Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS).
BACKGROUND
Motivational interviewing (MI) is a collaborative, goal-oriented method to help patients change behaviour. Tools that are often used to measure MI are the motivational interviewing skills code' (MISC), the 'motivational interviewing treatment integrity' (MITI) and the 'behaviour change counselling index' (BECCI). The first two instruments have not been designed to be used in primary healthcare (PHC) settings. The BECCI actually is time-consuming. The motivational interviewing assessment scale (MIAS, 'EVEM' in Spanish) was developed to measure MI in PHC encounters as an alternative to the previous instruments.


OBJECTIVE
To validate MIAS as an instrument to assess the quality of MI in PHC settings.


METHODS
(a)


METHODS
Sixteen experts in MI participated in the design, face and consensus validity, using a Delphi-type methodology. (b)


RESULTS



METHODS
27 PHC centres located in Spain.


METHODS
four experts in MI tested its psychometric properties with 332 video recordings coming from the Dislip-EM study (consultations provided by 37 practitioners).


METHODS
dimensionality, internal consistency, reliability (intra-class correlation coefficient-ICC), sensitivity to change and convergent validity with the BECCI scale.


RESULTS
A 14-item scale was obtained after the validation process. Factor analysis: two factors explained 76.6% of the total variance. Internal consistency, α = 0.99. Reliability: intra-rater ICC = 0.96; inter-rater ICC = 0.97. Sensitivity to change: means before and after training were 23.63 versus 38.57 (P < 0.001). Spearman's coefficient between the MIAS and the BECCI scale was 0.98 (P < 0.001).


CONCLUSIONS
The MIAS is a consistent and reliable instrument to assess the use of MI in PHC settings. [Box: see text].
a CAP Vallcarca , Barcelona , Spain ;
Manuel
M
Campiñez Navarro
b Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Distrito Sanitario Córdoba y Guadalquivir, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba , Córdoba , Spain ;
Luis Ángel
LÁ
Pérula de Torres
c Área Básica de Salud Encants (Maragall) , Institut Catala de la Salut , Barcelona , Spain ;
Josep M
JM
Bosch Fontcuberta
a CAP Vallcarca , Barcelona , Spain ;
Nieves
N
Barragán Brun
d Centro de Salud de Beraun-Errenteria , Donostia , Spain ;
Juan Carlos
JC
Arbonies Ortiz
e Centro de Saúde 'A Milagrosa' , Lugo , Spain ;
Jesús Manuel
JM
Novo Rodríguez
f EAP Colmeiro , Vigo , Spain ;
Julia
J
Bóveda Fontán
a CAP Vallcarca , Barcelona , Spain ;
Remedios
R
Martín Alvarez
g Centro de Salud Lucano, Servicio Andaluz de Salud , Córdoba Spain ;
Jose Antonio
JA
Prados Castillejo
h Universidad del País Vasco , San Sebastián , Spain ;
Gabriela Renée
GR
Rivas Doutreleau
h Universidad del País Vasco , San Sebastián , Spain ;
Carmen
C
Domingo Peña
i UGC La Carlota, Servicio Andaluz de Salud , Córdoba , Spain ;
Jaime Jesús
JJ
Castro Moreno
j UGC Occidente, Servicio Andaluz de Salud , Córdoba , Spain.
Esperanza María
EM
Romero Rodríguez
D002983:Clinical Competence; D003697:Delphi Technique; D005163:Factor Analysis, Statistical; D006801:Humans; D062405:Motivational Interviewing / Q000592:standards*; D015588:Observer Variation; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D011594:Psychometrics; D015203:Reproducibility of Results; D013030:Spain
Motivational interviewing; communication skills; measurement; skills training; validity and reliability