Embedding and sustaining motivational interviewing in clinical environments: a concurrent iterative mixed methods study

dc.contributor.author Lim, David en_US
dc.contributor.author Schoo, Adrian Martinus M en_US
dc.contributor.author Lawn, Sharon Joy en_US
dc.contributor.author Litt, John Charles en_US
dc.date.accessioned 2019-06-12T02:56:26Z
dc.date.available 2019-06-12T02:56:26Z
dc.date.issued 2019-05-22
dc.description © 2019 The Author(s) This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en_US
dc.description.abstract Motivational interviewing (MI) is internationally recognised as an effective intervention to facilitate health-related behaviour change; although, how it is best implemented and maintained in everyday clinical practice is not so clear. The aim of this study is to understand how MI as an intervention can be embedded and sustained in the clinical practice and learning environments. Methods A concurrent iterative mixed methodology was utilised. Data collection occurred in two parts: a scoping review to identify reported barriers and enablers to embedding and sustaining MI in healthcare settings, and a survey of health professionals at an international clinical educator workshop on the topic. Results from both methods were integrated at the analysis phase (‘following a thread’) to understand how MI is embedded and the fidelity sustained in the clinical environments. Complexity theory as a conceptualising framework was utilised. Results Eleven studies were included, and 30 health professionals were surveyed. Sustainability of MI at micro-clinical levels can be fostered through use of enabling technology, focus on patient-centred care, personnel development and process improvement. At the meso-organisational level, developing shared vision, creating opportunities and an organisational culture supportive of continuous learning are relevant issues. At the macro levels, adopting systems thinking and a learning organisation approach is important for sustaining MI. Conclusions In addressing the recognised barriers to embedding and sustaining MI in health service provisions, clinical educators could potentially play a central role as change agents within and across the complex clinical system. en_US
dc.identifier.citation Lim, D., Schoo, A., Lawn, S., & Litt, J. (2019). Embedding and sustaining motivational interviewing in clinical environments: a concurrent iterative mixed methods study. BMC Medical Education, 19(1). https://doi.org/10.1186/s12909-019-1606-y en_US
dc.identifier.doi https://doi.org/10.1186/s12909-019-1606-y en_US
dc.identifier.issn 1472-6920
dc.identifier.uri http://hdl.handle.net/2328/39209
dc.language.iso en en_US
dc.publisher Springer en_US
dc.rights © 2019 The Author(s) en_US
dc.rights.holder The Author(s) en_US
dc.rights.license CC-BY
dc.subject Motivational interviewing en_US
dc.subject Lifestyle counselling en_US
dc.subject Health behaviour change en_US
dc.subject Health education en_US
dc.subject Systems analysis en_US
dc.subject Implementation en_US
dc.subject Barriers en_US
dc.subject Fidelity en_US
dc.title Embedding and sustaining motivational interviewing in clinical environments: a concurrent iterative mixed methods study en_US
dc.type Article en_US
local.contributor.authorOrcidLookup Lim, David: https://orcid.org/0000-0002-2837-0973 en_US
local.contributor.authorOrcidLookup Schoo, Adrian Martinus M: https://orcid.org/0000-0001-9368-0778 en_US
local.contributor.authorOrcidLookup Lawn, Sharon Joy: https://orcid.org/0000-0002-5464-8887 en_US
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