Description
ackground: Motivational Interviewing (MI) involves interviewing a person in an autonomy-supporting, person-centered, encouraging way, eliciting the individuals internal change motivations. Thirteen modified Cochrane method (MCM) systematic reviews of MI impact on outcomes included varied populations, interventionist types, and target outcomes with a lens for whether MI training of interventionists was reported and/or met evidence-based MI training guidelines. The objective of this study was to review MI training reported in 126 retained articles across MCM MI reviews and describe level of evidence-based MI training reported. Methods: Each MCM review, published between 2012 to present, aimed to explore and report evidence and gaps in the literature for a broad research question about MI impact on outcome(s), focusing on a specific outcome (medication adherence) or the spectrum of outcomes. Each review assessed articles methodological quality using Cochranes Risk of Bias tool. Evidence-based guidelines for MI training as indicated by MI originator, William Miller, and other noted MI training scholars, defined levels of evidence-based training. Ratings were from 0 to 4, with 0 meaning no mention of MI training, and 4 equaling report of full evidence-based methods (the equivalent of a two-day MI workshop with conceptual and skills development activities including 2 rounds of MI role play with feedback and coaching). Results: The 126 total articles included 110 RCTs and 16 other experimental designs. A majority were rated with moderate risk of bias. Populations included adolescents or adults across varied conditions, delivery modes, with 35 primarily or secondarily assessing medication adherence. Articles per MI training level: level 0=29, level 1=55, level 2=7, level 3=23, level 4=12. MI fidelity assessment was reported by 36 articles. Discussion/conclusions: Twice as many studies had 0 or 1 ratings (n =84) as those having 2-4 (n = 42). These results suggest that either MI training was mostly underreported or not conducted. According to the literature, achieving 90% MI-consistency after training is required to impact outcomes. Adequate MI training and intervention fidelity assessment are critical to claims for validity of MI outcomes-impact. Inadequate report of MI training calls to question the validity of MI as the impact factor in outcomes.
Publication Info
2026.