Component Analysis of Motivational Interviewing

描述（由申请人提供）：本R21申请旨在严格研究动机性访谈（MI）中的行为改变（MOBC）机制。我们将进行一项小型试点研究，将MI分解为其组成部分，并将完整的MI与没有指导策略的MI进行比较。这个测试将比较心肌梗死的指示因素是否至关重要，或者心肌梗死的影响是否可能仅归因于其Rogerian非指示成分。罗氏元素通常被称为MI精神。我们将治疗条件标记为Full - MI （FMI）和Spirit-Only - MI （SOMI）。此外，我们将测试FMI的假设主要效应是否通过使用最先进的评估方法的承诺增加来介导。我们还将研究与控制非治疗因素的情况相比，非特异性治疗因素是否能显著减少饮酒。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候名单控制（WTL）进行比较来验证这一点。我们还将测试SOMI的主要影响是否由情绪的增加和对改变能力的更大信念所介导。此外，我们将使用日常过程数据检查介质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、扩展和评估一些有望改善未来MOBC研究的新方法。我们在MOBC治疗心肌梗死方面的工作将在研究寻求减少但不停止饮酒的原发性AUD患者的短期治疗的背景下进行。我们将招聘90名澳元员工；在预处理周收集每日工艺数据；然后评估并随机分配到3种情况：FMI， SOMI和WTL。参与者将在第0、1、4和8周使用每日交互式语音录音（IVR）和实验室评估进行为期9周的随访。接受治疗的患者将在第1、2、4和8周接受4次治疗。WTL在完成8周的评估期后接受治疗。FMI和SOMI的参与者将在治疗后再随访4周（第12周）。我们注意到，与R21的目的一致，本研究的目的是探索性的，旨在产生初步结果。项目描述：动机性访谈（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，包括吸烟、赌博、坚持锻炼、营养不良、非法药物使用和酗酒，具有巨大的影响。这项R21拨款是一项调查心肌梗死改变机制的试点研究。如果其目标得以实现，将加强心肌梗死的疗效，可在各种卫生环境中加以利用和实施。

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.