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This article explores how financial professionals can support clients with attention-deficit/hyperactivity disorder (ADHD) who face challenges in managing their money and often avoid seeking professional financial advice. Specifically, financial professionals can use motivational interviewing and solution-focused questioning techniques in their client-facing interactions, thereby enhancing their value, attracting new clients, and bolstering their career stability. This article explains key concepts and techniques of motivational interviewing and solution-focused questioning, provides research supporting their use with this population, and illustrates these techniques through a hypothetical case study of a client with ADHD. [ABSTRACT FROM AUTHOR]

BackgroundThere are no clinical practice guidelines addressing the treatment of tobacco-cannabis co-use and a dearth of studies to inform treatment for co-use. This narrative review aims to (1) summarize promising intervention components used in published co-use treatment studies, (2) describe key gaps and emerging issues in co-use, and (3) provide recommendations and considerations in the development and evaluation of co-use interventions.MethodsWe conducted a literature search in June 2024 across several databases to update previous reviews on tobacco-cannabis co-use treatment. We found 9 published intervention studies that specifically addressed treatment for both substances. Data from these studies were manually extracted and summarized.ResultsMost of the 9 included studies (1) focused on acceptability and/or feasibility, (2) provided both psychosocial/behavioral and pharmacotherapy intervention components, (3) were conducted in adults, and (4) were delivered in-person, with some having digital asynchronous components, for a 5-to-12-week duration. The most common psychosocial/behavioral strategies used were Cognitive Behavioral Therapy, Motivational Interviewing, and Contingency Management; while the most common pharmacotherapy was Nicotine Replacement Therapy. There was no evidence of compensatory use of tobacco or cannabis when providing simultaneous treatment for both substances.ConclusionsThe literature to date provides support for well-integrated multi-component interventions of psychosocial/behavioral and pharmacotherapy strategies for co-use treatment. This review reinforces an urgent need for treatments targeting tobacco and cannabis co-use. Future interventions should address key gaps, including co-use of vaporized products among youth and young adults, tailored interventions for priority populations, and digital applications to increase reach and advance health equity.

BACKGROUND: Male sex workers (MSWs), specifically cisgender men who exchange sex for money, goods, drugs, or other items of value with other cisgender men, are at high risk for HIV infection. Compared to men not engaged in sex work, MSWs are more likely to engage in frequent condomless sex with paying and non-paying sexual partners. While MSWs are often included as a subgroup of gay and bisexual men, data show that a large proportion identify as heterosexual; additionally, most MSWs do not identify as sex workers. This places MSWs in a unique position where they may not engage with traditional HIV prevention programs, and when they do, they may not feel comfortable, leading to poor retention. Thus, HIV prevention interventions that address MSWs unique life circumstances and provide support in exploring their sexual health options are needed. METHODS: In this protocol paper, we describe the design and procedures for a National Institute of Health-funded, randomized controlled trial testing the efficacy of PrEPare for Work,- a theory-based, manualized PrEP uptake and adherence intervention for MSW - using a 2-stage randomization design. Stage 1: MSWs are equally randomized to receive either the PrEPare for Work Stage 1 intervention (strength-based case management and facilitated PrEP linkage) or Standard of Care (SOC) to evaluate successful PrEP uptake (prescription filled) within two months post-randomization. Stage 2: Those who initiate PrEP are then equally re-randomized to receive either the PrEPare for Work Stage 2 intervention (1-on-1 skills training, problem-solving, and motivational interviewing adherence counseling and personalized, daily text message reminders) or SOC to assess adherence (Tenofovir concentrations in hair) over 12 months of follow up. Planned analyses will examine intervention efficacy, specific conceptual mediators, and hypothesized moderators. DISCUSSION: Based on our extensive preliminary research, multi-component, theory-informed interventions targeting this subpopulation of MSWs unique life circumstances are urgently needed. In this study, we are evaluating whether PrEPare for Work can improve PrEP uptake and adherence among MSWs. If this intervention is efficacious, it would be readily disseminated to diverse community organizations that serve MSWs and possibly other community or clinic-based settings. TRIAL REGISTRATION: ClinicalTrials.gov number NCT05736614, registered February 8, 2023.

Purpose: To explore what patients with rheumatic and musculoskeletal diseases (RMDs) need and receive of follow-up care after specialized rehabilitation, and whether received follow-up is associated with health outcomes after 1 year. Further, to compare these findings with patients' experiences to improve the understanding of how follow-up takes place. Methods: In a mixed methods study, patients received a rehabilitation programme designed to improve the continuity in rehabilitation across care levels. A total of 168 patients completed questionnaires, of which 21 were also interviewed. Results: At discharge, most patients reported needs for follow-up. These needs were largely met within 1 year, mainly resulting from patients' initiatives to re-connect with previous contacts. The degree of received follow-up was not associated with goal attainment, quality of life, or physical function. Factors related to providers (competence, communication skills), context (delays, limited access to care), and patients (motivation, life situation, preferences) seemed to be decisive for the progress of the rehabilitation process over time. Conclusions: The results provide evidence that access to follow-up care is crucial to patients with RMDs. However, it also highlights several factors that may influence its impact. These results can be used to optimise design and implementation of future follow-up interventions. IMPLICATIONS FOR REHABILITATION: Healthcare providers should take greater responsibility for creating continuity in rehabilitation across levels of care. Follow-up care should be adapted to patients' needs, goals, and preferences as regards content, timing, and mode of delivery. Follow-up should be linked to a rehabilitation plan for each patient to ensure continuity of care. More effective communication systems across service levels should be established. [ABSTRACT FROM AUTHOR]

Introduction: Communities with low socioeconomic status have disproportionately high rates of tobacco use, and community health workers (CHWs) have an increasing role in delivering tobacco cessation interventions. However, existing tobacco cessation trainings are not appropriate for the CHW model of care. The aim of this study was to identify training needs of CHWs to develop a tailored tobacco cessation curriculum to help them effectively serve their high-risk patients. Incorporating results of a previously conducted needs assessment survey, we developed a preliminary outline of a tobacco cessation training curriculum that was specific to the CHW experience. Methods: Participants (N = 14) discussed their impressions of (a) the training content, (b) the unique needs of patients seen by CHWs, and (c) tailoring to the CHW care model. We conducted virtual qualitative interviews and focus groups with stakeholders (i.e., managers/directors of CHW programs) and CHWs, respectively, to obtain feedback on training, as well as a sample 2-hour training schedule and curriculum. Two independent coders analyzed the data using the Framework method. Results: Two overarching themes emerged: the need for strategies to (a) personalize treatment to each high-risk patient and (b) increase and maintain patient motivation. CHWs also reported the need for specific language to engage patients who were not ready to quit. Conclusion: A tailored training might focus on motivational interviewing, including how to personalize treatment to the patient's experiences, and role-playing scenarios with scenes on how to flexibly support patients who are overburdened and unmotivated. [ABSTRACT FROM AUTHOR]

