Using Motivational Interviewing in a worksite translation of the Diabetes Prevention Program

Motivational Interviewing (MI) is a counseling approach that explores and elicits a person’s motivation for change. MI is increasingly used in weight-loss interventions, including the Diabetes Prevention Program, but little information is available on the way that MI was used in such programs.  This presentation will describe the systematic way in which Motivational Interviewing was incorporated into a worksite translation of DPP, describe how the use of MI was evaluated, and make recommendations for the its use in weight-loss interventions.

FUEL Your Life is a weight-loss program that uses scripted sessions with health coaches in small group and telephone-delivered formats. FYL sessions were built around the foundational concepts of MI (collaboration, evocation, autonomy, and rolling with resistance). The basic methods of MI (open-ended questions, affirmations, reflective listening, and summaries) were purposely incorporated into the scripts. For example, opportunities to evoke feedback from participants and to facilitate goal setting were included in every session. Health coaches were trained in MI and to recognize opportunities for its use.

Randomly selected sessions were observed by the research staff to evaluate the use of MI.  A total of 1382 group and phone sessions were held and 119 of these sessions (49 group, 70 telephone) were evaluated for use of MI, active listening, goal-setting and problem-solving. Coaches met expectations in 86% of sessions. Health coaches received feedback and training as a result of the observations, and over time scores improved. Practice, experience, and feedback for health coaches improve the use of MI in a weight loss intervention.