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Motivational Interviewing to Promote Adherence Behaviors in Pediatric Type 1 Diabetes

  • Psychosocial Aspects (KK Hood, Section Editor)
  • Published:
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Abstract

Suboptimal regimen adherence among youth with type 1 diabetes (T1D) is a common challenge for patients, families, and providers. Motivational interviewing (MI) is a brief communication style designed to elicit intrinsic motivation and strengthen commitment to behavior change goals. As pediatric MI research expands, a critical review of its evidence base and applicability to promote adherence behaviors for youth with T1D is needed. This review introduces the core tenets of MI and clinical applications in T1D, synthesizes the existing MI research in T1D, and discusses the next steps in MI research. Overall, mixed results for MI interventions in T1D reflect variations in research study design and clinical implementation. Targeting adherence rather than glycemic outcomes typically demonstrates greater results, highlighting the promise of MI to facilitate meaningful and enduring improvements in youths’ T1D adherence behaviors.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Miller WR, Rollnick S. Motivational interviewing: helping people change. 3rd ed. New York: Guilford Press; 2013. Miller and Rollnick are the founders of Motivational Interviewing. Recently updated, this seminal work presents the Spirit of MI, the core processes of MI and several vignettes to demonstrate clinical implementation of the MI approach.

    Google Scholar 

  2. Lundahl B, Moleni T, Burke BL, et al. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns. 2013;93:157–68.

    Article  PubMed  Google Scholar 

  3. Miller W. Motivational interviewing with problem drinkers. Beh Psychother. 1983;11:147–72.

    Article  Google Scholar 

  4. Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes Obes Metab. 2013;doi:10.1111/dom.12195. This recent paper reviews MI intervention research for individuals across the lifespan with type 1 and type 2 diabetes.

  5. Lundahl BW, Kunz C, Brownell C, Tollefson D, Burke B. A meta-analysis of motivational interviewing: twenty-five years of research of empirical studies. Res Soc Work Pract. 2010;20:137–60.

    Article  Google Scholar 

  6. Martins RK, McNeil. Review of motivational interviewing in promoting health behaviors. Clin Psychol Rev. 2009;29:283–93.

    Article  PubMed  Google Scholar 

  7. Hettema J, Steele J, Miller WR. Motivational interviewing. Annu Rev Clin Psychol. 2005;1:91–111.

    Article  PubMed  Google Scholar 

  8. Gayes LA, Steele RG. A meta-analysis of motivational interviewing interventions for pediatric health behavior change. J Consult Clin Psych. 2014;doi:10.1037/a0035917. This paper is the first and only meta-analysis of MI interventions to promote health behaviors for multiple pediatric populations to date.

  9. Erickson SJ, Gerstle M, Feldstein SW. Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings. Arch Pediatr Adolesc Med. 2005;159:1173–80.

    Article  PubMed  Google Scholar 

  10. Suarez M, Mullins S. Motivational interviewing and pediatric health behavior interventions. J Dev Behav Pediatr. 2008;29:417–28.

    Article  PubMed  Google Scholar 

  11. Sindelar HA, Abrantes AM, Hart C, Lewander W, Spirito A. Motivational interviewing in pediatric practice. Curr Probl Pediatr Adolesc Health Care. 2004;Oct:322–339.

  12. Horn K, Dino G, Hamilton C, Noerachmanto N. Efficacy of an emergency department-based motivational teenage smoking intervention. Prev Chronic Dis. 2007;4:A08.

    PubMed  PubMed Central  Google Scholar 

  13. Colby SM, Monti PM, Barnett NP, et al. Brief motivational interviewing in a hospital setting for adolescent smoking: a preliminary study. J Consult Clin Psych. 1998;66:574–8.

    Article  CAS  Google Scholar 

  14. McCambridge J, Strang J. The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results form a multi-site cluster randomized trial. Addiction. 2004;99:39–52.

    Article  PubMed  Google Scholar 

  15. Grenard JL, Ames SL, Pentz MA, Sussman S. Motivational interviewing with adolescents and young adults for drug-related problems. Int J Adolesc Med Health. 2006;18:53–67.

    Article  PubMed  Google Scholar 

  16. Chen X, Murphy DA, Naar-King S, Parsons JT. Adolescent medicine trials network for HIV/AIDS interventions a clinic-based motivational intervention improves condom use among subgroups of youth living with HIV. J Adolesc Health. 2011;49:193–8.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Resnicow K, Davis R, Rollnick S. Motivational interviewing for pediatric obesity: conceptual issues and evidence review. J Am Diet Assoc. 2006;106:2024–33.

    Article  PubMed  Google Scholar 

  18. Berg-Smith SM, Stevens VJ, Brown KM, et al. A brief motivational intervention to improve dietary adherence in adolescents. Health Educ Res. 1999;14:399–410.