In health sciences, including physical therapy, communication techniques are a critical part of the success in the therapeutic process. Managing the patient's beliefs, perceptions, and the narrative of their problems, becomes an essential part of the therapeutic process. This is the key to achieving real changes regarding how the patient copes with pain, illness, dysfunction, as well as the ability to develop adequate resources for facing them. We call this "Therapeutic expectancy" a new concept that originates from the well-known Therapeutic alliance and incorporates practices from the field of Motivational interviewing and Strategic dialogue. The Therapeutic expectancy starts from the first interaction with the patient and continues throughout the different stages of the therapeutic process. This article describes the structure of the relationship with the patient and some verbal communication techniques to generate an effective physical therapist-patient interaction, building Therapeutic expectancy, through a "centered on the patient's narrative" strategy. Expectancy constitutes a desirable goal in any patient and in any pathological condition as it pursues a change in an individual's perception of their state of health, thereby enhancing the desire for healing and empowerment. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the impact of baseline learner characteristics on motivational interviewing (MI) skill acquisition with and without virtual standardized patient (VSP) supplementation. Data from a two-group, randomized trial of 120 volunteer health care professionals recruited from a Department of Veterans Affairs and Department of Defense medical facility were used for this exploratory analysis. Training conditions included a branching storyline VSP, which provided MI skill rehearsal/feedback, and an academic study control. Nine multivariate analysis of variance models were used to examine the effects of baseline characteristics, assigned training condition, and their respective interactions in predicting MI skill improvements from baseline to posttraining. Follow-up between-subjects effects for significant omnibus tests were examined to evaluate the main effects for the baseline characteristics and the interaction effects. A statistically significant interaction was found between training condition and previous MI training, F(3, 99) = 2.77, p =.046; Pillai's trace =.077; ηp2 =.077, on motivational interviewing treatment integrity skill change. This study serves as an initial step in the direction of elucidating, which learners benefit most from simulation-based mental health care training using VSPs. We found that learners with minimal previous MI training benefited more from supplemented training with a VSP rather than traditional academic study alone. Public Significance Statement: This study reports on an exploratory analysis examining the impact of baseline learner characteristics on motivational interviewing (MI) skill acquisition with and without virtual standardized patient (VSP) supplementation. Learners with minimal previous MI training experienced greater increases in relational skills when training with a VSP. The VSP used in this study represents a scalable tool that may be particularly helpful for training novice clinicians in MI relational skills. [ABSTRACT FROM AUTHOR]

Objectives: Health promotion professionals can contribute to high‐quality motivation and sustained health behaviours, for example, physical activity (PA), using motivational interaction with their target groups. However, evidence shows that even after comprehensive training, professionals do not optimally adopt motivational counselling styles. To improve efforts to help professionals take up and sustain motivational interaction in their practice, we need a better understanding of influences on practising these styles. This study set out to investigate pre‐service physical education (PE) teachers' experienced facilitators and challenges of practising motivational interaction. Design: After a training course that aimed to teach pre‐service PE teachers the basic ideas and practical techniques of motivational interaction, 19 participants were interviewed. Methods: Inductive content analysis was employed to investigate semi‐structured interviews. Results: We developed three categories each including both facilitators and challenges of practising motivational interaction: (1) own style of interaction functioned as a basis for practising and involved (a) confidence in skills and resources as well as (b) reflecting, overcoming and forming habits, (2) regulation of one's own behaviour: autonomy and responsibility involved the freedom to choose and plan how to practise but also bearing responsibility for it, and (3) pursuing authentic interaction related to the search for natural ways to use motivational interaction with others. Conclusions: We provide suggestions on how future training can make use of this knowledge and systematically make use of behaviour change science to foster practising motivational interaction, for example, using self‐regulation strategies and habit‐forming/breaking skills. [ABSTRACT FROM AUTHOR]

Adolescent substance use is a growing public health concern, particularly given rising mortality rates from drug overdose deaths. The emergency department (ED) provides a unique opportunity to screen adolescents for substance use and provide brief interventions and linkage to care. This article provides a narrative review of the current evidence for ED screening and brief interventions for adolescents with substance use and identifies important opportunities, challenges, and areas for future research. There are several validated substance use screening and assessment tools for use with adolescents that can be implemented into ED screening programs. Brief motivational interviewing interventions may reduce alcohol use, but evidence for reductions of other substances is limited due to insufficient research. Both screening and interventions are feasible and acceptable in the ED setting with the appropriate resources. Increased training and the use of emerging technology can provide emergency physicians with opportunities to incorporate these tools into practice to when treating adolescents. Linkage to outpatient care for adolescents with substance use is understudied. The research on adult patient ED interventions and linkage to care is more robust and can provide insights for future ED studies among adolescents. ED-based adolescent substance use screening and interventions are necessary, feasible, and acceptable, but understudied. Future studies, focusing on optimizing ED interventions and linkage to care, are important next steps in determining the best care for adolescents with substance use who present to the ED. [ABSTRACT FROM AUTHOR]

• STAND is an evidence-based treatment for adolescent ADHD that focuses on engagement. • Provides a summary of the development of a community implementation model for STAND. • Features include use of artificial intelligence to monitor fidelity and digitizing clinician resources. • Pilot work in three community agencies suggests acceptability, feasibility, and fidelity to the model. Implementation of behavior therapy for ADHD faces challenges in community settings. We describe development of a community-based implementation model for adolescent ADHD behavior therapy (Supporting Teens' Autonomy Daily; STAND) blended with Motivational Interviewing (MI). A stakeholder-engaged development approach is used based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Resulting model features include: (a) task-shifting supervision from experts to agency supervisors, (b) holding bi-weekly technical assistance drop-ins to provide training and implementation supports, (c) MI integrity monitoring and feedback by artificial intelligence (AI), (d) AI-generated metrics for STAND content fidelity, (e) digitizing resources (manual, worksheets, tips, videos) on a clinician dashboard, (f) creating visual displays of feedback using badges and graphs, and (g) adding a rapport-building session prior to manualized content. We conducted stakeholder focus groups (N = 32) and two pilot studies to evaluate the new STAND AI measurement tool and revised service-delivery model (N = 6 therapists, 7 youth and parents, 3 agency supervisors). Results revealed advantages and disadvantages of the model, supported the promise of a STAND AI fidelity measurement tool, and indicated initial feasibility, acceptability, and agency engagement in STAND's community-based implementation model. We discuss future directions for continued iterative development and testing. Video examples are included as supplementary material. [ABSTRACT FROM AUTHOR]

Background/Objectives: Providing relevant, patient-centered care starts with recognizing that patients living with diabetes are racially and ethnically diverse, which will influence their dietary behaviors. Methods: The authors draw upon literature descriptions and personal experience in clinical practice dealing with ethnically diverse populations and include guidance offered in the literature regarding how to address these unique aspects when managing and educating patients with diabetes. Results: Proper interviewing techniques are described when dealing with culturally diverse populations, including ascertaining cultural, religious, and ethnic influences on dietary choices, and advice is given on how to improve nutritional behavior in these patients while acknowledging and validating these influences. Conclusions: When a proper nutrition interview is conducted, such as using motivational interviewing, aspects of the patient's cultural, religious, ethnic, and other influences can be ascertained, and appropriate advice can be given to the patient on how to modify these influences to achieve a healthier nutritional behavior. [ABSTRACT FROM AUTHOR]

Purpose: To ascertain current nutritional knowledge and training needs of community-based nurses caring for older adults in the United Kingdom. Method: A descriptive cross-sectional, anonymized, online survey of nurses' knowledge, attitudes, and practices related to older adults' nutrition was developed. Community-based nurses working with older adults in the United Kingdom were recruited via social media and convenience sampling. Results: Responses were received from 194 community-based nurses. Nutritional care was seen as a multidisciplinary responsibility by 62% of participants. Most undertook nutrition screening (93%), were confident in providing nutritional advice (83%), and ease of identifying those in need (88%) was high. However, some aspects of nutritional knowledge were less complete, including recommended daily intakes of protein (60% unsure) and fiber (52% unsure). Conclusion: High confidence in delivering nutritional advice contrasted with uncertainty around some aspects of nutritional knowledge, suggesting opportunities to improve training on the nutritional needs of older adults. [Journal of Gerontological Nursing, 50(11), 13–19.] [ABSTRACT FROM AUTHOR]

