Motivational Interviewing Implementation in Primary Care: A “Terrifying Challenge” Becoming a “Professional Revelation”

Abstract

Introduction Motivational interviewing (MI) is an evidence-based counseling approach within primary care. However, MI rarely translates to practice following introductory training programs, and a lack of evidence regarding its implementation persists today. This study describes primary care clinicians’ professional transformation in implementing MI through interprofessional communities of practice (ICP-MI). Method Qualitative data collection involved the research journal, participant observation of four ICP-MIs (76 hours/16 clinicians), and focus groups. A general inductive approach was used for data analysis. Results were conceptualized based on the Consolidated Framework for Implementation Research. Results Four processes of MI implementation in primary care are presented as a motivational endeavor: ambivalence, introspection, experimentation, and mobilization. The clinicians were initially ambivalent, taking into consideration the significant challenges involved. After introspecting actual practices, they realized the limits of their previous clinician-centered approaches. The experimentation of MI in the workplace followed and enabled clinicians to witness MI feasibility and its added value. Finally, they were mobilized to ensure MI sustainability in their practices/organization. Intrinsic factors of influence included the clinicians’ personal traits and their perception about MI as a clinical priority. Organizational support was also a crucial extrinsic factor in encouraging the clinicians’ efforts. Conclusion As described in a fragmented manner in previous studies, MI implementation processes and influencing factors are presented as integrated findings. Incorporating engaging educational activities to provide clinicians with motivational support and collaborating with health care organizations to plan appropriate resources should be considered in the development of MI implementation programs from the onset.

Medication Literacy in Chinese Patients with Stroke and Associated Factors: A Cross-Sectional Study

“…In clinical care, nurses and doctors can use some communication skills to help patients with stroke develop a sense of faith and confidence in taking medication. Motivational interviewing [23,24] can be used to change the medication attitudes of patients with stroke. Empathy and other communication methods can be used by caregivers to communicate their understanding of the emotional and psychological needs of patients with stroke to relieve negative emotions toward medication and establish timely medication confidence.…”

“From Health Experts to Health Guides”: Motivational Interviewing Learning Processes and Influencing Factors

“…While considering the clinicians’ learning needs and preferences, ongoing coaching/supervision were delivered using case discussions, practical exercises, interactive quizzes, and analysis of MI videos. The collaborative design of the training program and the impact of ICP-MI on PC practices are presented in other publications ( Langlois & Goudreau, 2022a , 2022b ; Langlois et al, 2022 ).…”