Motivational Interviewing for Stroke

Motivational Interviewing to Improve Outcomes After Stroke or Transient Ischemic Attack Attributable to Tobacco Use

Motivational interviewing (MI) is a style of communication designed to elicit a person's own reasons for change to drive commitment toward a goal. The goal of this study is to assess the effect of trainee-led MI on patients diagnosed with acute stroke or TIA attributable to modifiable risk factors in comparison to conventional post-stroke counseling, based on patient outcomes, and meaning of work and sense of fulfillment for trainees.

Study Overview

• Status: Terminated
• Conditions: Transient Ischemic Attack; Acute Stroke
• Intervention / Treatment: Behavioral: Motivational Interview

• Study Type: Interventional
• Enrollment (Actual): 1
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Florida
    • Gainesville, Florida, United States, 32608
      • University of Florida

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient presentation consistent with a stroke or TIA
• Patient is a current tobacco user and tobacco use contributed to the stroke
• Resident enrolled in study assigned to Vascular Neurology service during patient admission.

Exclusion Criteria:

• Patient unable or unwilling to follow up in the outpatient stroke clinic after discharge
• Patient has cognitive impairment or aphasia that would preclude meaningful participation in motivational interview (defined as a score of 0 on the National Institute of Health Stroke Scale [NIHSS] questions 1 and 9)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Motivational Interview; Patients included in the study who are being treated by a resident in the MI intervention group will have a motivational interview during their initial hospitalization.	Behavioral: Motivational Interview; The motivational interview (MI) is a 10-15 minute patient-centered conversation which will focus on tobacco use. Multiple communication strategies can be employed during the MI, including open-ended questions, affirmative statements, reflective listening, use of a 'confidence ruler', and summarizing. The 'confidence ruler' technique in this patient population involves asking the patient "On a scale of zero to ten, how confident are you that you can stop using tobacco?", and then requesting further information about why they selected a certain number. These communication strategies and techniques are designed to uncover and foster a patient's own internal motivations to change the target behavior.
No Intervention: Control; Patients included in the study who are being treated by a resident in the Control group will not have a motivational interview during their hospitalization.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Smoking cessation at 90-day post-discharge follow up	Yes or no	90 days post-discharge
Patient rating of ability to improve their health	Patient answers question "I am confident that I can work together with my care team to improve my health" with a rating from 1 (do not agree at all) to 10 (completely agree)	90 days post-discharge
Recurrence of stroke / TIA symptoms	Yes or no	90 days post-discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient ability to take stroke prevention medications as prescribed	Yes or no	90 days post-discharge

Collaborators and Investigators

• Sponsor: University of Florida
• Collaborators: Accreditation Council for Graduate Medical Education
• Investigators: Principal Investigator: Christina Wilson, MD PhD, University of Florida

Study record dates

Study Major Dates

• Study Start (Actual): December 20, 2023
• Primary Completion (Actual): December 20, 2023
• Study Completion (Actual): January 1, 2024

Study Registration Dates

• First Submitted: December 21, 2023
• First Submitted That Met QC Criteria: January 5, 2024
• First Posted (Actual): January 8, 2024

Study Record Updates

• Last Update Posted (Actual): August 21, 2024
• Last Update Submitted That Met QC Criteria: August 19, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Ischemia; Stroke; Ischemic Attack, Transient
• Other Study ID Numbers: IRB202201687

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No