The Change Questionnaire predicts change in hazardous tobacco and alcohol use.
BACKGROUND
Assessing motivation for change is deemed an important step in the treatment process that allows further refinement of the intervention in motivational interviewing (MI) and brief MI (BMI) adaptations. During MI (and BMI) sessions, motivation for change is expressed by the client as "change talk", i.e. all statements inclined toward or away from change. We tested the predictive validity of the Change Questionnaire, a 12-item instrument assessing motivation to change, on hazardous tobacco and alcohol use.


METHODS
As part of the baseline measurements for a randomized controlled trial on multi-substance BMI at the Lausanne recruitment center (army conscription is mandatory in Switzerland for males at age 20, and thus provides a unique opportunity to address a non-clinical and largely representative sample of young men), 213 participants completed the questionnaire on tobacco and 95 on alcohol and were followed-up six months later. The overall Change Questionnaire score and its six subscales (Desire, Ability, Reasons, Need, Commitment, and Taking steps) were used as predictors of hazardous tobacco use (defined as daily smoking) and hazardous alcohol use (defined as more than one occasion with six standard drinks or more per month, and/or more than 21 standard drinks per week) in bivariate logistic regression models at follow-up.


RESULTS
Higher overall Change scores were significant predictors of decreased risk for hazardous tobacco (odds ratio [OR] = 0.83, p = 0.046) and alcohol (OR = 0.76, p = 0.03) use. Several sub-dimensions were associated with the outcomes in bivariate analyses. Using a principal components analysis to reduce the number of predictors for multivariate models, we obtained two components. 'Ability to change' was strongly related to change in hazardous tobacco use (OR = 0.54, p < 0.001), the second we interpreted as 'Other change language dimensions' and which was significantly related to change in hazardous alcohol use (OR = 0.81, p = 0.05).


CONCLUSIONS
The present findings lend initial support for the predictive validity of the Change Questionnaire on hazardous tobacco and alcohol use, making it an interesting and potentially useful tool for assessing motivation to change among young males.
Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Avenue de Beaumont 21bis - Pavillon 2, 1011 Lausanne, Switzerland. Jacques.Gaume@chuv.ch
Jacques
J
Gaume
Nicolas
N
Bertholet
Jean-Bernard
JB
Daeppen
Gerhard
G
Gmel
D000428:Alcohol Drinking / Q000523:psychology*; D006801:Humans; D008297:Male; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods; D040242:Risk Reduction Behavior; D012907:Smoking / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
Alcohol; Change Questionnaire; Change language; Motivational interviewing; Tobacco