Background: Early childhood caries (ECC) has been found to be up to five times more common among children living in areas of low socio‐economic status (SES) than among children in areas of higher SES. Aim: To evaluate an ECC prevention programme from pregnancy to 3 and 6 years of age. Design: A prospective, controlled, intervention cohort study was initiated in 2013 in a low‐SES area in Sweden. The intervention group received an individual interdisciplinary ECC prevention programme starting pre‐birth, consisting of supportive oral health‐promoting talks using motivational interviewing techniques and individual ECC preventive actions. A control group, consisting of pregnant women living in a comparable area, received ordinary routines. Results: Of the 336 pregnant women, 64 mothers (with 64 children) completed the programme, and 394 children were born in the control group. At the sixth year examination, the proportion of children with no caries was similar between the groups (53% resp. 52%, p =.976), whereas the proportion with decayed, missed, filled primary teeth (dmft = 1–5) was slightly lower (23% resp. 36%, p =.063), and the proportion with severe caries disease (dmft > 5) was higher (p =.013) in the intervention group (25%) than in the control group (12%). Conclusion: No preventive effect regarding caries can be demonstrated at sixth year of age. Maternal behavioural change in dental care was not sufficient to even out inequalities in oral health in children, eventually due to difficulties in reaching the target group and the lack of effects among the families reached. [ABSTRACT FROM AUTHOR]

Home care (HC) aides experience numerous safety hazards in clients' homes; many hazards also put clients at risk. We hypothesized that safety coaching led by nurse managers (NMs) during their initial HC needs assessment could prompt clients to improve safety conditions in their homes. Following a 2-arm proof-of-concept intervention study design, intervention NMs used motivational interviewing (MI), facilitated by a safety handbook and video, to coach clients on home safety improvements. Control arm NMs performed intake assessments with no changes to usual practices. Intervention effectiveness was assessed by NMs and aides. Three HC agencies and two elder services contributed 35 intervention and 23 control homes. NMs coached 97% of clients and reported that 94% were engaged; 63% implemented improvements. NMs' and aides' assessments were consistent; homes with clients reported by NMs as resistant to safety changes had higher aides' hazard scores. Client coaching can be effective for improving HC safety. [ABSTRACT FROM AUTHOR]

Purpose : Despite the increasing number of elder abuse and self-neglect (EASN) cases, many older adults are reluctant to engage with formal support services, such as Adult Protective Services (APS). This study examined the use of motivational interviewing (MI) by advocates, as a component of a larger EASN intervention, RISE (Repair Harm, Inspire Change, Support Connection, Empower Choice), implemented in partnership with APS. Advocates applied MI as part of RISE to help clients explore and resolve ambivalence around pursuing change and ultimately enhance service engagement. Methods: This study conducted qualitative interviews and a focus group with all RISE advocates (n = 4) to understand how MI is applied in the context of an EASN intervention with older adult clients. A descriptive phenomenological approach involving two independent assessors was used to code verbatim transcripts into themes. Results: Three domains were identified: (1) therapeutic relationship, which describes the importance of foundational relationship building in MI to support older adults who have experienced EASN; (2) techniques, which refers to MI strategies advocates apply and adapt in the context of EASN intervention; and (3) implementation challenges, which reflects the difficulties advocates encounter when using MI in cases of EASN. Conclusions: The experiences of advocates suggest MI is a beneficial and amenable approach to help older adults who have experienced EASN navigate issues of ambivalence and explore their motivation for change. This study represents the first in-depth exploration of MI in the context of EASN intervention. [ABSTRACT FROM AUTHOR]

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Background: Working in healthcare often involves stressful situations and a high workload, and many healthcare workers experience burnout complaints or suffer from mental or physical problems. This also affects the overall quality of health care. Many previous workplace interventions focused on knowledge exchange instead of other health cognitions, and were not particularly effective. Multicomponent lifestyle interventions may offer the potential in improving lifestyle and well-being of healthcare professionals. This study aims to evaluate the impact of a multicomponent lifestyle intervention “Healthy and Vital” for healthcare professionals on several health-related outcomes. Methods: A pre- (multiple) post-pilot study has been conducted using data from 2012 to 2018 to evaluate the lifestyle intervention in 126 female healthcare professionals. Measurements were conducted before, directly after the intervention (at 3 months), and 6 months after finishing the intervention (at 9 months). Participants filled out questionnaires and anthropometrics measurements were conducted by a dietitian. The intervention is based on the ASE-model, theory of planned behavior, and motivational interviewing techniques. The intervention included workshops related to stress, eating, sleep, and individual meetings with a dietitian. Multilevel linear mixed models with a random intercept and fixed slope were used to evaluate the impact on lifestyle self-efficacy, eating behavior, anthropometric outcomes and quality of life. Results: Improvements were observed for lifestyle self-efficacy (total: beta= 1.32 95%CI 0.94;1.48, I know: beta= 1.19 95%CI 0.92;1.46, and I can: beta= 1.46 95%CI 1.19;1.73), eating behavior (emotional eating: beta=-0.33 95%CI-0.44;-0.23, external eating: beta=-0.35 95%CI -0.44;-0.26, and diet/restrictive behavior: beta= 0.41 95%CI 0.30;0.51), anthropometric outcomes (weight: beta=-5.03 95%CI -5.93;-4.12, BMI: beta=-1.873 95%CI -2.06;-1.41, waist circumference: beta=-6.83 95%CI -8.00;-5.65, and body fat percentage: beta=-1.80 95%CI -2.48;-1.17) and multiple outcomes of quality of life (physical functioning: beta= 4.43 95%CI 1.98;6.88, vitality: beta= 7.58 95%CI 4.74;10.42, pain: beta=4.59 95%CI 0.91;1.827, general health perception: beta= 7.43 95%CI 4.79;10.07, and health change: beta= 21.60 95%CI 16.41;28.80) directly after the intervention. The improvements remained after a six-month follow-up. Conclusions: Multicomponent interventions such as “Healthy and Vital” for healthcare professionals may be useful for improving the health of healthcare workers. More research using other designs with a control group, such as a stepped-wedge or RCT, is needed to verify our findings. Trial registration: Retrospectively registered on May 1 2024 at the Open Science Framework Registries (). [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) poses a global health challenge with high morbidity and mortality rates. Early detection and prompt intervention are critical in preventing progression to end-stage kidney disease (ESKD) and cardiovascular complications. Effective CKD management requires comprehensive care packages that integrate both pharmacological and non-pharmacological interventions within collaborative, team-based models, aiming to enhance patient outcomes and overall quality of life. The goal of the Strategies for Kidney Outcomes Prevention and Evaluation (SKOPE) study is to establish effective multicomponent intervention (MCI) strategies for evaluating and preventing kidney outcomes in patients with moderate to advanced CKD within primary care settings in Singapore. Methods: This study is a 3-year randomized controlled trial among 896 participants aged between 40 and 80 years with moderate or advanced CKD in five government-subsidized polyclinics in Singapore. The components of the MCI are (1) nurses/service coordinators trained as health coaches for motivational conversation and CKD-specific lifestyle counseling on diet and exercise, using a hybrid follow-up approach of in-person, telephone, and secure video meetings; (2) training physicians in algorithm-based standardized management of CKD; (3) subsidy on SGLT2i medications for CKD; and (4) regular CKD case review meetings. The primary outcome is the estimated glomerular filtration rate (eGFR) total slope from randomization to final follow-up at 36 months. Discussion: If shown to be effective, cost-effective, and acceptable, SKOPE should be considered for scaling country-wide and in similar regional healthcare systems. Trial registration: ClinicalTrials.gov NCT05295368. Registered on March 25, 2022. [ABSTRACT FROM AUTHOR]

