Using Motivational Interviewing to Promote Adoption of Healthy Lifestyle Behaviors

Purpose:

The Veterans Health Administration has made motivational interviewing training of clinicians a national priority. Research has shown that motivational interviewing is an effective tool in promoting adherence to healthy lifestyle recommendations and strengthens patient self-management skills. The purpose of this presentation is to outline practical strategies to encourage momentum toward health behavior change.

Methods:

This retrospective, longitudinal study reviewed Veteran health outcomes (N=1,865) following use of motivational interviewing and use of a collaborative goal setting tool at the Department of Veterans Affairs Medical Center in Salem, Virginia. The association among patient adherence, goal setting, and decision support on body mass index (BMI), glycated hemoglobin (HbA1c), and low-density lipoprotein (LDL) was examined using generalized estimating equations with exponential regression.

Results:

Collaborative goal setting, educational class attendance, cholesterol medication adherence, age, and type of health care provider were significant predictors of HbA1c and LDL. Twenty eight percent of the sample had an LDL higher than recommended but high risk status declined from 42.9% to 24.2% during the course of the study. Reduction in HbA1c values for the sample population was statistically significant but not clinically significant; the values remained close to the ADA goal of ≤7.0 during the entire study thus there was not a lot of room for improvement. The study showed that provision of regular verbal and written feedback, use of motivational interviewing and collaboration with patients, and having a consistent health care provider was effective in improving diabetes control and cholesterol status. Body mass index remained essentially unchanged.

Conclusion:

Findings included significant sustained reduction in LDL and improvement in diabetic control over the 5 year study period.  Motivational interviewing and collaborative goal setting are valuable tools in patient engagement. Veterans are at high risk for cardiovascular disease and this study showed that simple interventions can make an impact on lifestyle behaviors and adherence.