4.5 Review

Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors

Journal

PROGRESS IN CARDIOVASCULAR DISEASES
Volume 77, Issue -, Pages 86-94

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.pcad.2023.02.003

Keywords

Motivational interviewing; Brief action planning; Self -management support; Health behavior change; Lifestyle medicine

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Lifestyle medicine practice can be improved by utilizing interpersonal communication skills such as motivational interviewing and brief action planning. Motivational interviewing involves engaging, focusing, evoking motivation, and planning for change, all conducted in a compassionate, accepting, and empowering environment. Brief action planning utilizes a pragmatic algorithmic approach, using SMART action planning, patient commitment statements, confidence scaling, problem-solving, patient accountability, and follow-up.
Lifestyle medicine practice can be enhanced with interpersonal communication skills to help patients adopt and maintain positive health behaviors, such as improving diet or initiating exercise. We review two approaches that in-corporate evidenced-based skills for this purpose: motivational interviewing and brief action planning (BAP). Motivational interviewing involves four processes conducted in a climate of compassion, acceptance, partnership, and empowerment. First, engaging (or connecting) with patients uses the relational skills of active listening and empathic communication. Second, focusing elicits patients' full spectrum of concerns, expectations, and desires to negotiate a collaborative agenda. Third, evoking motivation, utilizes uniquely innovative skills (e.g., softening sustain talk and cultivating change talk) to increase intrinsic motivation of patients with ambivalence (or resis-tance) to become more open to choosing healthier behaviors for themselves. Fourth, planning for change, uses collaborative goal-setting skills to help patients specify concrete action plans for health. To this end, brief action planning (BAP) has been developed as a specific pragmatic algorithmic approach, utilizing collaborative SMART (specific, measurable, achievable, relevant, and time-based) action planning, encouragement of patient commitment statements, scaling for confidence, problem-solving to reduce barriers for change, fostering patient accountability, and emphasizing follow-up. BAP can be introduced at any point in a patient encounter when patients are ready or nearly ready for change.& COPY; 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

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