Modifiable behavioral risk factors for diabetes and cardiovascular disease, two of the most costly diseases in both human and monetary terms, include obesity, lack of physical activity, smoking tobacco and excess alcohol consumption. Despite a longstanding movement in the medical community towards models of chronic care to support changes in behavioral risk factors, primary care clinicians, in general, do not provide a key feature in chronic care models: patient-centered behavioral counseling. Motivational Interviewing (MI), an evidence-based form of patient-centered counseling, improves patient outcomes when applied to risk factors for diabetes and cardiovascular disease. To support dissemination of MI for health behavior change in primary care, the field needs low cost and highly accessible methods to both evaluate and train practitioners of many disciplines in patient-centered communication. The proposed project aims to develop a computer-based system to support healthcare providers consisting of a health care specific MI skills assessment and a suite of simulated patient training cases that providers can use to practice their MI skills. The system will be web-based to greatly facilitate access and utility. Phase I aims include developing a prototype of the skill assessment and one interactive practice case, conducting usability testing of the practice case with 12 clinicians and conducting a pilot study of the initial psychometric properties of the skill assessment with 24 primary care providers. In Phase II, the complete product will be developed and evaluated in a randomized trial to establish reliability and validity of the assessment and training effectiveness of the training cases. Given the crucial health challenge presented by diabetes and heart disease, as well as wide movement to adopt chronic care and primary care medical home models, we expect demand for such a product to be large.
This project will develop online training support resources for healthcare providers learning motivational interviewing. Chronic diseases such as diabetes have reached epidemic proportions in the US but are largely preventable and treatable with health behavior changes. With better access to training in motivational interviewing, healthcare providers may be better able to help patients make difficult lifestyle changes.