ABSTRACT
BACKGROUND
The Veterans Health Administration (VHA) is implementing the patient-centered medical home (PCMH) model of primary care which emphasizes patient-centered care and the promotion of healthy lifestyle changes. Motivational Interviewing (MI) is effective for promoting various health behaviors, thus a training protocol for primary care staff was implemented in a VHA health care setting.
OBJECTIVES
We examined the effect of the training protocol on MI knowledge, confidence in ability to use MI-related skills and apply them to written vignettes, perceived comfort level and skill in lifestyle counseling, and job-related burnout.
DESIGN
Training was provided by experts in MI. The training protocol consisted of three sessions—one half day in-person workshop followed by a 60-minute virtual training, followed by a second workshop. Each of the sessions were spaced two weeks apart and introduced trainees to the theory, principles, and skills of using MI in health care settings.
PARTICIPANTS
All primary care staff at the Veterans Affairs Palo Alto Health Care System were invited to participate.
MEASUREMENTS
Trainees completed a short set of questionnaires immediately before and immediately after the training.
RESULTS
We found support for our primary hypotheses related to knowledge, confidence, and written responses to the vignettes. Changes in perceived comfort level and skill in lifestyle counseling, and job-related burnout were not observed.
CONCLUSIONS
Training primary care staff in MI is likely to become increasingly common as health care systems transition to the PCMH model of care. Therefore, it is important for health care systems to have low-cost methods for evaluating the effectiveness of such trainings. This study is a first step in developing a brief written assessment with the potential of measuring change in a range of behaviors and skills consistent with MI.
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Acknowledgements
This research was supported by a Career Development Award—2 (CDA 08-004-3) to Dr. Cucciare by the Department of Veterans Health Services Research and Development Service and funds provided by the VA Palo Alto Health Care System. A determination of non-human subjects’ research was obtained from Stanford University Institutional Review Board. The views expressed are those of the authors and not of the U. S. Department of Veterans Affairs.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
Mr. Berg-Smith was employed as a contractor by the VA Palo Alto Health Care System to conduct part of the training in Motivational Interviewing for primary care staff.
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Cucciare, M.A., Ketroser, N., Wilbourne, P. et al. Teaching Motivational Interviewing to Primary Care Staff in the Veterans Health Administration. J GEN INTERN MED 27, 953–961 (2012). https://doi.org/10.1007/s11606-012-2016-6
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DOI: https://doi.org/10.1007/s11606-012-2016-6