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: 10581512
• 负责人: Benjamin O. Ladd
• 金额: $ 35.51万
• 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 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10581512
• 关键词: Addictive Behavior; Alcohol abuse; Alcohol consumption; Alcohols; Alternative Health; Behavior; Behavioral; Behavioral Mechanisms; Body mass index; Categories; Characteristics; Client; Code; Complement; Costs and Benefits; Data; Data Set; Decision Making; Demographic Factors; Development; Future; Gender; Goals; Health; Health behavior; Intervention; Language; Maintenance; Measurement; Measures; Mediating; Mediator; 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; Validity and Reliability; alcohol behavior; alcohol demand; alcohol free; alcohol response; behavior change; behavioral economics; brief intervention; clinical application; clinical practice; clinical training; 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 alcohol use; reduced substance use; reinforced behavior; reinforcer; skills; substance use; 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.

项目概要 动机访谈 (MI) 理论认为，客户语言的某些衡量标准是动机访谈的关键机制。 行为改变。具体来说，增加变革言论或支持走向健康运动的声明 行为，以及减少持续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 技术假设的各个方面，但也有一个 当前客户语言研究存在许多局限性。值得注意的是，大量的会话语言 未经审查，并且当前的 MI 模型缺乏理论指导会议内容，特别是在以下情况下 客户还没有准备好讨论饮酒的变化。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 其他可用活动的效益/成本；因此BE提供了一个结构来理解 酒精和其他强化行为。 BE 还将延迟奖励折扣视为一个关键因素 与行为的价值评价相关。拟议的研究旨在整合尖端的 MI 流程 使用BE理论进行研究，目标是开发一种创新的、理论驱动的概念化 与大学饮酒相关的客户语言以及对简短干预的反应。由BE和 MI 专家表示，拟议的研究团队将开发和测试使用并行的增强编码系统 决策过程涉及针对每种客户语言话语的多个独立选择：一个用于 动机状态，另一个行为目标（例如，谈论替代的无物质行为，例如 花更多的时间学习与确定的减少饮酒的目标行为），以及第三个相关的 时间方向（例如，讨论未来目标与当前情况）。在最初的开发过程中 阶段，三项已完成的随机对照试验的 MI 会话记录将使用新颖的方法进行编码 客户语言变量并与变革谈话和维持谈话的传统定义进行比较以检查 收敛效度、发散效度和增量效度。接下来，使用另外两个已完成的录音 随机对照试验中，新颖的编码系统将检查客户语言作为反应的预测因素 与传统的 MI 干预相比，这是一种创新的 BE 临床应用。最后，使用所有五个的数据 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。这 目前的研究具有巨大的潜力，可以加强努力减少年轻成人饮酒的风险并为临床提供信息 培训和实践。