The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review

Abstract

Motivational interviewing (MI) is a patient-centred approach to behaviour change that was originally developed in the addiction field but has increasingly been applied to public health settings with a focus on health promotion. The purpose of this review was to examine the evidence base for MI interventions in primary care settings with non-clinical populations to achieve behaviour change for physical activity, dietary behaviours and/or alcohol intake. We also sought to explore the specific behaviour change techniques included in MI interventions within primary care. Electronic databases were searched for relevant articles and 33 papers met inclusion criteria and were included. Approximately 50% of the included studies (n = 18) demonstrated positive effects in relation to health behaviour change. The efficacy of MI approaches is unclear given the inconsistency of MI descriptions and intervention components. Furthermore, research designs that do not isolate the effects of MI make it difficult to determine the effectiveness of such approaches. We offer a number of recommendations for researchers and practitioners seeking to include MI within behaviour change interventions to help improve the quality of the research and the effectiveness of MI-based interventions within primary care settings.

Keywords:

• motivational interviewing
• systematic review
• behaviour change
• physical activity
• dietary behaviour
• alcohol intake
• primary care

Notes

1. Alcohol dependence is defined as a primary, chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations (Morse & Flavin, 1992). It is a physical addiction to alcohol whereby one continues to drink despite problems with physical health, mental health and social, family or job responsibilities. We excluded studies in which participants had screened for alcohol dependence (alcoholism). Although alcohol intake may cause problems (alcohol abuse) it is not a physical addiction.

2. This is because (i) there are existing reviews of MI for the treatment of addictive behaviours and substance abuse (e.g., Dunn et al., 2001), (ii) less is known about effectiveness of MI for non-clinical populations that present in primary care settings and (iii) the goal of the review was to examine the efficacy of MI for health behaviour change with a goal of prevention rather than treatment of ‘addictive behaviours’.