (e.g., leadership) that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance.
Assuntos
Prática Clínica Baseada em Evidências , Humanos , Prisioneiros , Transtornos Relacionados ao Uso de Substâncias , LiderançaRESUMO
BACKGROUND: Despite male youth taking more sexual risks that lead to unwanted partner pregnancy and/or sexually transmitted infections (STIs), research evaluating interventions for risky sex has focused almost exclusively on adolescent and adult females. With STIs among male youth on the rise, behavioral interventions that target risky sex among male youth are needed. PURPOSE: A randomized controlled pilot study was conducted to examine the feasibility and acceptability of two manualized behavioral interventions for sexually active male youth. METHODS: Sexually active at-risk male youth (N = 27) were recruited and randomized to receive one session of motivational interviewing (MI) or didactic educational counseling (DEC). Assessment interviews were conducted prior to and 3 months following the intervention session. RESULTS: Support for the feasibility and acceptability of delivering behavioral interventions to reduce risky sexual behaviors among at-risk male youth was found. Compared to participants in DEC at follow-up, participants in MI reported having significantly fewer sexual encounters with casual partners, used substances at the time of sex significantly less often with all partners and casual partners, and reported fewer incidents of using substances at the time of sex without a condom with all partners. Conversely, participants who received MI used substances at the time of sex with main partners and used substances at the time of sex without a condom more often with main partners at follow-up compared to participants who received DEC. CONCLUSIONS: Results of the pilot study support conducting a larger randomized controlled trial to examine treatment effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Assuntos
Entrevista Motivacional , Adolescente , Adulto , Preservativos , Feminino , Humanos , Masculino , Projetos Piloto , Gravidez , Assunção de Riscos , Comportamento SexualRESUMO
BACKGROUND: Motivational Interviewing plus Cognitive Behavior Therapy (MI/CBT) has been used to reduce adolescent substance use, but has rarely been applied in youth correctional settings. This trial compared MI/CBT against Relaxation Training plus Substance-Education/12-Steps (RT/SET) to reduce substance use and crime among incarcerated youth. METHODS: Participants (Nâ¯=â¯199) were incarcerated juveniles (64.8 % non-White, 10.1 % girls, mean age of 17.1 years). Two individual sessions of MI (or RT) were followed by 10 group sessions of CBT (or SET). Youth were randomized to condition with follow-ups at 3- and 6-months after release. Major outcomes included alcohol, marijuana and crimes involving aggression. RESULTS: A marginal treatment by time interaction was found for percent heavy drinking days, with follow-up tests indicating less alcohol use in RT/SET than MI/CBT at 6 months, and increased use within MI/CBT from 3 to 6 months. A significant treatment by time interaction was found for alcohol-related predatory aggression, with follow-up tests indicating fewer youth engaged in this behavior from 3 to 6 months within RT/SET, and weak evidence favoring MI/CBT over RT/SET at 3 months. General predatory aggression decreased from 3 to 6-months for both treatments. CONCLUSIONS: Although weak evidence was found favoring MI/CBT with respect to alcohol-related predatory aggression, results generally support RT/SET in reducing percent heavy drinking days.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Entrevista Motivacional/métodos , Educação de Pacientes como Assunto/métodos , Prisioneiros , Terapia de Relaxamento/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Agressão/psicologia , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/terapia , Terapia Combinada/métodos , Crime/psicologia , Feminino , Seguimentos , Humanos , Masculino , Uso da Maconha/epidemiologia , Uso da Maconha/psicologia , Uso da Maconha/terapia , Prisioneiros/psicologia , Terapia de Relaxamento/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto JovemRESUMO
OBJECTIVES: We examined the feasibility and acceptability of a novel home-based intervention to improve the food parenting practices of low-income mothers with preschool-aged children. METHODS: Mother-child dyads (N = 15) were recruited from WIC in southern Rhode Island. A non-experimental, pretest-posttest design was used to assess changes in maternal food parenting practices. Dyads participated in 3 home-based sessions that included baseline measures and an evening meal video recording at session 1, a motivational interviewing (MI) intervention that included feedback on the evening meal video recording at session 2, and a satisfaction ques- tionnaire at session 3. Pretest-posttest measures included 5 subscales of the Comprehensive Feeding Practices Questionnaire. RESULTS: Fifteen mother-child dyads (mothers: 32.3, SD = 4.6 years, 86.7% white; children: 3.2, SD = 0.9 years, male = 73.3%, 66.7% white) completed the study. Mothers reported improvements in food parenting practices following the home-based MI intervention. Overall, 93% of mothers 'strongly agreed' that it was worth their effort to participate in the study. CONCLUSIONS: A home-based MI intervention may be an effective strategy for improving maternal food parenting practices in low-income populations. Most mothers found that watching themselves was informative and applicable to their own lives.
Assuntos
Comportamento Alimentar/psicologia , Alimentos , Mães/psicologia , Entrevista Motivacional , Poder Familiar/psicologia , Adulto , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Masculino , Refeições , Satisfação Pessoal , Inquéritos e QuestionáriosRESUMO
The impact of Motivational Interviewing (MI) on risky behaviors of incarcerated adolescents and adults has been investigated with promising results. Findings suggest that MI reduces substance use, improves motivation and confidence to reduce use, and decreases risky behaviors. The current study investigated the impact of MI on general, alcohol-related, and marijuana-related delinquent behaviors in incarcerated adolescents. Participants in the study were incarcerated adolescents in a state correctional facility in the Northeast region and were assessed as part of a larger randomized clinical trial. Adolescents were randomly assigned to receive MI or relaxation therapy (RT) (N=189) treatment. Delinquent behaviors and depressive symptomatology were measured using the Delinquent Activities Scale (DAS; Reavy, Stein, Paiva, Quina, & Rossi, 2012) and the Center for Epidemiological Studies-Depression scale (CES-D; Radloff, 1991) respectively. Findings indicate that depression moderated treatment effects. Compared to RT, MI was better at reducing predatory aggression and alcohol-related predatory aggression 3 months post-release when depressive symptoms were low. Identifying an efficacious treatment for these adolescents may benefit society in that it may decrease crimes against persons (i.e., predatory aggression) post release.