Patient attitudes towards change in adapted motivational interviewing for substance abuse: a systematic review

Figures & data

Figure 1 Flow chart depicting study inclusion.

Note: Some articles report multiple results and therefore appear in multiple categories.
Abbreviations: AMI, adapted motivational interviewing; NOS, Newcastle-Ottawa Quality Assessment Scale; RCT, randomized controlled trial.

Table 1 Newcastle-Ottawa Scale (NOS) quality assessment scoring for included studies

Article	NOS overall score
	1	2	3	4	5	6	7	8	9
Carroll^Citation39			*
Alemagno^Citation40				*
Baker^Citation41				*
Dench^Citation42				*
Longshore^Citation43				*
McKee^Citation44				*
Swanson^Citation45				*
D’Amico^Citation46					*
Davis^Citation47					*
Carey^Citation48					*
LaChance^Citation49					*
Otiashvili^Citation50					*
Saunders^Citation51					*
Bellack^Citation52						*
Booth^Citation53						*
Borsari^Citation54						*
Brown^Citation55						*
Carey^Citation56						*
Carroll^Citation57						*
Carroll^Citation58						*
Freyer-Adam^Citation8						*
Fromme^Citation9						*
Goti^Citation59						*
Ingersoll^Citation60						*
Kidorf^Citation61						*
Maisto^Citation62						*
Mason^Citation63						*
McCambridge^Citation64						*
Montgomery^Citation65						*
Ondersma^Citation66						*
Orford^Citation67						*
Osterman^Citation68						*
Robles^Citation69						*
Stein^Citation70						*
Stotts^Citation71						*
Ball^Citation72							*
Brown^Citation13							*
Mastroleo^Citation73							*
Monti^Citation74							*
Mullins^Citation75							*
Stein^Citation76							*
Stein^Citation77							*
Walters^Citation78							*
Barrowclough^Citation79								*
Dennis^Citation80								*
Naar-King^Citation81								*
Peterson^Citation82								*
Project MATCH^Citation83								*
Rohsenow^Citation84								*
Wain^Citation85								*
Walker ^Citation86								*
Walton^Citation87								*
Winhusen^Citation88								*
Project MATCH^Citation89									*

Table 2 Included studies examining attitudes towards change as a moderator of the impact of AMI on substance abuse

Reference	N	Conditions	Population	Follow-up period	Attitude	Attitude assessment	Substance abuse assessment	Direction of effecta	Effect sizeb
Mastroleo^Citation73	225	AMI/CTL	Mandated college students	3 months	RTC	Contemplation ladder	Number of heavy drinking days or drinkers per drinking day measured by the TLFB	Null	NA
Peterson^Citation82	285	AMI/CTL	Homeless adolescents	1 and 3 months	Personal engagement	Counselor assessment	Drug use measured by the TLFB	Negative	Small/medium
Project MATCH Research Group^Citation83	785	AMI/CTL	Outpatients and aftercare patients	36 months	Self-efficacy	Alcohol Abstinence Self-Efficacy Scale	Drinks per drinking day measured by the TLFB and Comprehensive Drinker Profile	Negative	NC
Rohsenow^Citation84	165	AMI/CTL	Cocaine-dependent patients	12 months	Motivation	CCAQ	Number of cocaine use days measured by the TLFB	Positive	Medium/large
Walters^Citation78	279	AMI/AMI without feedback/CTL	Heavy drinking college students	3 and 6 months	RTC	SOCRATES	Drinking measured by the DDQ	Null	NA
Walton^Citation87	575	AMI /CTL	At-risk drinkers in the ER	3 and 12 months	Self-efficacy	One question related to self-efficacy	Questions related to alcohol consumption and frequency	Null	NA
					RTC	Two questions related to readiness to change	Questions related to alcohol consumption and frequency	Null	NA
					Personal attributions	Question related to attribution of alcohol to injury	Questions related to alcohol consumption and frequency	Negative	Small/medium

Note:

a Positive effect refers to changes in attitude and drinking in the same direction, negative effect refers to changes in attitude and drinking in the opposite direction, and null effect refers to no statistically significant moderation effect

b Small effect size = 0.2, medium effect size = 0.5, and large effect size = 0.8.

