Component Analysis of Motivational Interviewing

描述(由申请者提供)：这份R21申请书建议严格检查动机面试中的行为改变机制(MOBC)。我们将进行一项小规模的试点研究，将MI分解为其组成部分，并与没有其指导策略的MI进行比较，测试完整的MI。这项测试将比较MI的指导性因素是否关键，或者MI效应是否可能仅归因于其罗杰式的非指导性成分。罗杰斯元素通常被称为MI精神。我们将我们的治疗条件标记为完全MI(FMI)和纯精神MI(SOMI)。此外，我们将测试FMI的假设主要影响是否通过增加对使用最先进评估方法的承诺来调节。我们还将研究与控制非治疗因素的情况相比，非特定治疗因素单独使用是否显著减少饮酒。我们将通过将SOMI的结果与包含评估并鼓励自我监控和自我改变的等待名单控制(WTL)进行比较来测试这一点。我们还将测试SOMI的主要影响是否通过情绪的增加和对改变能力的更大信念来调节。此外，我们将使用日常过程数据来检验调解人和饮酒之间的时间关系模式，试图解决时间顺序问题。最后，我们将采用、推广和评估一些新的方法，这些方法有望改善未来的MOBC研究。我们在MOBC治疗心肌梗死方面的工作将在研究对寻求减少但不是停止饮酒的原发AUD患者的简短治疗的背景下进行。我们将招募90名AUD患者；收集治疗前一周的日常流程数据；然后评估并随机将他们分配到3种情况：FMI、SOMI和WTL。参与者将在0、1、4和8周使用每日互动语音记录(IVR)和实验室评估进行为期9周的跟踪。治疗情况良好的患者将在1、2、4和8周接受4个疗程的治疗。WTL将在完成8周评估期后接受治疗。FMI和SOMI的参与者将在治疗后再跟踪4周(第12周)。我们注意到，与R21的目的一致，这项研究的目的是探索性的，旨在产生初步结果。项目简介：动机访谈(MI)是一种有效的干预措施，对患有与公共卫生有关的疾病和障碍的各种人群具有巨大的影响，包括吸烟、赌博、坚持锻炼、营养、非法药物使用和酗酒。这项R21拨款是一项研究MI变化机制的先导性研究。如果它的目标实现了，它将加强MI的功效，它可以在各种卫生环境中使用和实施。

DESCRIPTION (provided by applicant): This R21 application proposes to rigorously examine the mechanisms of behavior change (MOBC in Motivational Interviewing (MI). We will conduct a small pilot study to disaggregate MI into its component parts and test full MI compared to MI without its directive strategies. This test will compare whether the directive elements of MI are critical or whether MI effects may be attributable solely to its Rogerian, non-directive components. Rogerian elements are commonly referred to as MI spirit. We label our treatment conditions Full MI (FMI) and Spirit-Only MI (SOMI). In addition, we will test whether hypothesized main effects of FMI are mediated via increases in commitment to using state-of-the-art assessment methods. We will also examine whether non-specific therapy factors alone significantly reduce drinking when compared to a condition that controls for non-therapy factors. We will test this by comparing outcomes of SOMI to a wait-list control (WTL) that incorporates assessment and encourages self-monitoring and self-change. We will also test whether SOMI's main effects are mediated by increases in mood and greater belief in the ability to change. In addition, we will examine patterns of temporal relationship between mediators and drinking using daily process data in an attempt to address temporal ordering issues. Finally, we will employ, extend, and evaluate a number of new methodologies that hold promise for improving future MOBC research. Our work on MOBC for MI will take place in the context of studying brief treatment for individuals with primary AUD who seek to reduce but not stop drinking. We will recruit 90 individuals with AUD; collect daily process data during a pre-treatment week; and then assess and randomly assign them to 3 conditions: FMI, SOMI, and WTL. Participants will be followed for 9 weeks using daily Interactive Voice Recording (IVR) and in-laboratory assessments at weeks 0, 1, 4 and 8. Those in treatment conditions will receive 4 sessions of treatment at weeks 1, 2, 4, and 8. WTL will receive treatment after completing the 8 week assessment period. Participants in FMI and SOMI will be followed for an additional 4 weeks post-treatment (week 12). We note that, consistent with the purposes of the R21, the aims of this study are exploratory and designed to generate preliminary results. PROJECT NARRATIVE: Motivational Interviewing (MI) is an effective intervention with tremendous implications for a variety of populations suffering from conditions and disorders related to public health, including smoking, gambling, exercise adherence, nutrition, illicit drug use, and alcohol abuse. This R21 grant is a pilot study to investigate the mechanisms of change of MI. If its aims are achieved, it will strengthen the efficacy of MI, which can be utilized and implemented in a variety of health\settings.