Teaching Physicians Motivational Interviewing for Discussing Weight With Overweight Adolescents.

Kathryn I Pollak, Cynthia J Coffman, James A Tulsky, Stewart C Alexander, Truls Østbye, David Farrell, Pauline Lyna, Rowena J Dolor, Alicia Bilheimer, Pao-Hwa Lin, Michael E Bodner, Terrill D Bravender

Journal: The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2017;59(1):96-103

PMID: 27155958

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Abstract

PURPOSE

We tested whether an online intervention combined with a patient feedback report improved physicians' use of motivational interviewing (MI) techniques when discussing weight with overweight and obese adolescents.

METHODS

We randomized 46 pediatricians and family physicians and audio recorded 527 patient encounters. Half of the physicians received an individually tailored, online intervention. Then, all physicians received a summary report detailing patient's weight-related behaviors. We coded MI techniques and used multilevel linear mixed-effects models to examine arm differences. We assessed patients' motivation to change and perceived empathy after encounter.

RESULTS

We found arm differences in the Intervention Phase and the Summary Report Phase: Empathy (p < .001), MI Spirit (p < .001), open questions (p = .02), and MI consistent behaviors (p = .04). Across all three phases (Baseline, Intervention, and Summary Report), when physicians had higher Empathy scores, patients were more motivated to change diet (p = .03) and physical activity (p = .03). In addition, patients rated physicians as more empathic when physicians used more MI consistent techniques (p = .02).

CONCLUSIONS

An individually tailored, online intervention coupled with a Summary Report improved physicians' use of MI, which improved the patient experience.

Address: Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, North Carolina; Department of Community and Family Medicine, Duke School of Medicine, Durham, North Carolina. Electronic address: [email protected].; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina; Health Services Research and Development Service, Durham VA Medical Center, Durham, North Carolina.; Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, North Carolina; Department of Medicine, Duke University Medical Center, Durham, North Carolina.; Department of Consumer Science, Purdue University, West Lafayette, Indiana.; Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, North Carolina; Department of Community and Family Medicine, Duke School of Medicine, Durham, North Carolina.; People Designs Inc., Durham, North Carolina.; Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, North Carolina.; Department of Medicine, Duke University Medical Center, Durham, North Carolina.; School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada.; Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.

DOI: 10.1016/j.jadohealth.2016.03.026

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MeSH Terms: Adolescent, Adult, Education, Medical, Empathy, Female, Humans, Male, Middle Aged, Motivation, Motivational Interviewing, Overweight, Physician-Patient Relations, Physicians, Practice Patterns, Physicians'