Motivational interviewing adherence tools: A scoping review investigating content validity

• Published in: Patient education and counseling Vol. 102; no. 12; pp. 2145 - 2155
• Main Authors: Lundahl, Brad, Droubay, Brian A., Burke, Brian, Butters, Rob P., Nelford, Kalani, Hardy, Clinton, Keovongsa, Kevin, Bowles, Marti
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.12.2019
• Subjects: Adherence; Humans; Implementation; Medication Adherence; Motivational Interviewing; Nursing; Reproducibility of Results; Scoping review; Motivational interviewing; Adherence; Scoping review; Implementation
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2019.07.003

•Motivational Interviewing adherence measures vary in content assessed.•Motivational Interviewing adherence measures tend to assess only counselor behavior.•Motivational Interviewing adherence measures consistently neglect finer points of MI.•Motivational Interviewing adherence measures may need to be more accessible to clinicians. We sought to understand the content validity of Motivational Interviewing (MI)as a concept and the relative emphasis of specific MI aspects by assessing MI adherence measures. We followed PRISMA guidelines for scoping reviews. Twenty-eight adherence measures were identified. From these, 407 specific MI adherence codes were extracted and submitted to content analysis. Fifteen MI themes emerged, 13 focused on clinician behaviors and 2 on client responses. Four themes (OARS, MI Spirit, evoking motivation, and MI-inconsistent behaviors) accounted for 72% of all codes. No other theme (e.g., preventing/responding to resistance, engaging ambivalence) accounted for more than 6% of codes. One measure assessed 11 of 15 themes; on average, 5.68 themes were assessed with a mean of 14.54 questions per measure. Process and psychometric characteristics of the measures are described. MI adherence measures agree about the importance of certain aspects of MI but lag behind current research and best skill practice. Considerable variance exists in assessing MI nuances and specific behaviors, suggesting questions about what constitutes MI in practice settings and what should be taught. Importantly, most measures focused only on the counselor’s behavior, missing the impact of MI on the client.