Background: Criminal legal system-involved individuals with serious mental illness (SMI) experience more challenges accessing mental health and other community services than those without a history of criminal legal system involvement. A formative qualitative study was conducted to explore feasibility and acceptability and inform the adaptation of a mental health peer navigation intervention for individuals with SMI reentering the community after jail incarceration. Methods: In-depth qualitative interviews and focus-group discussions were conducted with mental health peer navigators (i.e., certified mental health peer support specialists, peer recovery coaches) and individuals with lived experience of SMI and criminal legal system involvement (N = 20 total). Data were analyzed using applied thematic analysis. Results: Four major themes emerged: (1) Feasibility and acceptability of peer-provided services: all participants reported that peer navigation services would be feasible and acceptable for individuals with SMI reentering the community after jail incarceration; (2) roles of peer navigators in addressing barriers to care: peers can address barriers to care experienced during community reentry and contribute towards service linkage/engagement; (3) shared identity and combating stigma: having a shared identity with peer navigators may minimize the impact of stigma and make it easier for clients with multiple marginalized identities to seek support; and (4) peer navigator skills and recommendations for the planned program: essential peer navigation skills include authenticity, reliability, active listening, advocacy, trauma-informed care, motivational interviewing, and empathy. Recommendations for the planned program include initiating services while clients are in custody, emphasizing the voluntary nature of peer support, knowing the limits of a peer navigation intervention, and offering support for peer navigators while on the job. Conclusion: Participants saw peer navigation services for individuals with SMI with criminal legal system involvement as potentially feasible and acceptable. Such programs may enhance their impact by offering supportive supervision, emphasizing the voluntary nature of the service, and acknowledging recovery as a self-directed endeavor. [ABSTRACT FROM AUTHOR]

The main objective was to perform a description of the potential biobehavioral factors that influence disability in patients with migraines and develop a multimodal physiotherapy treatment proposal incorporating therapeutic education and exercise prescription, applying a biobehavioral approach. This manuscript highlights the complex interplay between migraines and physical activity, with many migraine sufferers performing reduced physical activity, even during headache-free intervals. The kinesiophobia present in a significant portion of patients with migraine exacerbates functional disability and compromises quality of life. Psychological elements, especially pain catastrophizing, depression, and self-efficacy, further compound migraine-related disability. Addressing these issues requires a multidisciplinary approach that integrates physical activity and behavioral interventions. We propose a therapeutic education model of motor behavior that emphasizes the enhancement of therapeutic exercise outcomes. This model consists of the four following phases: (1) biobehavioral analysis of movement; (2) goal setting; (3) education about exercise benefits; and (4) movement education. A notable feature is the incorporation of motivational interviewing, a communication strategy that amplifies intrinsic motivation for change. Recent clinical guidelines have advocated for specific exercise modalities to ameliorate migraine symptoms. However, we highlight the importance of a tailored exercise prescription to maximize the benefits of exercise and reduce the possible adverse effects. The integration of exercise with other lifestyle recommendations, such as maintaining consistent sleep patterns and employing stress management techniques, is pivotal for improving outcomes in patients with migraine. Although evidence supports the benefits of these interventions in various painful conditions, further research is needed to establish their efficacy specifically for migraine management. [ABSTRACT FROM AUTHOR]

Cannabis has been legalized for medical and recreational purposes in multiple countries. A large number of people are using cannabis and some will develop cannabis use disorder (CUD). There is a growing recognition that CUD requires specific interventions. This Review will cover this topic from a variety of perspectives, with a particular emphasis on neurobiological findings and innovative treatment approaches that are being pursued. We will first describe the epidemiology and burden of disease of CUD, including risk factors associated with CUD (both in terms of general risk and genetic risk variants). Neurobiological alterations identified in brain imaging studies will be presented. Several psychosocial interventions that are useful for the management of CUD, including motivational enhancement therapy, behavioral and cognitive therapy, and contingency management, will be covered. Although no pharmacological interventions are yet approved for CUD, we present the most promising pharmacological interventions being tested. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Results Conclusions Tobacco use spreads through social networks influencing social norms around tobacco use. However, the social norms scholarship is extremely diverse and occasionally conflicting, complicating efforts to understand how best to leverage social norms to reduce tobacco use. This study systematically reviewed and meta‐analyzed this vast terrain by focusing on social norms measurement and mechanism, and intervention effectiveness and modality aimed at changing social norms around tobacco use and actual tobacco use.We searched Scopus, PubMed, PsycInfo, Clinicaltrials.gov, ProQuest Dissertations, the Cochrane Trial Registry, as well as the websites of the Society for Research on Nicotine and Tobacco, the Open Science Framework, medrXiv and the Truth Initiative for experimental and quasi‐experimental evaluation studies of interventions designed to shift tobacco use. We included studies written in English from inception to 30 May 2024. We only included studies which noted social norms or social influence as part of the intervention design or set of measured variables. We excluded studies with only one time point, without an intervention being evaluated and those not published in English. Study screening followed the PRISMA 2020 guidelines, and was conducted by at least two independent reviewers who resolved discrepancies through discussion and consensus. All included studies were analyzed in a narrative synthesis, and those providing sufficient statistics for tobacco and social norms outcomes were included in meta‐analyses, which were performed separately for tobacco outcomes and social norms outcomes. Study outcomes were transformed into a standardized mean difference (Hedges' g) and several meta‐regressions were fit to explore sources of heterogeneity using a robust variance estimation specification to handle effect size dependency.A total of 95 studies met inclusion criteria for the narrative synthesis, 200 effect sizes from 86 studies were included in the tobacco outcomes meta‐analysis, and 66 effect sizes from 29 studies were included in the social norms outcomes meta‐analysis. Nearly 90% of included studies were conducted in high‐income settings, with the remainder conducted in middle‐income settings. No studies were conducted in Latin America or on the African continent. Social norms change interventions had a statistically significant effect on reducing tobacco use and pro‐tobacco social normative perceptions [g = 0.233, 95% confidence interval (CI) = 0.166, 0.301, P < 0.001 and g = 0.292, 95% CI = 0.090, 0.494, P = 0.007, respectively]. Interventions were commonly conducted among schoolchildren in classrooms through multicomponent education sessions, often coupled with regular ‘booster' sessions over time. Among adult populations, motivational interviewing and other counselling approaches were used in some cases, and few interventions leveraged digital technologies to change social norms.Social norms change interventions appear to be effective for reducing tobacco use and pro‐tobacco social normative perceptions. In particular, leveraging role models appears to be the most effective social norms change mechanisms for tobacco control. [ABSTRACT FROM AUTHOR]

Aim: A workshop on concordance and oral hygiene was held in February 2024. To address the topic, a systematic review aimed at investigating the effectiveness of motivational interventions in improving oral hygiene and focusing on periodontal clinical indices outcomes was designed. Materials and Methods: A comprehensive literature search was conducted across PubMed and Scopus electronic databases to identify relevant articles published up to 2024. Inclusion criteria encompassed studies comparing motivational interventions targeting oral hygiene behaviours, with a focus on periodontal clinical indices. Twelve articles meeting the eligibility criteria were selected for analysis. Quality assessment and data extraction were performed systematically. Results: The synthesis of findings from the selected studies revealed a consistent positive effect of motivational interventions on periodontal clinical indices. These interventions encompassed various strategies, including educational sessions, personalized feedback and motivational interviewing. Improvement in indices such as plaque index (PI), gingival index (GI) and periodontal probing depth was observed following motivational interventions, despite the variety of motivational protocols employed. Conclusion: Motivational interventions are effective in enhancing oral hygiene practices and improving periodontal clinical indices. Tailored motivational approaches can serve as valuable tools in promoting oral health behaviours among individuals, potentially reducing the risk of periodontal diseases. Further research is warranted to explore the long‐term sustainability and scalability of motivational interventions in diverse populations and settings. [ABSTRACT FROM AUTHOR]

Background: This study aimed to systematically evaluate interventions and effects that promote involvement in medication safety among older people with chronic diseases and to provide new ideas and references for developing standardized and effective intervention strategies to improve patient involvement in medication safety. Methods: A comprehensive literature search across twelve databases was conducted using both computerized and manual methods. The search was limited to studies designated as randomized controlled trials or quasi-experimental studies and was conducted from the time of each database's inception until September 2023. Two researchers independently carried out qualitative analyses, which included screening the literature, extracting the data, and assessing the quality of the selected studies. Results: This study included five studies involving a total of 388 participants, with interventions aimed at enhancing patient involvement in medication safety, including interactive health education, motivational interviewing, and medication reconciliation. However, direct evidence confirming the positive impact of these interventions in promoting medication safety behaviors among older people with chronic diseases is still lacking. Conclusions: Patient involvement in medication safety behaviors is essential for promoting healthy aging. Medication education, motivational interviewing, and medication reconciliation may improve the willingness and ability of older people to participate. However, limitations in the methodological quality of current studies prevent drawing definitive conclusions, highlighting the urgent need for more high-quality research. Trial registration: PROSPERO number CRD42023494924. [ABSTRACT FROM AUTHOR]

