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Member Research & Reports

Member Research & Reports

Brown: Using Topic Coding to Understand the Nature of Change Language in a Motivational Intervention to Reduce Alcohol and Sex Risk Behaviors in Emergency Department Patients

Dr. Christopher W. Kahler, professor and chair in the department of behavioral and social sciences in the Brown University School of Public Health, and colleagues developed a novel coding system to characterize topics of patient speech in a motivational intervention targeting alcohol and HIV/sexual risk in 90 Emergency Department patients and found that topic coding provided unique insights into the content of patient change and sustain talk. The work is published in Patient Education and Counseling.

[Photo: Dr. Christopher W. Kahler]

Coding patient language during health behavior counseling is an emerging method for understanding mechanisms responsible for behavior change, a necessary step for improving health behavior counseling. Typically, behavior change counseling covers a range of topics including a patient’s pattern of behavior, consequences of that behavior and of behavior change, barriers and facilitators of change, and change plans. This study by Brown University School of Public Health researchers examined how topics of discussion in a health behavior intervention relate to patient change language across two target behaviors, alcohol use and sex risk.

This study demonstrated application of the newly developed Generalized Behavioral Intervention Analysis System (GBIAS) to the coding of sessions of an efficacious MI intervention that reduced both alcohol use and sexual risk behaviors. The results provide insights counselors can consider when discussing alcohol use and sex. For both behaviors, discussion focusing on potential behavior change and its benefits is likely to include change talk and rarely results in sustain talk; therefore counselors may want to guide more discussion toward these topics. Likewise, counselors may consider how much discussion should focus on positive aspects of alcohol use; although such discussion provides valuable understanding of patients’ motivations, it also is the greatest source of sustain talk. Furthermore, counselors discussing sex risk should be prepared to address the potential drawbacks of protective sexual behaviors and negation of the risk of ongoing sexual behaviors since these are common sources of sustain talk. Future research can aid further refinement of targeted discussion in multi-target brief intervention by examining which counselor behaviors are most effective in eliciting talk supporting change. The study was published May 2016 in Patient Education and Counseling.

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