| Literature DB >> 25177533 |
Lars Forsberg1, Hans Wickström1, Håkan Källmén1.
Abstract
In the present work inspectors used Motivational Interviewing (MI) to promote environmentally sustainable behaviour in inspectees. MI is a counselling method with scientific support for various health behaviour changes. Inspectors (n = 32) in four Swedish municipalities received training in MI over a yearlong period. Their MI competency as well as their experience of using MI in routine inspections was monitored over the year. The results showed that inspectors significantly increased their competence in the Empathy variable, defined as accurate listening to inspectees. Inspectors judged MI to be useful in inspections, approximately 5 on the 6-point scale. There were indications that MI may be easier or more appropriate to use in certain inspections than in others.Entities:
Keywords: Behaviour change; Environmental behaviour; Environmental inspections and enforcement; Intervention; Motivational interviewing
Year: 2014 PMID: 25177533 PMCID: PMC4145070 DOI: 10.7717/peerj.508
Source DB: PubMed Journal: PeerJ ISSN: 2167-8359 Impact factor: 2.984
Age, gender and inspection target behaviour under different regulations and codes for inspectors within four municipalities.
| Municipality | All inspectors | Inspection target behaviour under the law and administration of | |||||
|---|---|---|---|---|---|---|---|
| Men | Women | ≤ 35 yrs | ≥ 35 yrs | National food | National environmental | National board of | |
| Ale | 0 | 8 | 1 | 7 | 4 | 4 | |
| Nybro | 6 | 4 | 6 | 4 | 2 | 8 | |
| Älmhult | 2 | 4 | 3 | 3 | 2 | 2 | 2 |
| Östersund | 8 | 8 | 7 | 9 | 5 | 11 | |
| Total | 16 | 24 | 17 | 23 | 13 | 25 | 2 |
Themes for each of the six days of MI-training.
| Training day | MI–theme |
|---|---|
| DAY 1 |
|
| – To understand the meaning of MI | |
| – To listen and engage in conversation | |
| – To convey cooperation and equality | |
| – To direct toward a target behaviour | |
| DAY 2 |
|
| – To recognize, elicit, and strengthen change talk | |
| – To ask open-ended and exploring questions | |
| DAY 3 |
|
| – To inform as a dialogue | |
| – To understand and implement positive and negative reinforcement | |
| – To convey listening by reflecting | |
| DAY 4 |
|
| – To use empathic listening | |
| – To convey that you are listening and trying to understand through reflections | |
| – To use MITI-coding as feedback | |
| DAY 5 |
|
| – To explore readiness to change and ambivalence | |
| – To meet and roll with resistance | |
| – To avoid MI-non-adherent utterances | |
| DAY 6 |
|
| – To summarize what has been gone through at the training | |
| – To form a personal plan for upholding MI-proficiency |
Number of planned and recorded conversations and per cent dropout (number) from planned recordings distributed for each municipality.
| Municipality | All 32 inspectors, including 9 intense recording group members | ||
|---|---|---|---|
| Number of planned | Number of recorded and | Per cent dropout | |
| Ale | 82 | 56 | 32 (26) |
| Nybro | 94 | 67 | 29 (27) |
| Älmhult | 85 | 57 | 33 (28) |
| Östersund | 119 | 109 | 8 (10) |
| Total | 380 | 289 | 24 (91) |
Figure 1Number of coded conversations per training day for 32 inspectors and for 9 inspectors in the intense recording group.
Reliability between three coders estimated in a random sample (n = 28) of 289 recordings.
Intra-class-correlations (ICC) are calculated as mixed models, with absolute agreement, and reported as single measures. Also, percentage agreement (numbers).
| MITI global | Exact agreement | One of the coders is one | One of the coders is two | ICC |
|---|---|---|---|---|
| Empathy | 50% (14) | 43% (12) | 7% (2) | 0.35 |
| Evocation | 39% (11) | 54% (15) | 7% (2) | 0.36 |
| Collaboration | 36% (10) | 57% (16) | 7% (2) | 0.47 |
| Autonomy | 36% (10) | 57% (16) | 7% (2) | 0.53 |
| MI-spirit | 0.67 | |||
| Direction | 46% (13) | 46% (13) | 7% (2) | 0.21 |
| Information | 0.44 | |||
| MI-adherent | 0.52 | |||
| MI-non-adherent | 0.70 | |||
| Closed questions | 0.70 | |||
| Open questions | 0.76 | |||
| Simple reflections | 0.78 | |||
| Complex reflections | 0.22 |
Inspector participation at six training days, submitted questionnaires and per cent questionnaire dropout (numbers).
| Municipality | Number of | Per cent attendance | Submitted | Per cent dropout |
|---|---|---|---|---|
| Ale | 8 | 60 (29) | 23 | 21 (6) |
| Nybro | 10 | 86 (52) | 39 | 25 (13) |
| Älmhult | 6 | 97 (35) | 31 | 11 (4) |
| Östersund | 16 | 100 (117) | 101 | 14 (16) |
| All municipalities | 40 | 233 | 195 | 16 (38) |
MITI global variables for all recordings (n = 289).
