Fidelity of motivational interviewing in an early childhood caries intervention involving indigenous Australian mothers

Abstract

Objectives. This paper assessed the fidelity of an early childhood caries MI intervention among Aboriginal mothers in South Australia. Methods. Four MI-trained staff delivered the intervention and all interviews were recorded. A randomly selected subset (n = 164, 41.2%) were tested for MI fidelity using the Motivational Interviewing Treatment Integrity (MITI) code 3.1.1. A further randomly selected 20 taped sessions were additionally scored by an external expert to assess external reliability. Results. Mean scores for evocation, collaboration, autonomy/support, direction and empathy ranged from 3.5 (95% CI 3.4–3.7) to 4.1 (95% CI 4.0–4.2). The mean global score was 3.8 (95% 3.7–3.9). The Reflection:Question ratio was 0.9 (95% CI 0.8–1.0), % Open-ended Questions was 54.9 (95% CI 50.0–59.8), % Complex Reflections was 54.0 (95% CI 50.5–57.5) and % MI-adherent statements was 95.0 (95% CI 92.0–98.0). Inter-assessor reliability was high. Conclusions. Beginner to expert competency in fidelity to the MI model was observed.