title: Teaching motivational interviewing to primary care staff in the Veterans Health Administration.
abstract: BACKGROUND
  The Veterans Health Administration (VHA) is implementing the patient-centered medical home (PCMH) model of primary care which emphasizes patient-centered care and the promotion of healthy lifestyle changes. Motivational Interviewing (MI) is effective for promoting various health behaviors, thus a training protocol for primary care staff was implemented in a VHA health care setting.
  
  
  OBJECTIVE
  We examined the effect of the training protocol on MI knowledge, confidence in ability to use MI-related skills and apply them to written vignettes, perceived comfort level and skill in lifestyle counseling, and job-related burnout.
  
  
  METHODS
  Training was provided by experts in MI. The training protocol consisted of three sessions--one half day in-person workshop followed by a 60-minute virtual training, followed by a second workshop. Each of the sessions were spaced two weeks apart and introduced trainees to the theory, principles, and skills of using MI in health care settings.
  
  
  METHODS
  All primary care staff at the Veterans Affairs Palo Alto Health Care System were invited to participate.
  
  
  METHODS
  Trainees completed a short set of questionnaires immediately before and immediately after the training.
  
  
  RESULTS
  We found support for our primary hypotheses related to knowledge, confidence, and written responses to the vignettes. Changes in perceived comfort level and skill in lifestyle counseling, and job-related burnout were not observed.
  
  
  CONCLUSIONS
  Training primary care staff in MI is likely to become increasingly common as health care systems transition to the PCMH model of care. Therefore, it is important for health care systems to have low-cost methods for evaluating the effectiveness of such trainings. This study is a first step in developing a brief written assessment with the potential of measuring change in a range of behaviors and skills consistent with MI.
authors.affiliation: Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA 94025, USA. michael.cucciare@va.gov
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cucciare
authors.forename: Nicole
authors.initials: N
authors.lastname: Ketroser
authors.forename: Paula
authors.initials: P
authors.lastname: Wilbourne
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Midboe
authors.forename: Ruth
authors.initials: R
authors.lastname: Cronkite
authors.forename: Steven M
authors.initials: SM
authors.lastname: Berg-Smith
authors.forename: John
authors.initials: J
authors.lastname: Chardos
mesh_terms: D006282:Health Personnel / Q000193:education*; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D009042:Motivation; D018802:Patient-Centered Care / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D011369:Professional-Patient Relations; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health / Q000193:education*