Number of recordings per scale value on five-point ordinal Likert scales per MI training occasion. Expected counts in parenthesis.
| Recording MITI | Scale value | 1st training | 2nd | 3rd | 4th | 5th | 6th | After training |
|---|---|---|---|---|---|---|---|---|
| Empathy | 1 | 19 (16.3) | 14 (10.7) | 17 (13) | 12 (13) | 11 (10.7) | 4 (9.6) | 7 (10.7) |
| 2 | 10 (10.7) | 3 (7) | 4 (8.5) | 11 (8.5) | 6 (7) | 11 (6.3) | 10 (7) | |
| >=3 | 0 (1.9) | 2 (1.3) | 2 (1.5) | 0 (1.5) | 2 (1.3) | 2 (1.1) | 2 (1.3) | |
| Chi-square (12) = 23.25, | ||||||||
| Evocation | 1 | 24 (17.2) | 12 (10.7) | 19 (13.5) | 13 (13.7) | 8 (11.5) | 5 (10.1) | 7 (11.3) |
| 2 | 4 (9.4) | 5 (5.8) | 2 (7.5) | 9 (7.5) | 8 (6.2) | 11 (5.5) | 9 (6.2) | |
| >=3 | 1 (2.4) | 1 (1.5) | 2 (1.9) | 2 (1.9) | 3 (1.5) | 1 (1.4) | 3 (1.5) | |
| Chi-square (12) = 29.12, | ||||||||
| Collaboration | 1 | 11 (7.4) | 4 (4.8) | 10 (5.9) | 7 (5.9) | 3 (4.8) | 2 (4.3) | 1 (4.8) |
| 2 | 16 (16.5) | 10 (10.8) | 8 (13.1) | 14 (13.1) | 12 (10.8) | 11 (9.7) | 14 (10.8) | |
| >=3 | 2 (5.1) | 5 (3.3) | 5 (4.0) | 2 (3) | 4 (3.3) | 4 (3.0) | 4 (3.3) | |
| Chi-square (12) = 18.01, | ||||||||
| Autonomy | 1 | 6 (5.7) | 4 (3.5) | 8 (4.5) | 7 (4.5) | 2 (3.7) | 2 (3.3) | 0 (3.7) |
| 2 | 18 (14.7) | 8 (9.1) | 7 (11.7) | 11 (11.7) | 12 (9.6) | 8 (8.6) | 11 (9.6) | |
| >=3 | 5 (8.6) | 6 (5.4) | 8 (6.8) | 5 (6.8) | 5 (5.6) | 7 (5.1) | 8 (5.6) | |
| Chi-square (12)= 16.92, | ||||||||
| Direction | 1 | 0 (0.4) | 1 (0.2) | 1 (0.3) | 0 (0.3) | 0 (1.1) | 0 (0.2) | 0 (0.3) |
| 2 | 3 (1.4) | 1 (0.8) | 2 (2) | 1 (1.1) | 0 (0.9) | 0 (0.8) | 0 (0.9) | |
| >=3 | 26 (27.2) | 16 (16.9) | 21 (22.6) | 22 (21.6) | 19 (17.9) | 17 (16) | 19 (17.9) | |
| Chi-square (12) = 10.94, | ||||||||
MITI behaviour count variables for all recordings (n = 289).
Mean and (standard deviation/sd) per behaviour count variable in MITI and MI training occasion and after the MI training (n = inspectors per training occasion) were calculated.
| Recording MITI | 1st | 2nd | 3rd | 4th | 5th | 6th | After training | |
|---|---|---|---|---|---|---|---|---|
| ( | ( | ( | ( | ( | ( | ( | ||
| Information | mean (ds) | 17.6 (6.0) | 18.5 (8.1) | 15.2 (8.1) | 16.4 (6.0) | 16.5 (8.0) | 13.6 (3.4) | 13.2 (3.6) |
| MI-adherent | mean (ds) | 0.1 (0.2) | 0.1 (0.3) | 0.1 (0.3) | 0.2 (0.3) | 0.3 (0.4) | 0.3 (0.5) | 0.3 (0.4) |
| MI-non-adherent | mean (ds) | 3.8 (3.6) | 2.7 (3.3) | 3.5 (3.2) | 3.3 (2.5) | 2.4 (2.1) | 2.7 (2.6) | 2.0 (1.4) |
| Closed questions | mean (ds) | 12.8 (6.8) | 14.2 (7.2) | 15.0 (7.5) | 13.7 (6.4) | 12.2 (5.6) | 13.0 (4.4) | 15.3 (4.7) |
| Open questions | mean (ds) | 3.7 (3.6) | 4.0 (4.0) | 5.1 (4.0) | 4.0 (3.8) | 4.1 (2.9) | 4.3 (2.7) | 4.0 (3.3) |
| Open question/question ratio | mean (ds) | .28 (.64) | .30 (.72) | .40 (.93) | .38 (.45) | .42 (.35) | .47 (.58) | .31 (.42) |
| Simple reflections | mean (ds) | 6.4 (3.4) | 5.7 (3.9) | 7.6 (6.7) | 7.5 (4.9) | 6.7 (4.7) | 6.6 (1.5) | 6.3 (4.5) |
| Reflection/Question ratio | mean (ds) | .46 (0.29) | .34 (.19) | .40 (.34) | .56 (.39) | .51 (.36) | .52 (.27) | .43 (.27) |