JMIR Publications

ABSTRACT

Background:

Motivational Interviewing (MI) is frequently used to facilitate behavior change. The use of change talk during motivational interviews can predict subsequent behavior change. Yet, no studies have compared the information obtained from traditional face-to-face motivational interviews and computer-mediated motivational interviews or results in the same amount of behavior change.

Objective:

This study investigated if face-to-face motivational-type interviews and computer-mediated motivational-type interviews (MTIs) elicit the same amount of 'change talk' and behavior change when young adults discuss their ambivalence about using marijuana.

Methods:

One hundred and fifty frequent marijuana users, occasional marijuana users, and non-marijuana users participated in the study; all participants reported being at least moderately ambivalent about their current level of marijuana use. Participants were randomly assigned to complete a brief motivational-type interview using either the standard face-to-face format or a computer-mediated format. Amrhein's manual for assessing the presence of 'change talk' and 'sustain talk' was used to code the language produced by respondents in each interview format. Reduction in marijuana use was assessed at a two-month follow-up.

Results:

Word count was significantly higher in face-to-face MTIs than in computer-mediated MTIs (P<0.001). Face-to-face MTIs also elicited significantly more reasons for reducing future marijuana use (i.e., change talk; P=.02) and readiness toward not using marijuana use (i.e., change talk; P=.009), even after controlling for verbosity. However, these latter differences were not statistically significant after employing a conservative Bonferroni correction (P<.004). The strength of an interviewee's statements denoting a commitment to reduce their marijuana use (i.e., change talk) and their subsequent frequency of marijuana use at two-month follow-up were negatively correlated, r=-.41, P<.001. The association between Time 1 change talk and Time 2 marijuana use depended upon the type of motivational interview that participants experienced: face-to-face MTI versus computer-mediated MTI (B=.45, P=.007). A negative binomial regression with a log link function was used to probe this relationship after controlling for two covariates: gender and Time 1 (baseline assessment) marijuana use. Among participants in the face-to-face MTI condition, Time 2 (follow-up) marijuana use decreased as the strength of Time 1 change talk increased, although this finding was not significant (B=-.21, P=.08). Among participants in the computer-mediated MTI condition, however, Time 2 marijuana use was not significantly related to the strength of Time 1 change talk (B=.19, P=.16).

Conclusions:

Computer-mediated motivational type interviews and face-to-face motivational type interviews elicit both change talk and sustain talk, which suggests motivational interviews could potentially be adapted for delivery via text-based computer platforms. Yet, further research is needed to enhance the predictive validity of the type of language obtained via computer-delivered MI.