Abbreviations: AMI, adapted motivational interviewing; CTL, control; RTC, readiness to change; TLFB, timeline follow back; NA, not applicable; NC, not calculated; CCAQ, Cocaine Change Assessment Questionnaire; SOCRATES, Stage of Change Readiness and Treatment Eagerness Scale; DDQ, Daily Drinking Questionnaire; ER, emergency room.

Table 3 Included studies examining AMI’s impact on attitudes towards changing substance abuse

Reference	N	Conditions	Population	Follow-up period	Attitude	Attitude assessment	Direction of effecta	Effect sizeb
Ball^Citation72	461	AMI/CTL	Outpatients at substance abuse programs	16 weeks	Treatment retention	Treatment utilization form	Null	NA
Barrowclough^Citation79	327	AMI+CBT/CTL	Patients with comorbid psychosis and substance use	6, 12, 18, and 24 months	RTC	RTC	Positive	NC
					Perceived negative consequences	DrlnC	Null	NA
Brown^Citation13	184	AMI/CTL	Driving While Impaired Recidivists	6 and 12 months	RTC	RTCQ	Null	NA
					Treatment seeking	Questions related to treatment utilization	Null	NA
Dennis^Citation80	448	AMI/CTL	Adults presenting for substance abuse treatment	3 and 24 months	Treatment adherence	Total days of received treatment	Positive	Small/medium
Monti^Citation74	198	AMI/CTL	ER patients	6 and 12 months	Treatment seeking	Questions assessing alcohol treatment in the past year	Null	NA
Mullins^Citation75	71	AMI/CTL	Pregnant substance abusers	2 months	Treatment retention	Proportion of group meetings attended	Null	NA
Naar-King^Citation81	186	AMI/CTL	Youth living with HIV	3, 6, and 9 months	RTC	Readiness Ruler	Positive	Small/medium
					Self-efficacy	Temptation scales	Null	NA
Rohsenow^Citation84	165	AMI/CTL	Cocaine-dependent patients	12 months	Pros and cons of using cocaine	The Cocaine Decisional Balance Scale	Positive	Small/medium
Stein^Citation77	198	AMI/CTL	Cocaine users	1, 3, and 6 months	Treatment entry	Question related to entry into drug treatment	Null	NA
Wain^Citation85	75	AMI/CTL	Homeless and substance-dependent veterans	6 months	Treatment initiation	Program entry	Positive	Medium/large
					RTC	Alcohol Readiness to Change Scale	Null	NA
					Self-efficacy	Situational ConfidenceQuestionnaire	Positive	Large
Walker^Citation86	310	AMI/CTL (immediate/delay)	Non-treatment seeking adolescent cannabis users	3 and 12 months	Treatment attendance	Global Appraisal of Individual Needs-I	Null	NA
Winhusen^Citation88	200	AMI/CTL	Pregnant substance abusers	1 month	Treatment utilization	Ratio of number of treatment hours scheduled versus attended	Null	NA

Notes:

a Positive effect refers to an increase in attitudes, negative effect refers to a decrease in attitudes, and null effect refers to no statistically significant difference between conditions

b Small effect size = 0.2, medium effect size = 0.5, and large effect size = 0.8.

Abbreviations: AMI, adapted motivational interviewing; CTL, control; NA, not applicable; CBT, cognitive behavioural therapy; RTC, readiness to change; RTCQ, Readiness to Change Questionnaire; NC, not calculated; Drlnc; Drinker Inventory of Consequences; ER, emergency room.

Table 4 Included studies examining attitudes towards change as a mediator of the impact of AMI on substance abuse

Reference	N	Conditions	Population	Follow-up period	Attitude	Attitude assessment	Substance abuse assessment	Direction of effecta
Stein^Citation76,b	417	AMI/AMI + booster/CTL	Hazardous drinkers in the ER	3-and 12-months	RTC	Contemplation Ladder	Negative consequence measured by the DrInC	Negative
Walters^Citation78	279	AMI with feedback/AMI without feedback/CTL	Heavy drinking college students	6 months	Norm perceptions	Questions related to perceptions of US college student drinking	Drinking measured by the DDQ	Positive

Notes:

a Positive effect refers to changes in attitude and drinking in the same direction, and negative effect refers to changes in attitude and drinking in the opposite direction

b moderated mediation.

Abbreviations: AMI, adapted motivational interviewing; CTL, control; ER, emergency room; RTC, readiness to change; DrInC, Drinker Inventory of Consequences; DDQ, Daily Drinking Questionnaire.

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