Background Method Results Conclusions Attention Deficit/Hyperactivity Disorder (ADHD) demonstrates unique developmental manifestations in adolescence with implications for optimized, age‐appropriate treatment. This 10‐year update is the third in a series of systematic reviews examining the efficacy and safety of adolescent ADHD treatments. We broadly examined efficacy on ADHD symptoms, impairments, and other reported outcomes. Acute and long‐term efficacy, and treatment moderators, were considered.We performed PubMed, EMBASE, and PsycINFO searches for articles published or in press from 2013 to 2024, integrated with hand search and randomized controlled trials (RCTs) identified in this series' earlier reviews. RCTs examining the safety or efficacy of interventions delivered to adolescents (ages 10.0–19.9) with a diagnosis of ADHD were included. Study characteristics were extracted and reviewed, quality of evidence was assessed using GRADE, and effect sizes were calculated for individual studies and illustrated using forest plots.Sixty‐three RCTs were identified. Quality of evidence ranged from high (medication; k = 29) to very low (nutrient supplementation, neurofeedback, occupational therapy; k = 1 each). Medications demonstrated consistent strong impact on ADHD symptoms and inconsistent impact on impairment. Diverse cognitive/behavioral treatments (C/BTs) demonstrated inconsistent impact on ADHD symptoms but strong and consistent impact on impairment and executive function skills, plus moderate benefits on internalizing symptoms. No interventions demonstrated significant safety concerns. Long‐term maintenance (up to 3 years post‐treatment) was demonstrated for C/BTs, though moderate quality of evidence was noted because participants cannot be fully blinded to receipt of treatment.The effects of C/BTs and medication appear complementary, not duplicative. Combining medication and C/BT is advised at treatment outset to maximize engagement, maintenance, and response breadth (i.e. improving both ADHD symptoms/cognitive performance and coping skills/functional impairments). Engagement strategies (e.g. motivational interviewing) may facilitate uptake. Novel treatments do not yet demonstrate effects on ADHD symptoms or impairments in adolescents but remain a promising area for research. [ABSTRACT FROM AUTHOR]

Purpose Material and Method Findings Conclusion This study aims to examine the effect of online individual motivational interviewing based on the transtheoretical model on pregnant women's smoking cessation behaviour.Sixty‐two pregnant women who did not complete the 16th gestational week and who smoked were randomly assigned to intervention (n = 31) and control (n = 31) groups. While the intervention group was administered model‐based motivational individual counselling interventions, the control group was administered no interventions.The results showed that 58.1% of the pregnant women in the intervention group and 22.6% of the pregnant women in the control group ceased smoking.Online motivational interviewing based on the transtheoretical model was found to be effective in pregnant women's smoking cessation. [ABSTRACT FROM AUTHOR]

Purpose: To explore the attitudes and experiences of clinicians and individuals with chronic stroke on the use of shared decision-making (SDM) during upper extremity rehabilitation to improve daily arm use in the home environment. Specifically, we aimed to describe clinician and client perspectives regarding the facilitators and barriers to using SDM within the context of a self-directed upper extremity intervention for individuals living in the community with chronic stroke. Methods: Data were collected within the context of an interventional study examining the feasibility of the Use My Arm-Remote intervention. Focus group interviews were conducted with the clinicians (n = 3) providing the intervention and individual semi-structured interviews with the participants (n = 15) of the study. All interview data were collected after the end of the intervention period. Data were analyzed using thematic analysis. Results: The following themes were identified: (1) Equal partnership; (2) Enhancing clinician confidence; and (3) This is different. Facilitators and barriers were identified within each theme. Key facilitators for clinicians were competence with SDM and patient characteristics; while facilitators for patients were open and trusting relationships with clinicians and personalized experience. Key barriers to SDM for clinicians were lack of expertise in SDM and participant buy in; while patients identified a lack of foundational knowledge of stroke rehabilitation as a potential barrier. Conclusions: Key barriers were analyzed using the consolidated framework for advancing implementation science to interpret results and identify strategies for enhancing the implementation of SDM in a virtual setting. The CFIR-ERIC tool highlighted the need for targeted educational meetings and materials to address the training and educational needs of both clinicians and patients for future iterations of this intervention. [ABSTRACT FROM AUTHOR]

This study explored the feasibility and acceptability of Entre Herman@s, a novel sibling-based intervention designed to engage siblings to increase PrEP utilization among Latino men who have sex with men (LMSM). Siblings were trained in rudimentary motivational interviewing skills to uncover, evoke, and strengthen their brother's motivation to use PrEP, using the constructs of the Information-Motivation-Behavioral Skills (IMB) model for health behavior change. This pilot demonstrated high feasibility, meeting recruitment, retention, and intervention completion targets. Of the 23 LMSM enrolled, 16 (70%) commenced PrEP, with 12 (75%) continuing at the 3-month follow-up. Initially, 15 participants (65%) were open to PrEP, with 9 (39%) ready to start within the next month. Those who began PrEP use reported a significantly higher degree of closeness to their siblings (p =.019) than those who did not. All LMSMs affirmed that their decision to use PrEP was influenced to some degree by their sibling. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a sexual rehabilitation program, SEXHAB, in improving sexual functioning, reducing sexual distress, and enhancing marital satisfaction for women after gynecological cancer treatment. Methods: This is a randomized controlled trial that included 150 women newly diagnosed with gynecological cancer from three public hospitals in Hong Kong. Participants were randomly assigned to the intervention group (n = 78) to receive the SEXHAB or to an attention control group (n = 72) to receive attention. The SEXHAB comprises four individual‐ or couple‐based sessions with three major components: information provision, cognitive‐behavioral therapy and counseling using motivational interviewing skills. The outcomes were measured at baseline (T0), upon completion of the program (T1) and 12‐month post‐treatment (T2). Semi‐structured interviews were also conducted with the SEXHAB group participants to explore their experiences with and opinions toward the program. Results: At both follow‐ups, there were no statistically significant differences between groups in improving sexual functioning, sexual distress and marital satisfaction. Nevertheless, participants in the SEXHAB group reported their partners having significantly greater sexual interest at T1 (76% vs. 52%, rate ratio: 1.46, 95% CI: 1.07 to 1.99, p = 0.024) and T2 (74% vs. 48%, rate ratio: 1.55, 95% CI: 1.11 to 2.10, p = 0.014). From the qualitative interviews, the interviewees who resumed sexual activity reported positive experiences in rebuilding sexuality and intimacy. Conclusions: Despite the quantitative results are negative, the qualitative findings suggest potential benefits of the SEXHAB for women resuming sexual activities after treatment for gynecological cancer. Further studies with longer intervention period and follow‐ups are needed to confirm the intervention effects. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of the PerioRisk prognostic tool in implementing the effect of motivational interviewing (MI) on psychological outcomes and supragingival plaque control. Materials and Methods: Participants underwent MI immediately after their first periodontal visit. According to a parallel‐arm, randomized study design, MI was performed with (RISK group) or without (CTR group) information on PerioRisk level and treatment goals based on PerioRisk output. Psychological outcomes were assessed using the Positive Affect Negative Affect Scale (PANAS) and Protection Motivation Theory (PMT). Plaque index (PI) was re‐evaluated after 8–12 weeks. Results: Significant improvements in PMT overall score and PI were observed in CTR and RISK groups, without inter‐group difference in PANAS and PMT overall scores and PI. A sub‐analysis showed that the overall PMT scores recorded immediately after MI in both CTR and RISK groups for subjects with no tooth loss due to periodontitis were higher than those recorded before MI in subjects with tooth loss due to periodontitis. Conclusions: At first periodontal visit, MI (implemented with without PerioRisk) has tangible effects on psychological outcomes and supragingival plaque control and seems to anticipate the awareness that is commonly generated by periodontitis‐related tooth loss (ClinicalTrials.gov protocol registration ID: NCT05078411). [ABSTRACT FROM AUTHOR]

