Training Teen Mothers as Motivational Interviewers: A Feasibility Study

When teen mothers do not graduate from high school, they and their children risk a lifetime of negative outcomes. They face major economic and health difficulties, often repeated across generations.  To address this growing national concern that particularly impacts Hispanic teen mothers, we began by training young nonprofessional peer mentors in motivational interviewing (MI) to provide one-to-one support for teen mothers.  To our knowledge, young non-clinicians have never before been formally evaluated for MI competency.  Our preliminary investigation tested whether teen mothers who had succeeded in graduating could use MI effectively in conversations with their peers who had not yet completed high school.  The six peer mentors were able to attain basic competency in MI. Some of their demonstrated skills went beyond competency to MI proficiency as measured by the MITI coding system.  They also expressed their enthusiasm for the experience.  They fully participated in the study protocols and also maintained the spirit of MI throughout the study. These findings are being used to design a training strategy for the peer mentors that can be used in schools and clinics throughout New Mexico. The question we asked was:  “Can these young mothers, who have succeeded in graduating from high school, competently use MI to support other teen moms to continue their education?”  The answer in this feasibility study was “yes”

Client Commitment Language During Motivational Interviewing Predicts Drug Use Outcomes

Client language from a motivational interview (MI) and drug use outcome were investigated. Interview videotapes of 84 drug abusers were coded for frequency and strength of utterances expressing commitment, desire, ability, need, readiness, and reasons to change or maintain their habit. Cluster analysis of proportion days abstinent (PDA) revealed 3 groups: high PDA at intake and follow-up (3, 6, 9, 12 months; maintainers); low intake PDA/high follow-up PDA (changers); and low intake PDA/low to moderate follow-up PDA (stragglers). Distinct group patterns emerged for commitment strength (CS) during MI. Clients dishonest in checklist self-report exhibited CS similar to stragglers. CS for client evaluation of a change plan predicted outcome PDA. CS was predicted by the strength of desire, ability, need, and reasons, but more strongly predicted outcome PDA, suggesting CS is a pathway for their influence on behavior

Client Commitment Language During Motivational Interviewing Predicts Drug Use Outcomes

Client language from a motivational interview (MI) and drug use outcome were investigated. Interview videotapes of 84 drug abusers were coded for frequency and strength of utterances expressing commitment, desire, ability, need, readiness, and reasons to change or maintain their habit. Cluster analysis of proportion days abstinent (PDA) revealed 3 groups: high PDA at intake and follow-up (3, 6, 9, 12 months; maintainers); low intake PDA/high follow-up PDA (changers); and low intake PDA/low to moderate follow-up PDA (strugglers). Distinct group patterns emerged for commitment strength (CS) during MI. Clients dishonest in checklist self-report exhibited CS similar to strugglers. CS for client evaluation of a change plan predicted outcome PDA. CS was predicted by strength of desire, ability, need, and reasons, but more strongly predicted outcome PDA, suggesting CS is a pathway for their influence on behavior

School-Based Health Center Intervention Improves Body Mass Index in Overweight and Obese Adolescents

Adolescents Committed to Improvement of Nutrition and Physical Activity (ACTION) was undertaken to determine feasibility of a school-based health center (SBHC) weight management program. Two urban New Mexico SBHCs were randomized to deliver ACTION or standard care. ACTION consisted of eight visits using motivational interviewing to improve eating and physical activity behavior. An educational nutrition and physical activity DVD for students and a clinician toolkit were created for use as menu of options. Standard care consisted of one visit with the SBHC provider who prescribed recommendations for healthy weight. Sixty nondiabetic overweight/obese adolescents were enrolled. Measures included BMI percentile, waist circumference, insulin resistance by homeostasis model assessment (HOMA-IR), blood pressure, triglycerides, and HDL-C levels. Pre- to postchanges for participants were compared between groups. Fifty-one students (mean age 15 years, 62% female, 75% Hispanic) completed pre- and postmeasures. ACTION students (n=28) had improvements in BMI percentile (P=0.04) and waist circumference (P=0.04) as compared with students receiving standard care (n=23). No differences were found between the two groups in blood pressure, HOMA-IR, triglycerides, and HDL-C. The ACTION SBHC weight management program was feasible and demonstrated improved outcomes in BMI percentile and waist circumference