TY - JOUR
T1 - A randomized controlled trial of telephone motivational interviewing to enhance mental health treatment engagement in Iraq and Afghanistan veterans
AU - Seal, Karen H.
AU - Abadjian, Linda
AU - McCamish, Nicole
AU - Shi, Ying
AU - Tarasovsky, Gary
AU - Weingardt, Kenneth
N1 - Funding Information:
Funding support: This work was funded by a grant from the Department of Veterans Affairs (VA), Clinical Sciences Research and Development (award no. MN078889-01 ) and by the VA Health Services Research and Development (HSR&D) Research Enhancement Award Program at the San Francisco VA Medical Center .
PY - 2012/9
Y1 - 2012/9
N2 - Objective: To test the efficacy of telephone-administered motivational interviewing (MI) to enhance treatment engagement in Iraq and Afghanistan veterans with mental health (MH) problems. Method: Between April 23, 2008, and February 25, 2011, 73 Iraq and Afghanistan veterans who screened positive for ≥ 1 MH problem(s) on telephone-administered psychometric assessment, but were not engaged in treatment, were randomized to either personalized referral for MH services and four sessions of telephone MI or standard referral and four neutral telephone check-in sessions (control) at baseline, 2, 4 and 8 weeks. Blinded assessment occurred at 8 and 16 weeks. Results: In intent-to-treat analyses, 62% assigned to telephone MI engaged in MH treatment compared to 26% of controls [relative risk (RR)=2.41, 95% confidence interval (CI)=1.33-4.37, P=.004], which represented a large effect size (Cohen's h=0.74). Participants in the MI group also demonstrated significantly greater retention in MH treatment than controls [MI mean visits (S.D.)=1.68 (2.73) and control mean visits (S.D.)=0.38 (0.81), incidence rate ratio (IRR)=4.36, 95% CI=1.96-9.68, P<.001], as well as significant reductions in stigma and marijuana use at 8 weeks (P<.05). Conclusions: Telephone MI enhances MH treatment engagement in Iraq and Afghanistan veterans with MH problems.
AB - Objective: To test the efficacy of telephone-administered motivational interviewing (MI) to enhance treatment engagement in Iraq and Afghanistan veterans with mental health (MH) problems. Method: Between April 23, 2008, and February 25, 2011, 73 Iraq and Afghanistan veterans who screened positive for ≥ 1 MH problem(s) on telephone-administered psychometric assessment, but were not engaged in treatment, were randomized to either personalized referral for MH services and four sessions of telephone MI or standard referral and four neutral telephone check-in sessions (control) at baseline, 2, 4 and 8 weeks. Blinded assessment occurred at 8 and 16 weeks. Results: In intent-to-treat analyses, 62% assigned to telephone MI engaged in MH treatment compared to 26% of controls [relative risk (RR)=2.41, 95% confidence interval (CI)=1.33-4.37, P=.004], which represented a large effect size (Cohen's h=0.74). Participants in the MI group also demonstrated significantly greater retention in MH treatment than controls [MI mean visits (S.D.)=1.68 (2.73) and control mean visits (S.D.)=0.38 (0.81), incidence rate ratio (IRR)=4.36, 95% CI=1.96-9.68, P<.001], as well as significant reductions in stigma and marijuana use at 8 weeks (P<.05). Conclusions: Telephone MI enhances MH treatment engagement in Iraq and Afghanistan veterans with MH problems.
KW - Motivational interviewing
KW - Posttraumatic stress disorder
KW - Treatment engagement
KW - Trial
KW - War veterans
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U2 - 10.1016/j.genhosppsych.2012.04.007
DO - 10.1016/j.genhosppsych.2012.04.007
M3 - Article
C2 - 22632925
AN - SCOPUS:84865351525
SN - 0163-8343
VL - 34
SP - 450
EP - 459
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 5
ER -