    Article  PubMed  CAS  Google Scholar 

  19. Taveras EM, Gortmaker SL, Hohman KH, et al. Randomized controlled trial to improve primary care to prevent and manage childhood obesity. High Five Kids Study Arch Pediatr Adolesc Med. 2011;165:714–22.

    Article  Google Scholar 

  20. Schwartz RP, Hamre R, Dietz WH, et al. Office-based motivational interviewing to prevent childhood obesity. Arch Pediatr Adolesc Med. 2007;161:495–501.

    Article  PubMed  Google Scholar 

  21. Wong EMY, Cheng MMH. Effects of motivational interviewing to promote weight loss in obese children. J Clin Nurs. 2013;22:2519–30.

    Article  PubMed  Google Scholar 

  22. Naar-King S, Parsons JT, Murphy DA, Chen X, Harris DR, Belzer ME. Improving health outcomes for youth living with the human immunodeficiency virus: a multisite randomized trial of a motivational intervention targeting multiple risk behaviors. Arch Pediatr Adolesc Med. 2009;163:1092–8.

    PubMed  PubMed Central  Google Scholar 

  23. Naar-King S, Outlaw AY, Saar M, et al. Motivational enhancement system for adherence (MESA): pilot randomized trial of a brief computer-delivered prevention intervention for youth initiating antiretroviral treatment. J Pediatr Psychol. 2013;38:638–48.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Halterman JS, Szilagyi PG, Fisher SG, et al. Randomized controlled trial to improve care for urban children with asthma: results of the school-based asthma therapy trial. Arch Pediatr Adolesc Med. 2011;165:262–8.

    PubMed  PubMed Central  Google Scholar 

  25. Seid M, D’Amico EJ, Varni JW, et al. The in vivo adherence intervention for at risk adolescents with asthma: report of a randomized pilot trial. J Pediatr Psychol. 2012;37:390–403.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Channon S, Smith VJ, Gregory JW. A pilot study of motivational interviewing in adolescents with diabetes. Arch Dis Child. 2003;88:680–3.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  27. Channon SJ, Huws-Thomas MV, Rollnick S, et al. A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes. Diabetes Care. 2007;30:1390–5.

    Article  PubMed  Google Scholar 

  28. Stanger C, Ryan SR, Delhey LM, et al. A multicomponent motivational intervention to improve adherence among adolescents with poorly controlled type 1 diabetes: a pilot study. J Pediatr Psychol. 2013;38:629-637.This recent paper describes one approach for integrating MI within a pilot RCT of a multicomponent intervention program for youth with T1D.

  29. Viner RM, Taylor VT, Hey S. Motivational/solution-focused intervention improves HbA1c in adolescents with type 1 diabetes. Diabetic Med. 2003;20:739–42.

    Article  PubMed  CAS  Google Scholar 

  30. Naar-King S, Suarez M. Motivational interviewing with adolescents and young adults. New York: Guilford Press; 2011. Naar-King and Suarez are both established researchers in MI interventions to promote health behaviors in pediatric populations, as well as training health care providers in MI. This book is comprised of an overview of MI within a developmental context and individual chapters targeting specific pediatric populations, meant to serve as a guide for providers interested in integrating MI into practice with adolescent and young adult populations.

  31. Wang JT, Wiebe DJ, White PC. Developmental trajectories of metabolic control among white, black, and hispanic youth with type 1 diabetes. J Pediatr. 2011;159:571–6.

    Article  PubMed  Google Scholar 

  32. Helgeson VS, Snyder PR, Seltman H, Escobar O, Becker D, Siminerio L. Brief report: trajectories of glycemic control over early to middle adolescence. J Pediatr Psychol. 2010;35:1161–7.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bryden KS, Peveler RC, Stein A, Neil A, Mayou RA, Dunger DB. Clinical and psychological course of diabetes from adolescence to young adulthood. Diabetes Care. 2001;24:1536–40.

    Article  PubMed  CAS  Google Scholar 

  34. Baer JS, Peterson PL. Motivational interviewing for adolescents and young adults. In: Miller WR, Rollnick S, editors. Motivational interviewing: preparing people for change. 2nd ed. New York: The Guildford Press; 2002. p. 320–32.

    Google Scholar 

  35. Monaghan M, Hilliard M, Sweenie R, Riekert K. Transition readiness in adolescents and emerging adults with diabetes: the role of patient-provider communication. Curr Diab Rep. 2013;13:900–8.

    Article  PubMed  Google Scholar 

  36. Garvey KC, Wolpert HA, Rhodes ET, et al. Health care transition in patients with type 1 diabetes: young adult experiences and relationship to glycemic control. Diabetes Care. 2012;35:1716–22.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Garvey KC, Markowitz JT, Laffel LMB. Transition to adult care for youth with type 1 diabetes. Curr Diab Rep. 2012;12:533–41.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Channon S, Rubak S. Family-based intervention. In: Naar-King S, Suarez M, editors. Motivational interviewing with adolescents and young adults. New York: Guilford Press; 2011. p. 165–70.

