Rural healthcare providers question the practicality of motivational interviewing and report varied physical activity counseling experience

OBJECTIVE: To evaluate rural healthcare providers (HCP) physical activity (PA) counseling experiences and perceptions of motivational interviewing (MI), a behavioral counseling style, prior to MI training. METHODS: Four moderator-led focus groups were conducted among rural HCPs providing care to rural African American women with Type 2 diabetes. Questions about experiences with PA counseling in this patient population were asked. Following a DVD demonstration of a MI patient/provider consultation, MI impressions were solicited. Focus groups data were transcribed verbatim. Content-based analysis was conducted using qualitative data analysis software, Atlas.ti., and thematic coding by two analysts. RESULTS: Thirty-three HCPs (64% nurses) participated. Fifty-five percent reported little or no PA counseling comfort due to either the lack of knowledge of PA recommendations or individual challenges in being physically active. MI was viewed as a potentially effective communication approach (positive impression theme). However, HCPs voiced concern about the limited input of the provider during the MI consultation (disadvantage theme) and the feasibility of implementing MI in healthcare settings (disadvantage theme). CONCLUSION: Future studies should evaluate whether integrating, into MI training, information about previous PA counseling experiences and impressions of MI from rural HCPs truly increases the effectiveness of MI training and subsequent PA interventions.