Background: Suicidal ambivalence is considered a characteristic condition of suicidal individuals. At the same time, there is a lack of a uniform definition, conception and assessment of suicidal ambivalence. On this background, the current scoping review aims to explore the extent, range, and nature of research activity on suicidal ambivalence and to summarize research findings. Methods: A systematic literature search was conducted in four different databases (PubMed, Psychinfo, Web of Science, and Google Scholar) using an array of search terms (e.g., ambivalence, internal suicide debate, reasons for living and reasons for dying, wish to live and wish to die). Results: In total, 28 articles published between 1977 and 2023 were included in the scoping review. The study situation lacks a clear definition, conceptualization and operationalization of suicidal ambivalence. Nonetheless, suicidal ambivalence is a common experience in persons contemplating suicide and suicidal ambivalence seems to be present before, during and after a suicide attempt. Suicidal ambivalence is associated with diverse markers of negative/positive mental health as well as suicidal ideation and behavior. Conclusion: Results point to the relevance of suicidal ambivalence. At the same time, there are large gaps in knowledge about the development, impact and therapeutic responsiveness of suicidal ambivalence. [ABSTRACT FROM AUTHOR]

Introduction: Cancer‐related stigma is a key driver of advanced breast cancer stage in Sub‐Saharan Africa (SSA). We developed and tested the impact of a breast cancer survivor‐led Stigma reduction intervention (SRI) on stigma and treatment adherence of newly diagnosed patients with breast cancer in Tanzania. Methods: Breast cancer survivors were trained on breast cancer knowledge and motivational interviewing. A total of 4 trained survivors delivered a SRI (standardized flipchart breast education talk, personal testimony, and motivational interviewing) to 30 newly diagnosed patients with breast cancer before treatment. Pre‐ and post‐intervention knowledge surveys and stigma scale surveys were analyzed via Fisher's exact test and Wilcoxon rank‐sum tests. A discussion was held with a group of survivors after the intervention period to elicit feedback on their intervention experience. Results: Among the 30 patients, breast cancer knowledge (median overall percent correct) increased from 28% (IQR: 18%–45%) to 85% (IQR: 79%–88%) (p < 0.001) and stigma (median score) decreased from 75 (IQR: 57–81) to 53 (IQR: 44–66) (p < 0.01) following the intervention. All participants were willing to pursue hospital‐based treatment after undergoing the intervention. Eighty‐seven percent (n = 26) initiated treatment at 8‐week follow‐up after the intervention. All survivors endorsed feeling empowered and valued in their role in this intervention. Conclusions: Breast cancer survivors are a powerful group to combat the lack of knowledge and stigma in community and healthcare settings. Expanding the scope and scale of this intervention holds promise for improving treatment‐seeking behavior and ultimately breast cancer outcomes in SSA. [ABSTRACT FROM AUTHOR]

Background: Given the pivotal role of medication adherence in improving survival rates and reducing hospital readmissions, this research aims to address the gap in adherence rates through a patient-centered approach. This study investigates the efficacy of selfefficacy-based motivational interviewing in enhancing medication adherence among patients with myocardial infarction (Ml). Methods: A semi-experimental pretest-posttest design was employed, involving 216 patients with Ml from the Ibn Al-Bitar Specialized Center for Cardiac Surgery in Baghdad, Iraq. Participants were randomized into intervention and control groups. The sample size was calculated using G*Power software with a power of 0.80 and an alpha of 0.05, yielding a required sample of 100 participants (50 per group). The intervention group received motivational interviewing sessions based on the self-efficacy, while the control group did not. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Data analysis was performed using SPSS software, with repeated measures analysis of variance (ANOVA) used to assess changes in adherence over time. Results: The intervention group showed significant improvement in medication adherence scores from pre-test (5.46 ± 1.05) to post-test (2.45 ± 0.71) and follow-up (2.57 ± 0.80). In contrast, the control group's scores showed minimal change, from 5.44 ± 1.01 on pre-test to 5.04 ± 1.36 at follow-up. Statistical analysis using repeated measures ANOVA revealed a substantial impact of the intervention on medication adherence (F = 214.70, P < 0.001) with a large effect size (0.85). Conclusion: The study validates the effectiveness of self-efficacy-based motivational interviewing in improving medication adherence in patients with Ml. This approach could revolutionize chronic disease management, underscoring the necessity of incorporating behavioral interventions into patient care. The findings suggest potential applications of this method in broader chronic disease management contexts, warranting further investigation. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the experiences of older adults and counsellors involved in virtual motivational interviewing (MI). This study was part of the Virtual Motivational INTerviewing (VIMINT) feasibility trial of virtual MI for physical activity in older adults. A descriptive qualitative design utilized content analysis. Seven older adults and three counsellors were interviewed. Four categories were developed: (i) Benefits and limitations of using technology (ii) Relationships between older adults and counsellors (iii) MI skills and spirit and (iv) Effects of virtual MI. Older adults and counsellors reported that receiving/delivering MI virtually was convenient and flexible. They described reduced non-verbal communication in virtual MI. Virtual MI facilitates interpersonal relationships, and counsellors reported that MI skills and spirit can be applied virtually. This study showed that virtual MI offers potential benefits with some limitations. The findings could inform future research involving virtual delivery of MI. [ABSTRACT FROM AUTHOR]

Background: Low-cost, scalable strategies are necessary to reach the UNAIDS 2030 target of ending HIV as a public health threat. Use of treatment partners, informal caregivers selected by people living with HIV to support antiretroviral therapy adherence, is one such strategy that is included in many countries' HIV guidelines, including Botswana, a country with high HIV prevalence. Method: From June 2021 to June 2022, we pilot tested a clinic-based treatment partner intervention ("Mopati"), including standardized language for providers to guide patients on treatment partner selection and workshops to train treatment partners on providing non-directive support to patients using a non-confrontational, non-judgmental approach. Sixty unsuppressed patients (30 per clinic) and 45 treatment partners (17 intervention, 28 control) were recruited from an intervention–control clinic matched-pair in Gaborone, Botswana. Results: Mopati had medium-to-large effects on increasing patients' adherence, adherence self-efficacy, intrinsic adherence motivation, and perceived non-directive support from treatment partners, and decreasing treatment partner caregiver burden. Aggregate viral suppression rates significantly increased in the intervention (vs. control) clinic. Qualitative data from 14 clinic staff, 21 patients, and 16 treatment partners indicated that Mopati was viewed as effective. Providers said the guidance empowered them to be proactive in communicating about adherence; most reported using the guidance. Conclusion: This study shows preliminary support for the use of treatment partners in HIV care, and further evidence for interventions that leverage patients' existing support. This research can inform ways to improve adherence to HIV treatment as well as the treatment of HIV-related comorbid conditions in lower-resource settings. Trial Registration: ClinicalTrials.gov Identifier: NCT04796610. [ABSTRACT FROM AUTHOR]

The article focuses on the development and evaluation of an online Motivational Interviewing (MI) training tool for pediatricians to improve smoking cessation support for caregivers. Topics include the effectiveness of MI for tobacco cessation, the challenges of integrating MI into pediatric care, and the design and feasibility of the online training for pediatricians.