    Google Scholar 

  39. Miller WR, Rose GS. Toward a theory of motivational interviewing. Am Psychol. 2009;64:527–37.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Wang Y, Stewart SM, Mackenzie M, Nakonezny PA, Edwards D, White PC. A randomized controlled trial comparing motivational interviewing in education to structured diabetes education in teens with type 1 diabetes. Diabetes Care. 2010;33:1741–3.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Robling M, McNamara R, Bennert K, et al. The effect of the Talking Diabetes consulting skills intervention on glycaemic control and quality of life in children with type 1 diabetes: cluster randomized controlled trial (DEPICTED study). BMJ. 2012; doi:10.1136/bmj.e2359

  42. Bean MK, Biskobing D, Francis GL, Wickham E. Motivational interviewing in health care: results of a brief training in endocrinology. J Grad Med Educ. 2012;357–361.

  43. Berger BA, Villaume WA. Motivational interviewing for health care professionals: a sensible approach. Washington DC: American Pharmacists Association; 2013.

    Google Scholar 

  44. Rollnick S, Miler WR, Butler CC. Motivational interviewing in health care: helping patients change behavior. New York: Guilford Press; 2008.

    Google Scholar 

  45. Sonderlund LL, Madson MB, Rubak S, Nilsen P. A systematic review of motivational interviewing training for general health care practitioners. Patient Educ Couns. 2011;84:16–26.

    Article  Google Scholar 

  46. Gourlan M, Sarrazin P, Trouilloud D. Motivational interviewing as a way to promote physical activity in obese adolescents: a randomized-controlled trial using self-determination theory as an explanatory framework. Psychol Health. 2013;28:1265–86.

    Article  PubMed  Google Scholar 

  47. Whitlock EP, O'Connor EA, Williams SB, Beil TL, Lutz KW. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics. 2010;125:e396–418.

    Article  PubMed  Google Scholar 

  48. Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12:e273–281.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  49. Bean MK, Powell P, Quinoy A, Ingersoll K, Wickham III EP. Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial. Pediatric Obesity. 2014; doi:10.1111/j.2047-6310. This recent paper describes innovative applications of MI to improve engagement and retention in comprehensive treatment programs for youth with obesity. Use of MI pretreatment, or at enrollment may enhance participation and outcomes of existing research and clinical programs for youth with T1D.

  50. Bean MK, Jeffers AJ, Tully CB, Thornton LM, Mazzeo SE. Motivational interviewing with parents of overweight children: study design and methods for the NOURISH + MI study. Contemp Clin Trials. 2014;37:312–21.

    Article  PubMed  Google Scholar 

  51. MacDonnell K, Brogan K, Naar-King S, Ellis D, Marshall MD. A pilot study of motivational interviewing targeting weight-related behaviors in overweight or obese African American adolescents. J Adolesc Health. 2012;50:201–3.

    Article  Google Scholar 

  52. Harris MA, Hood KK, Mulvaney SA. Pumpers, skypers, surfers and texters: technology to improve the management of diabetes in teenagers. Diabetes Obes Metab. 2012;14:967–72.

    Article  PubMed  CAS  Google Scholar 

  53. Driscoll KA, Johnson JB, Hogan J, Gill E, Wright N, Deeb LC. Insulin bolusing software: the potential to optimize health outcomes in type 1 diabetes. J Diabetes Sci Technol. 2013;7:646–52.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Rosengren DB. Building motivational interviewing skills; a practitioner workbook. New York: Guilford Press; 2009.

    Google Scholar 

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Acknowledgment

For those who are interested or may be considering learning more about MI, self-study resources [1••, 30••, 43, 44, 54] and introductory training workshops (www.motivationalinterviewing.org) are widely available. The authors have received grant support from a K12 Career Development Award from NIH/NIDDK 1K12 DK097696.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Priscilla W. Powell, Marisa E. Hilliard, and Barbara J. Anderson declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Baylor College of Medicine, Texas Children’s Hospital, 1102 Bates St. Suite 940.37, Houston, TX, 77030, USA

    Priscilla W. Powell

  2. Baylor College of Medicine, Texas Children’s Hospital, 1102 Bates St. Suite 940.35A, Houston, TX, 77030, USA

    Marisa E. Hilliard

  3. Baylor College of Medicine, Texas Children’s Hospital, 1102 Bates St. Suite 940.36, Houston, TX, 77030, USA

    Barbara J. Anderson

Authors
  1. Priscilla W. Powell
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  2. Marisa E. Hilliard
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  3. Barbara J. Anderson
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Correspondence to Priscilla W. Powell.

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This article is part of the Topical Collection on Psychosocial Aspects

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Powell, P.W., Hilliard, M.E. & Anderson, B.J. Motivational Interviewing to Promote Adherence Behaviors in Pediatric Type 1 Diabetes. Curr Diab Rep 14, 531 (2014). https://doi.org/10.1007/s11892-014-0531-z

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