Integration of Motivational Interviewing and Behavioral Economics Theories to Enhance Measurement of Client Language as a Mechanism of Behavior Change

动机访谈与行为经济学理论相结合，加强对客户语言作为行为改变机制的测量

• 批准号: 9887048
• 负责人: Benjamin O. Ladd
• 金额: $ 39.66万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-10 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9887048
• 关键词: Addictive Behavior; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Alternative Health; Area; Behavior; Behavioral; Behavioral Mechanisms; Categories; Characteristics; Client; Clinical; Code; Complement; Costs and Benefits; Data; Data Set; Decision Making; Demographic Factors; Development; Future; Gender; Goals; Health; Health behavior; Intervention; Language; Lead; Maintenance; Measurement; Measures; Mediating; Mediator of activation protein; Modeling; Motivation; Movement; Outcome; Perception; Physical Exercise; Population; Prediction of Response to Therapy; Process; Psychological reinforcement; Randomized Controlled Trials; Research; Rewards; Severities; Structure; System; Testing; Theoretical model; Time; Training; Validity and Reliability; alcohol behavior; alcohol demand; alcohol response; behavior change; behavioral economics; brief intervention; clinical application; clinical practice; clinically relevant; college; college drinking; cost; design; discounting; drinking; economic indicator; follow-up; free behavior; high risk drinking; improved; innovation; motivational enhancement therapy; novel; predicting response; psychologic; rate of change; reduced substance use; reinforcer; skills; theories; treatment response; trial comparing; university student; young adult; young adult alcohol use

Project Summary Motivational interviewing (MI) theory posits certain measures of client language serve as key mechanisms of behavior change. Specifically, increased change talk, or statements supporting movement toward healthy behavior, and decreased sustain talk, or statement supporting maintenance of unhealthy behavior, should lead to reductions in risky alcohol use. While findings support aspects of this technical hypothesis of MI, there are a number of limitations to the current study of client language. Of note, large amounts of in-session language go unexamined and the current MI model lacks a theory guiding session content, particularly in contexts where clients are not ready to discuss changes in drinking. Behavioral economics (BE) theory assumes the reinforcing value of a substance is a function of the benefit/cost ratio of substance use in relation to the benefit/cost of other available activities; thus BE provides a structure by which to understand the value of alcohol and other reinforcing behaviors. BE also identifies delayed reward discounting as a critical factor associated with value appraisal of behavior. The proposed research aims to integrate cutting-edge MI process research with BE theory with the goal of developing an innovative, theoretically-driven conceptualization of client language associated with college alcohol use and response to brief intervention. Comprised of BE and MI experts, the proposed research team will develop and test an enhanced coding system that uses a parallel decision-making process involving multiple independent choices for each client language utterance: one for motivational state, another for behavioral target (e.g., talking about an alternative substance-free behavior such as spending more time studying vs. the identified target behavior of alcohol use reduction), and a third related to temporal orientation (e.g., discussing future goals vs. present circumstances). During the initial development stage, MI session recordings from three completed randomized controlled trials will be coded using the novel client language variables and compared to conventional definitions of change talk and sustain talk to examine convergent, divergent, and incremental validity. Next, using recordings from another two completed randomized controlled trials, the novel coding system will examine client language as a predictor of response to an innovative BE clinical application compared to a traditional MI intervention. Finally, using data from all five original trials, we will examine conditional models of client language as predictors of treatment response. The current study has significant potential to enhance efforts to reduce risky young adult drinking and inform clinical training and practice.

项目摘要 动机性面试（MI）理论认为，客户语言的某些措施是成功的关键机制。 行为改变具体来说，增加的变化谈话，或声明支持朝着健康的运动， 行为，以及减少持续的谈话，或支持维持不健康行为的声明，应该导致 减少危险的酒精使用。虽然研究结果支持MI的这一技术假设的各个方面， 目前对客户语言的研究存在许多局限性。值得注意的是，大量的会话语言 目前的多元智能模型缺乏指导会话内容的理论，特别是在以下情况下， 客户不准备讨论饮酒的变化。行为经济学（BE）理论假设 物质的强化价值是物质使用的效益/成本比的函数， 其他可用活动的收益/成本;因此，BE提供了一个结构，通过该结构可以了解 酒精和其他强化行为。BE还将延迟奖励折扣确定为关键因素 与行为的价值评估有关。拟议的研究旨在整合尖端的管理信息流程 研究与BE理论的目标是开发一个创新的，理论驱动的概念化， 与大学酒精使用相关的客户语言和对简短干预的反应。由BE和 MI专家，拟议的研究小组将开发和测试一个增强的编码系统，使用并行 决策过程涉及对每个客户语言话语的多个独立选择：一个用于 动机状态，另一个用于行为目标（例如，谈论替代的无物质行为，例如 与减少饮酒的目标行为相比， 到时间取向（例如，未来的目标vs.目前的情况）。在最初的发展过程中， 阶段，来自三项已完成的随机对照试验的MI会话记录将使用新的 客户语言变量，并与传统的定义相比，改变谈话和维持谈话，以检查 收敛、发散和增量效度。接下来，使用另外两个完成的录音 在随机对照试验中，新的编码系统将检查客户语言作为反应的预测因子 与传统MI干预相比，创新的BE临床应用。最后，使用所有五个数据 在最初的试验中，我们将检查客户语言的条件模型作为治疗反应的预测因子。的 目前的研究有很大的潜力，以加强努力，以减少危险的年轻人饮酒，并告知临床 训练和实践。