Yalom's therapeutic factors (TFs) have been a focal point in therapeutic literature for over three decades. However, their specific application in group therapy for substance use disorders (SUD) remains underexplored. This review paper is divided into two primary sections. The first section offers a comprehensive review of the literature on TFs in general group therapy, highlighting empirical findings. The second section delves into the application of TFs in group therapy for SUD, with particular emphasis on 12-step programs and motivational interviewing groups. The paper concludes by discussing the implications for future development and enhancement of group therapy practices through the perspective of TFs. [ABSTRACT FROM AUTHOR]

Background: Personalized Normative Feedback (PNF) aims to modify misperceptions about peer consumption that influence one's drinking. PNF is usually a component in Brief Interventions delivered to university students. Despite this, whether PNF contributes to improving the effect of brief interventions is unclear. Objectives: This randomized controlled trial aimed to determine the role of PNF as an active ingredient in a face-to-face motivational brief intervention. Results: Participants were students from an Argentinian university (n=806; M=20.14; SD=3.17; 63.2% women) who presented at least one binge drinking episode in the last 12 months. Students were randomly assigned to 1) a Brief Intervention, 2) a Brief Intervention with PNF, or 3) an evaluation-only control group. The follow-up was three months later. After controlling sex and age, General Linear Models showed that both the brief intervention and the brief intervention with PNF reduced the quantity and frequency of alcohol consumption, binge drinking, and alcohol problems compared to the control condition. No differences were found between the brief intervention and the brief intervention with PNF. Also, treating eight students with brief intervention and 10 with brief intervention with PNF was necessary to benefit one student. Conclusions: In conclusion, this study demonstrates that brief intervention reduces alcohol consumption among Latin American university students and that PNF might not be an active ingredient of its effectiveness in this population. However, PNF could benefit students with specific characteristics, like those who overestimate their peers' drinking, highlighting the need to study moderators of effectiveness further. [ABSTRACT FROM AUTHOR]

Background: This pilot proof-of-concept study examined the feasibility and acceptability of the Daily Progress System (DPS), a web-based platform designed to improve treatment engagement and retention among clients in outpatient substance use treatment. Methods: The study included adults under justice supervision in the community (probation or parole) who were clients at an outpatient treatment program (N = 30; 60% males). Participants were instructed to utilize the DPS daily for 4 weeks. Incentives were paid to participants for using the platform. At the end of the study, they completed a post-satisfaction questionnaire. Results: Of the 30 participants enrolled in the study, 28 (93.3%) completed the post-satisfaction questionnaire. Overall, they were extremely satisfied with the platform as 21/30 (70.0%) logged into the DPS on a daily basis and completed at least 15 daily surveys or more over the 30-day study period and 27/28 (96.5%) would recommend that the participating treatment program use the platform as part of treatment for other clients. Conclusions: The DPS was well-utilized and perceived as valuable by this group of justice involved, low-income, underserved, and hard-to-reach individuals. Further research is needed to refine platform content and evaluate its ability to meaningfully enhance and extend the benefits of treatment. [ABSTRACT FROM AUTHOR]

Objective: Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial. Methods: PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size. Results: A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37–27.99), with an NNT of 6 (95% CI: 4–19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73–24.24%), and the NNT was 8 (95% CI: 4–37). Conclusions: We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC. [ABSTRACT FROM AUTHOR]

Purpose: This study was intended to investigate a small-scale School-based Motivational Interviewing (SBMI) pilot with first-year college students. This approach honors student autonomy, supports self-determination and has the potential to impact educational outcomes in higher education. Motivational Interviewing (MI) is an evidence based conversational skill set, defined as "a collaborative conversational style for strengthening a person's own motivation and commitment to change" (Miller and Rollnick, 2013, p. 12). Student perceptions of satisfaction with the faculty-student mentoring intervention were sought. Relational aspects of MI (partnership, empathy and alliance) were also explored. Design/methodology/approach: A mixed-method approach was used for the SBMI study, focused on college students with recent academic setbacks (N = 19). Findings: The intervention was deployed with high levels of MI technical fidelity and relational quality. Participants reported high satisfaction with the intervention. The relational aspects and participant perceived alliance with their faculty were highly correlated across the intervention, adding to the discussion of the mechanisms of MI that contribute to its effectiveness. Research limitations/implications: This work is formative, yet at this point is not generalizable given the scope of the study. Practical implications: Findings are encouraging for further development of this innovative pedagogical approach. Possible future applications of research are provided. Social implications: Discussed herein, SBMI has the potential to meet the needs of traditionally underrepresented student groups. Originality/value: The reported study is the initial portion of a larger intervention development project. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome is a chronic illness that influences physical and psychological health and well-being and requires continuous treatment and effective self-care. This two-group quasi-experimental study investigated the effectiveness of the Self-Care Support Program for People with Acute Coronary Syndrome. Sixty participants were purposively recruited from medical wards of a university-affiliated hospital in Bangkok, Thailand. A Self-Care Support Program based on Orem's self-care theory was integrated with a motivational interviewing approach. The experimental group (n = 30) received the 4-week intervention program with the usual care, while the comparison group (n = 30) received only usual care. Instruments for data collection included a Demographic and Health Data Form, the Self-Care Behavior for Acute Coronary Syndrome Questionnaire, the Veterans Specific Activity Questionnaire, and the Rehospitalization Record Form. Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test, and two-way repeated measures analysis of variance. Results revealed that the experimental group had significantly improved self-care behavior and functional ability immediately and four weeks after program completion (week 8), compared to the comparison group. There was no difference in rehospitalization between the two groups. Nurses with advanced skills in motivational training can use this program to promote effective self-care practices, improve functional ability, and reduce rehospitalization. Further study using randomized controlled trials and other settings is needed before it can be widely used. [ABSTRACT FROM AUTHOR]

Objective. To investigate the impact of counseling interventions, using face‐to‐face training vs. mobile app for choosing mode of delivery. Design. A four‐armed, randomized, controlled parallel‐design trial. Setting. Ebnesina Private Hospital in Tehran, Iran. Population. Pregnant women, between 24 and 32 weeks of gestation (n = 120). Methods. Pregnant women were randomly assigned in three psycho‐educational intervention groups: (1) motivational interviewing via face‐to‐face training, (2) information, motivation, and behavioral skills model via face‐to‐face training, (3) the same model via a mobile application, and (4) usual antenatal care (control group). To assess the face‐to‐face and mobile app training method on women's self‐efficacy and intention in choosing a mode of delivery. Main Outcome Measures. Mode of delivery (Cesarean section). Results. While all three intervention groups showed significant increases in women's self‐efficacy and intentions to choose vaginal delivery, the increase was particularly noticeable among those using mobile applications: Before the intervention, self‐efficacy and intention Mean ± SD were 77.1 ± 38.6 (CI‐95%: [62.72, 91.60]) and 1.10 ± 0.305 (CI‐95%: [0.99, 1.21]), respectively. After the intervention, these scores increased to 99.7 ± 30.7 (CI‐95%: [88.27, 111.20]) for self‐efficacy and 1.70 ± 0.466 (CI‐95%: [1.53, 1.87]) for intention. Although 56.7% of women in the intervention groups expressed a preference for vaginal delivery, only 37.5% ultimately pursued this birthing method. Conclusions. Brief psycho‐educational interventions, particularly technology‐driven interventions (mobile apps) can increase the likelihood of women choosing vaginal delivery. To enhance the effectiveness of such interventions, they can be conducted in conjunction with interventions for doctors and healthcare providers. This trial is registered with IRCT20151208025431N7. [ABSTRACT FROM AUTHOR]

The student check‐up (SCU) is a brief school‐based motivational interviewing intervention developed to promote academic‐related behavioral changes and to increase accessibility to mental health services. Despite published randomized controlled trials demonstrating SCU's effectiveness in promoting student self‐efficacy in academic efforts, the SCU's impact on student grade outcome has been inconsistent across studies. This study examines whether student participants' written statements that represent change talk and sustain talk predict differences in post‐treatment grade outcomes and whether these effects are moderated by students' pre‐treatment academic achievement. In addition, we examine whether change and sustain statements mediate the relationship between study sites and grade outcomes. A two‐level linear regression controlling for pre‐treatment grades indicated that as the frequency of change statements increases, students' post‐treatment grades in English Language Arts decrease (B = −0.62, p = .03), suggesting that “the more” is not always “the merrier” when it comes to evoking change statements related to academic goals that require multiple behavioral changes for attainment. [ABSTRACT FROM AUTHOR]

