Date Presented 03/23/24

An intervention’s fidelity allows confidence in the program’s outcomes and is needed for dissemination. This poster describes a mixed-methods fidelity assessment of an occupation-based wellness program for caregivers and its delivery and receipt.

Primary Author and Speaker: Elizabeth Larson

PURPOSE: To examine the fidelity with which motivational interviewing (MI) was provided to caregivers in the 5Minutes4Myself program feasibility study. Fidelity in the delivery was assessed via a standardized assessment & participants’ receipt of motivational interviewing was examined via an analysis of focus group data.

DESIGN: Analysis of mixed-method feasibility data

METHOD: 15 participants participated in 5Minutes4Myself wellness program for caregivers of children with autism (ages 8-21 years). This program included coaching and use of a habit-building app. OT graduate students served as coaches; they received systematic training in MI that included personalized feedback. Coaches used a manualized MI-approach to design wellness-promoting changes via a lifestyle consultation and used and MI approache during check-ins with participants over 4 months’ time. Lifestyle consultations were rated for adherence to MI practices using a standardized tool (Motivational Interviewing Treatment Integrity 4.2.1). Post-participation focus group data describing MI coaching was subset and coded conceptually & generatively.

RESULTS: 87% of lifestyle consultations achieved beginning level competence. In their narratives, caregivers noted that coaches use of MI evoked deeply emotional insights related to their wellness goals and that this approach was more productive and useful to them compared to their prior therapy experiences.

CONCLUSION: OT graduate students can be trained to deliver high level MI coaching to support wellness promotion for caregivers in need of wellness. The systematic MI training protocol used here effectively trained pre-service professionals at levels that have not often been achieved in other intervention studies. This provides gives confidence that future practitioners who deliver the program, who are similarly trained, will be able to do so with fidelity.

References

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Jelsma, J. G. M., Mertens, V-C., Forsberg, L & Forsberg L. 92015). How to measure motivational interviewing fidelity in randomized controlled trials: Practical recommendations. Contemporary Clinical Trials, 43, 93–9. http://dx.doi.org/10.1016/j.cct.2015.05.001

Moyers, T. B., Rowell, L. N., Manuel, J. K., Ernst, D., Houck, J. M. (2016). The motivational interviewing treatment integrity code (MITI 4): Rationale, preliminary reliability and validity. Journal of Substance Abuse Treatment, 65, 36–42. https://doi.org/10.1016/j.jsat.2016.01.001