Motivational Interviewing for Providers Managing Adolescents with Cystic Fibrosis
Erin W. Hermann and Sharon K. Davis
Background: Methods to increase treatment compliance in adolescents with cystic fibrosis (CF) is of utmost importance to improve outcomes and survival. Motivational interviewing (MI) has gained momentum as an effective strategy to address ambivalence to change in a variety of chronic health conditions and remains a promising strategy to facilitate treatment adherence in adolescents with CF.
Methods: The project utilized the Plan-Do-Study-Act cycle of quality improvement (QI). A repeated measure pretest-posttest design was used to evaluate the effectiveness of a MI training. An interactive, 4-hour MI workshop was executed within a single CF center. CF care providers (N = 12) from a single CF team completed surveys evaluating knowledge, perceived importance, usage, and confidence in using MI with adolescents before and after the training. Following the MI training, care providers engaged high-risk adolescent patients using MI techniques. To determine the effect of MI on patient adherence (N = 32), markers of lung function and weight were measured before and after MI exposure.
Results: Quantitative analysis of provider surveys indicated enhanced MI-related knowledge and confidence after the training. Provider usage, perception of the usefulness, and importance of using MI was unchanged. Patient-specific outcomes indicated no significant change in patient-forced expiratory volume in 1 second (FEV1), a marker of lung function, or body mass index (BMI), five months after exposure of MI in the CF clinic setting.
Conclusions: This QI project demonstrates the effectiveness of a brief MI training on CF care providersí knowledge and confidence in engaging adolescents using MI techniques. Though no statistically significant differences were found in patient-specific outcomes during this brief intervention period, it is critical that longer-term exposure to MI be explored further in adolescents with CF. This study adds to a growing body of evidence supporting team-based MI trainings for CF providers. Future research focusing on patient experience and perceived benefit of MI counseling is warranted.