Background: The goal is to analyze the need for reinterventions under deep sedation to treat oral pathologies in a population of children with special health care needs (SHCNs) and healthy children who followed a prevention program and to study the influence of parental motivation and child collaboration on the need for reinterventions under deep sedation. Methods: A retrospective study was carried out in a private clinic in Cartagena (Murcia, Spain), with patients treated under deep sedation from 2006 to 2018, both years included, following the Strobe statement. Results: In this study with 230 children who were treated under deep sedation, 23.92% underwent two or more sedations. The mean time elapsed between the first and the second sedations was 21.64 ± 15.87 months, and the main cause for reinterventions was the occurrence of new pathologies. Significantly more pulp treatments were performed in the first sedation than in the second (p = 0.013) and in the third (p = 0.007). Healthy children required fewer reinterventions under deep sedation than children with special needs (6.42% vs. 39.67%). Similarly, patients who followed the preventive program and required some type of dental treatment were reoperated fewer times than those who did not follow the preventive program (35.8 vs. 50%); than "cooperative" children as opposed to "non-cooperative" (12.12% vs. 60.93%) and than patients with "motivated" parents as opposed to those with "non-motivated" parents (20.83% vs. 46.34%). A total of 50% of the children who participated in the preventive program became "cooperative", and 100% were able to receive some treatment in the dental chair. Conclusions: Prevention programs, including motivational interviewing, are essential to improve children's behavior in the dental chair and reduce the need for reinterventions under general anesthesia or deep sedation. Although patients with special needs do require more sedation during their lifetime due to their inability to cooperate, these programs are necessary for the maintenance of oral health status and for the early diagnosis of caries lesions. Pediatric dentists should implement a quarterly preventive program because it improves patient collaboration. It is essential to achieve the motivation of parents in the oral care of their children. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) is a chronic condition that significantly affects patients' physical, mental, and social health, as well as their overall quality of life. Effective management of the disease demands self-management skills, enabling patients to navigate the daily challenges associated with IBD, such as unpredictable flare-ups, frequent hospitalization, severe symptoms, pain, and physical changes. Objectives: This study examines the motivational aspects of self-management for patients with IBD and focuses on the role of autonomy and directive support from healthcare professionals in enhancing their self-concordance and self-efficacy. Design: From November 2022 to February 2023, a cross-sectional questionnaire study was conducted at the IBD Center of Internal Medicine Clinic in Szeged, Hungary. Methods: A total of 374 adult patients with IBD completed the paper–pencil questionnaire, of whom 241 patients (64.4%) had Crohn's disease, and 133 patients (35.6%) had ulcerative colitis. Results: Based on the findings of the path analysis (χ2 (8) = 18.914, p = 0.01, comparative fit index = 0.935, TLI = 0.837, root mean squared error of approximation = 0.06), autonomy support positively predicted self-concordance (β = 0.48) and self-efficacy (β = 0.02), particularly during disease relapse. In addition, self-concordance and self-efficacy predicted more positive (βs = 0.28 and 0.35) and fewer negative emotional experiences (βs = −0.09 and −0.20). The model's associations varied between the relapse and remission groups, indicating distinct impacts on different states of the disease. Conclusion: Overall, autonomy support from healthcare professionals has been shown to enhance self-management in patients with IBD, particularly during disease relapse. Meanwhile, self-concordance and self-efficacy act as positive internal factors, thus reducing negative emotional experiences, especially during remission. In sum, this study underscores the need for further exploration of the motivational aspects of self-management and provides insights into developing interventions that promote the health behaviors of patients with IBD. Plain language summary: Self-management of inflammatory bowel disease patients Autonomy support from healthcare professionals has been shown to significantly improve the effectiveness of self-management in patients with inflammatory bowel disease (IBD) (especially during disease relapse), by enhancing their self-concordance and self-efficacy. In this case, the interplay between disease activity, positive and negative emotions, and self-regulatory mechanisms underscores the importance of examining the motivational aspects for developing interventions that promote health behaviors in patients with IBD. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionsHealth coaching may supplement the multidisciplinary ALS clinic model to facilitate patient-centered health behavior change. The aim of this study was to determine the effects of nurse health coaching (NHC) on the quality of life and self-efficacy of individuals living with ALS.Twenty-nine participants were randomized at 1:1 to the standard of care and coaching arms. All participants attended multidisciplinary ALS clinic visits quarterly, at which times they completed assessments of quality of life and self-efficacy. Those in the coaching arm participated in monthly coaching with a nurse coach over 12 months. The coaching sessions utilized motivational interviewing to identify personal goals along with barriers and solutions to achieve them. Linear mixed-effect models were used to quantify the effect of coaching on quality of life and self-efficacy outcomes. Thematic analysis was performed to summarize the participants’ experiences with coaching.Adherence to the coaching intervention was good. No effects of coaching were observed on the primary outcomes of quality of life and self-efficacy, although debriefed participants reported that they would recommend it to others. Patients and caregivers reflected on the impacts of coaching that extended beyond the pre-defined study outcomes and measures put in place to gauge effectiveness.The elicited qualitative themes illustrating patient experience of coaching demonstrate the utility of nurse coaching as an important adjunct support to complement the multidisciplinary ALS clinic model. [ABSTRACT FROM AUTHOR]

This article aims to consider the 'lifestyle medicine' approach to nursing, which focuses on patients with conditions that would benefit from a lifestyle nursing approach, supporting and empowering people to make lifestyle changes that would benefit their health. Lifestyle medicine in nursing is gaining momentum in the USA and could be a nursing leadership opportunity in the UK. This article explores the importance of lifestyle approaches to health care and why nurses have a pivotal role in the movement. [ABSTRACT FROM AUTHOR]

Background: Individuals experiencing alcohol dependence syndrome (ADS) may struggle with relapse due to various factors, even after receiving successful inpatient treatment. While motivation enhancement therapy (MET) and pharmacotherapy are commonly used interventions for ADS, incorporating task-centered casework (TCP) -- a nondirective, goal-oriented, and time-limited approach -- may yield promising outcomes. Aim: This study examined the effects of adjunctive TCP in conjunction with pharmacotherapy and MET on frequently relapsing patients with ADS. Materials and Methods: This study utilized a case-control design to evaluate the efficacy of combined therapies (pharmacotherapy, MET, and TCP) on 60 male subjects with a diagnosis of ADS and multiple admissions in a tertiary deaddiction center. The participants were divided equally into experimental and control groups, with the experimental group receiving all three therapies and the control group only receiving pharmacotherapy and MET. Both groups maintained their pharmacotherapy regimens throughout the 2-month study period. Assessments were conducted at baseline and the end of the study using various measures, including social--demographic and clinical data, the SAD-Q, ACQ SF-R, SOCRATES-8A, CIWA-Ar, and WHOQOL-BREF Hindi version. Results: The results of the study indicate that the experimental group exhibited a marked decrease in alcohol cravings, an increased willingness to make positive changes, and overall better treatment outcomes and quality of life compared to the control group. In patients with ADS who underwent treatment with MET, TCP, and pharmacotherapy, it was observed that cravings were a significant predictor of their quality of life and readiness to make changes. Conclusions: TCP can be complemented with existing addiction therapies in the treatment of addiction because it has additional advantages in the form of nondirectiveness, goal orientation, time-limitedness, and collaboration between the therapist and the patient. ADS patients can benefit from this therapy by discovering their inert potential and identifying their shortcomings. [ABSTRACT FROM AUTHOR]