Effectiveness of Motivational Interviewing for Improving Self-Care Among Northern Plains Indians With Type 2 Diabetes

Abstract

A study was conducted to assess the utility of motivational interviewing techniques to improve management of type 2 diabetes among residents of an American Indian reservation. A convenience sample of participants was recruited at an Indian Health Service diabetes clinic (n = 26). Random blood glucose, A1C, and demographic variables for the 6 months before baseline were collected via chart review; data on random blood glucose, A1C, demographic variables, health-related behaviors, and psychological self-report instruments were collected at baseline and 3 months after intervention. The intervention consisted of two individual, 30-minute sessions of motivational interviewing (MI) delivered over 3 weeks. Significant improvements in participants' self-reported depressive symptoms, genetic/racial fatalism, treatment satisfaction, and social/vocational worry were observed. Stepwise regression revealed seven predictors of change in A1C from baseline to study end: completion of the study, total blood quantum, change in A1C from 6 months before baseline to baseline, and change in provider trust, treatment acceptance, depression, and reported hours of exercise per week from baseline to study completion. The final analysis had an R2 value of 0.896, accounting for 89.6% of the variance in A1C change. This pilot study provides preliminary support for the utility of MI techniques in diabetes care among American Indians.