title: Motivational Interviewing Support for a Behavioral Health Internet Intervention for Drivers with Type 1 Diabetes.
abstract: While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI) intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized toDD.com plus MIvs.DD.com only. The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t176 df= -2.25; p<.03) and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t177 df= -1.69; p<. 10) or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data.
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Ingersoll
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Thomas
authors.initials: T
authors.lastname: Banton
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Gorlin
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Karen
authors.initials: K
authors.lastname: Vajda
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Harsimran
authors.initials: H
authors.lastname: Singh
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Ninoska
authors.initials: N
authors.lastname: Peterson
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Linda
authors.initials: L
authors.lastname: Gonder-Frederick
authors.affiliation: University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cox