Mixed-method Evaluation of Fidelity of Motivational Interviewing-based Coaching in Program for Caregivers of Children with Autism

Overview

Journal PEC Innov

Specialty Health Services

Date 2023 May 22

PMID 37214523

Authors

Elizabeth Larson

Noreen Jeglum

Chloe Shmays

Affiliations

Soon will be listed here.

Abstract

Objective: This mixed method analysis examined fidelity of the motivational interviewing (MI) delivered during the wellness program for caregivers of children with Autism Spectrum Disorders.

Methods: Coaches used a manualized MI-approach to collaboratively design participants' individualized wellness programs, and then used it in monthly coaching sessions to support goal pursuit. Audio-recorded consultations and post-participation focus groups were transcribed verbatim. Consultation transcripts were rated for MI adherence using Motivational Interviewing Treatment Integrity Code. Focus group data was coded by the team to identify conceptual categories.

Results: Eighty-seven percent of consultations achieved a beginning (competent) level expert-derived MI standard. Caregivers noted that coaches' MI approach evoked deep emotions and understandings about their lives related to wellness goals, allowed for a permissive flexibility in goal pursuit, and fostered supportive accountability.

Conclusion: MI was used with high levels of fidelity. Participants described the MI approach as more productive, precise, and useful in addressing their needs compared to other available interventions.

Citing Articles

Assessment of Acceptability, Usage, and Impact on Caregivers of Children With Autism's Stress and Mindfulness: Multiple-Method Feasibility Study of the 5Minutes4Myself App's Mindfulness Module.

Larson E, Mattie R, Riffkin S JMIR Hum Factors. 2024; 11:e54171.

PMID: 39480802 PMC: 11542669. DOI: 10.2196/54171.

References

Jelsma J, Mertens V, Forsberg L, Forsberg L . How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations. Contemp Clin Trials. 2015; 43:93-9. DOI: 10.1016/j.cct.2015.05.001. View

Sepulveda A, Wise C, Zabala M, Todd G, Treasure J . Development and reliability of a Motivational Interviewing Scenarios Tool for Eating Disorders (MIST-ED) using a skills-based intervention among caregivers. Eat Behav. 2013; 14(4):432-6. DOI: 10.1016/j.eatbeh.2013.07.010. View

Gallagher S, Whiteley J . The association between stress and physical health in parents caring for children with intellectual disabilities is moderated by children's challenging behaviours. J Health Psychol. 2012; 18(9):1220-31. DOI: 10.1177/1359105312464672. View

Hallgren K, Dembe A, Pace B, Imel Z, Lee C, Atkins D . Variability in motivational interviewing adherence across sessions, providers, sites, and research contexts. J Subst Abuse Treat. 2017; 84:30-41. PMC: 5718367. DOI: 10.1016/j.jsat.2017.10.011. View

Leske A, Mustchin C, Bhujel N, Rajan S, Satur J . Fidelity of motivational interviewing with families in high-caries-risk children. Community Dent Oral Epidemiol. 2020; 49(5):410-419. DOI: 10.1111/cdoe.12614. View

Small J, Frey A, Lee J, Seeley J, Scott T, Sibley M . Fidelity of Motivational Interviewing in School-Based Intervention and Research. Prev Sci. 2020; 22(6):712-721. DOI: 10.1007/s11121-020-01167-7. View

Copeland L, Merrett L, McQuire C, Grant A, Gobat N, Tedstone S . Feasibility and acceptability of a motivational interviewing breastfeeding peer support intervention. Matern Child Nutr. 2018; 15(2):e12703. PMC: 7198929. DOI: 10.1111/mcn.12703. View

Bellg A, Borrelli B, Resnick B, Hecht J, Minicucci D, Ory M . Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004; 23(5):443-51. DOI: 10.1037/0278-6133.23.5.443. View

Barker E, Hartley S, Seltzer M, Floyd F, Greenberg J, Orsmond G . Trajectories of emotional well-being in mothers of adolescents and adults with autism. Dev Psychol. 2010; 47(2):551-61. PMC: 3074104. DOI: 10.1037/a0021268. View

10.

Barac R, Kimber M, Johnson S, Barwick M . The effectiveness of consultation for clinicians learning to deliver motivational interviewing with fidelity. J Evid Inf Soc Work. 2018; 15(5):510-533. DOI: 10.1080/23761407.2018.1480988. View

11.

Abbeduto L, Seltzer M, Shattuck P, Krauss M, Orsmond G, Murphy M . Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile X syndrome. Am J Ment Retard. 2004; 109(3):237-54. DOI: 10.1352/0895-8017(2004)109<237:PWACIM>2.0.CO;2. View

12.

Berg C, McCollum M, Cho E, Jason D . Development of the Adolescent and Young Adult Activity Card Sort. OTJR (Thorofare N J). 2016; 35(4):221-31. DOI: 10.1177/1539449215578651. View

13.

Ma J, Rosas L, Lv N . Precision Lifestyle Medicine: A New Frontier in the Science of Behavior Change and Population Health. Am J Prev Med. 2015; 50(3):395-397. PMC: 4762748. DOI: 10.1016/j.amepre.2015.09.035. View

14.

Miller W, Rollnick S . The effectiveness and ineffectiveness of complex behavioral interventions: impact of treatment fidelity. Contemp Clin Trials. 2014; 37(2):234-41. DOI: 10.1016/j.cct.2014.01.005. View

15.

Larson E . Development of a Wellness Program for Caregivers of Children with Autism. Can J Occup Ther. 2023; 91(1):17-28. DOI: 10.1177/00084174231172036. View

16.

Larson E, Martin B . Measuring motivational interviewing self-efficacy of pre-service students completing a competency-based motivational interviewing course. Explor Res Clin Soc Pharm. 2022; 1:100009. PMC: 9030277. DOI: 10.1016/j.rcsop.2021.100009. View

17.

Fortune J, Breckon J, Norris M, Eva G, Frater T . Motivational interviewing training for physiotherapy and occupational therapy students: Effect on confidence, knowledge and skills. Patient Educ Couns. 2018; 102(4):694-700. DOI: 10.1016/j.pec.2018.11.014. View

18.

Bailey Jr D, Golden R, Roberts J, Ford A . Maternal depression and developmental disability: research critique. Ment Retard Dev Disabil Res Rev. 2007; 13(4):321-9. DOI: 10.1002/mrdd.20172. View

19.

Larson E, Miller-Bishoff T . Family routines within the ecological niche: an analysis of the psychological well-being of U.S. caregivers of children with disabilities. Front Psychol. 2014; 5:495. PMC: 4038926. DOI: 10.3389/fpsyg.2014.00495. View

20.

Herring S, Gray K, Taffe J, Tonge B, Sweeney D, Einfeld S . Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: associations with parental mental health and family functioning. J Intellect Disabil Res. 2006; 50(Pt 12):874-82. DOI: 10.1111/j.1365-2788.2006.00904.x. View