Fidelity of motivational interviewing in an American Indian oral health intervention.
Fidelity of motivational interviewing in an American Indian oral health intervention.
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美洲印第安人口腔健康干预中动机访谈的保真度。
DOI：
10.1111/cdoe.12368
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发表时间：
2018
影响因子：
2.3
通讯作者：
Albino,Judith
中科院分区：
文献类型：
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作者：
Wilson,AnneR;Fehringer,KarenA;Henderson,WilliamG;Venner,Kamilla;Thomas,Jacob;Harper,MayaM;Batliner,TerrenceS;Albino,Judith
目的评估动机性访谈（MI）干预在一组有新生儿的美国印第安母亲中预防早期儿童龋齿的有效性。方法对4名干预医师进行口腔健康心肌梗死干预培训。MI会话被录音，以便作为保真度研究的一部分进行评分，以评估干预者使用MI原则的能力程度。干预者的评估采用动机性访谈治疗完整性（MITI） 3.1.1完成。它评估全球评级和行为计数。两名评审员评估和评分MI课程；总访谈的20%随机抽样由受过训练的审稿人打分，随机选择的50%档案由外部专家打分。共有225个文件由经过培训的审稿人编码，121个文件由外部专家编码。结果所有干预者的综合平均得分在4.0分左右（专家能力）。对问题的反思得分（约0.6）低于初学者的能力。开放性问题（54% - 56%）、复杂反思（38% - 43%）和MI -粘附陈述（93% - 95%）的得分范围从初学者到专家。当单独分析时，四位干预者的能力存在差异。两位评论者的评价间信度评分从一般（0.40‐0.59）到良好（0.60‐0.74）不等。与其他干预者相比，在保真度评估中得分最高的心肌梗死干预者的研究结果最差。个体干预者在MITI全球评级和行为计数上的得分反映了能力的差异，从初级到专家水平不等。在保真度研究中，干预者的能力水平越高，研究结果越好。
ObjectivesAssess fidelity of a motivational interviewing (MI) intervention focused on preventing early childhood caries in a cohort of American Indian mothers with newborns.MethodsFour interventionists were trained to administer an oral health MI intervention. The MI sessions were audio recorded to enable scoring as part of fidelity studies to assess the interventionist's degree of competence in using MI principles. Evaluation of the interventionists was completed using the Motivational Interviewing Treatment Integrity (MITI) 3.1.1. which assesses global ratings and behaviour counts. Two reviewers evaluated and scored the MI sessions; a random sample of twenty per cent of the total interviews was scored by a trained reviewer and fifty per cent of the randomly selected files scored by an external expert. A total of 225 files were coded by the trained reviewer and 121 files by the external expert.ResultsMean global scores for all interventionists combined were around 4.0 (expert competence). Scores for reflection to question ratios (around 0.6) were below beginner competence. Scores ranged from beginner to expert competence for open‐ended questions (54%‐56%), complex reflections (38%‐43%) and MI‐adherent statements (93%‐95%). There was variation in competence for the four interventionists when analysed individually. Inter‐rater reliability scores for the two reviewers ranged from fair (0.40‐0.59) to good (0.60‐0.74). The MI interventionist rated the best in the fidelity assessment had the worst study outcomes compared to other interventionists.ConclusionsIndividual interventionists' scores for the MITI global ratings and behaviour counts reflected variation in competence and ranged from below beginner to expert levels. A higher competence level of the interventionist as assessed by the fidelity study was not related to better study outcomes.