S09C - A Theory Basis for Evidence-Based Motivational Interviewing Training Outcomes for Healthcare Providers

Key Takeaways of Your Research: 1. Motivational Interviewing, a person-centered approach with vast evidence base for impact on outcomes, is complex and requires evidence-based, behavior change theory-based training to help participants gain and sustain skills. 2. Established behavior change theories like Bandura's Self-efficacy theory and the Theory of Reasoned Action/Theory of Planned Behavior (TRA/TPB) include self-efficacy and intention variables, respectively, that have been shown to explain and predict engagement in a target behavior; this study of MI training participants demonstrated that using theory-based MI strategies to teach and train MI exhibited an increase in self-reported self-efficacy for and intention to be engaging MI skills in future encounters for diabetes medication taking conversations. 3. Behavior change theories and adult learning theories forming a basis for training aimed at helping practitioners change practice communication behaviors can increase likelihood of effectiveness.

Background/Purpose: Motivational Interviewing (MI) includes both person-centered communication skills and approach for helping individuals decide to change behavior and includes established theory-based components (self-efficacy, intention) shown to influence/predict behavior change. MI training has its own evidence base for methods shown to help trainees change their own practice behaviors for empowering communication. Behavior theory approaches in training delivery are key to helping practitioners gain/sustain complex MI skills. Research Hypothesis and/or Research Questions and Specific

Aims: Primary objective: assess theory-based MI training impact on trainee perceptions of outcomes known to predict behavior change (familiarity, self-efficacy, and intention) for likelihood of using MI in post-training patient encounters. Secondary objective: describe post-training perceptions of implementation science domains (development, importance, usefulness, benefits, feasibility) for post-training MI use in practice. Methods/Methodology: A theory-based outcomes survey was adapted for virtual training; post-training implementation domain questions for future MI use perceptions were added. Question formats included 1-5 Likert type or 1-10 sliding scale. 186 pharmacists in evidence-based 9-hour virtual trainings for a diabetes medication taking project in 2020/2021 were asked to complete pre/post surveys. Data per research objective were analyzed using descriptive statistics.

Results: 160 complete pre/post responses:  68.1% female, 85.0% Caucasian, 53.8% practicing < 10 years. Objective 1 means (SD) for theory-based, change-predicting variables using 1-10 sliding scale in context of using MI in diabetes medication taking encounters (pre/post, change): familiarity (5.0 (2.3) / 8.5 (1.3), +3.5), self-efficacy (4.2 (2.1) / 7.7 (1.3), +3.5), intention (8.5 (1.8) / 9.3 (0.9), +0.8). Objective 2 mean (SD) perceptions of future implementation domains using 1-5 Likert questions: Skills development 4.8 (0.4), Importance 4.8 (0.4), Usefulness 4.8 (0.5), Enhancement benefit 4.8 (0.4), Feasibility 4.6 (0.6); additional mean (SD) virtual training delivery perceptions: Ease of use 4.6 (0.6), Convenience 4.7 (0.6), 'Yes' for Pros Outweigh Cons 4.7 (0.6). Conclusions (Impact on Diabetes Care and Education): MI training aimed at helping change practitioner communication behaviors using established behavior change theories and adult learning theories for MI conceptual and skills development showed increases in trainee perceptions of key variables (familiarity, self-efficacy, intention) known to predict engagement in a target behavior. Translating from literature for Self-efficacy Theory and the TRA/TPB's intention construct, the post-training likelihood of using MI skills in actual practice increased. Source of Funding for this Research: This project was self-funded; no external funding sources were received.