Anne R Wilson1, Karen A Fehringer2, William G Henderson3, Kamilla Venner4, Jacob Thomas3, Maya M Harper2, Terrence S Batliner2, Judith Albino2. 1. Department of Pediatric Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 2. Centers of American Indian and Alaska Native Health, Center for Native Oral Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 3. Children's Outcomes Research, Colorado Health Outcomes Programs, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 4. Department of Psychology, Center on Alcoholism, Substance Abuse and Addiction (UNM CASAA), University of New Mexico, Albuquerque, NM, USA.
Abstract
OBJECTIVES: Assess fidelity of a motivational interviewing (MI) intervention focused on preventing early childhood caries in a cohort of American Indian mothers with newborns. METHODS: Four interventionists were trained to administer an oral health MI intervention. The MI sessions were audio recorded to enable scoring as part of fidelity studies to assess the interventionist's degree of competence in using MI principles. Evaluation of the interventionists was completed using the Motivational Interviewing Treatment Integrity (MITI) 3.1.1. which assesses global ratings and behaviour counts. Two reviewers evaluated and scored the MI sessions; a random sample of twenty per cent of the total interviews was scored by a trained reviewer and fifty per cent of the randomly selected files scored by an external expert. A total of 225 files were coded by the trained reviewer and 121 files by the external expert. RESULTS:Mean global scores for all interventionists combined were around 4.0 (expert competence). Scores for reflection to question ratios (around 0.6) were below beginner competence. Scores ranged from beginner to expert competence for open-ended questions (54%-56%), complex reflections (38%-43%) and MI-adherent statements (93%-95%). There was variation in competence for the four interventionists when analysed individually. Inter-rater reliability scores for the two reviewers ranged from fair (0.40-0.59) to good (0.60-0.74). The MI interventionist rated the best in the fidelity assessment had the worst study outcomes compared to other interventionists. CONCLUSIONS: Individual interventionists' scores for the MITI global ratings and behaviour counts reflected variation in competence and ranged from below beginner to expert levels. A higher competence level of the interventionist as assessed by the fidelity study was not related to better study outcomes.
RCT Entities:
OBJECTIVES: Assess fidelity of a motivational interviewing (MI) intervention focused on preventing early childhood caries in a cohort of American Indian mothers with newborns. METHODS: Four interventionists were trained to administer an oral health MI intervention. The MI sessions were audio recorded to enable scoring as part of fidelity studies to assess the interventionist's degree of competence in using MI principles. Evaluation of the interventionists was completed using the Motivational Interviewing Treatment Integrity (MITI) 3.1.1. which assesses global ratings and behaviour counts. Two reviewers evaluated and scored the MI sessions; a random sample of twenty per cent of the total interviews was scored by a trained reviewer and fifty per cent of the randomly selected files scored by an external expert. A total of 225 files were coded by the trained reviewer and 121 files by the external expert. RESULTS: Mean global scores for all interventionists combined were around 4.0 (expert competence). Scores for reflection to question ratios (around 0.6) were below beginner competence. Scores ranged from beginner to expert competence for open-ended questions (54%-56%), complex reflections (38%-43%) and MI-adherent statements (93%-95%). There was variation in competence for the four interventionists when analysed individually. Inter-rater reliability scores for the two reviewers ranged from fair (0.40-0.59) to good (0.60-0.74). The MI interventionist rated the best in the fidelity assessment had the worst study outcomes compared to other interventionists. CONCLUSIONS: Individual interventionists' scores for the MITI global ratings and behaviour counts reflected variation in competence and ranged from below beginner to expert levels. A higher competence level of the interventionist as assessed by the fidelity study was not related to better study outcomes.
Authors: Anne Wilson; Angela G Brega; Terrence S Batliner; William Henderson; Elizabeth J Campagna; Karen Fehringer; Joaquin Gallegos; Dallas Daniels; Judith Albino Journal: J Public Health Dent Date: 2013-10-09 Impact factor: 1.821
Authors: Anne R Wilson; Angela G Brega; Elizabeth J Campagna; Patricia A Braun; William G Henderson; Lucinda L Bryant; Terrence S Batliner; David O Quissell; Judith Albino Journal: Pediatr Dent Date: 2016 Jan-Feb Impact factor: 1.874
Authors: Jessica Merrick; Alwin Chong; Eleanor Parker; Kaye Roberts-Thomson; Gary Misan; John Spencer; John Broughton; Herenia Lawrence; Lisa Jamieson Journal: BMC Public Health Date: 2012-05-02 Impact factor: 3.295
Authors: Terrence Batliner; Karen A Fehringer; Tamanna Tiwari; William G Henderson; Anne Wilson; Angela G Brega; Judith Albino Journal: Trials Date: 2014-04-14 Impact factor: 2.279
Authors: T S Batliner; T Tiwari; W G Henderson; A R Wilson; S E Gregorich; K A Fehringer; A G Brega; E Swyers; T Zacher; M M Harper; K Plunkett; W Santo; N F Cheng; S Shain; M Rasmussen; S M Manson; J Albino Journal: JDR Clin Trans Res Date: 2018-07-12