An Effectiveness Evaluation of Motivational Interviewing as an Addition to an Internet-Based Health Promotion Program for Vocational Rehabilitation Consumers

Casey Nicole Ruggiero, The University of Montana

Abstract

People with disabilities (PWD) frequently experience preventable and/or manageable secondary health conditions such as weight problems, depression, and chronic pain (Jones & Bell, 2003; Seekins, Clay, & Ravesloot, 1994). Importantly, high rates of secondary conditions are correlated with low employment rates in Vocational Rehabilitation (VR) consumers (Ipsen, Seekins, & Ravesloot, 2010; Ipsen, Seekins, & Arnold, 2011). Thus, one pathway to improving employment outcomes in rehabilitation programs may involve enhancing health through the reduction of limiting secondary conditions (Ipsen, 2006; Ipsen et al., 2010). This pilot study tested whether the addition of telephone-based Motivational Interviewing (HPE+MI) to Health Plans for Employment (HPE), an internet-based health promotion and goal setting intervention targeting secondary conditions, resulted in higher self-efficacy beliefs than a factsheets only minimal intervention group or HPE alone. One-hundred and forty-two male and female active VR consumers were randomized to 1 of these 3 intervention groups. Contrary to expectation, no group effects or group × time interaction effects on targeted specific health behavior self- efficacy, reduction in limitation resulting from secondary conditions, or health related quality of life were observed. A main effect for time was, however, observed for targeted specific health behavior self-efficacy suggesting that participation in both the HPE and the HPE+MI interventions led to higher self reported self-efficacy beliefs on specific targeted health behaviors such as balanced diet, stress management, sleep, and physical activity. Importantly, main effects for time were also observed on measures of secondary condition limitation and health related quality of life suggesting the possibility that all three intervention groups were effective in reducing limitation and enhancing health related quality of life. Of note, program adherence across groups was high, and, contrary to expectation, program adherence did not differ between groups. Study findings suggest that PWD enrolled in VR programs can benefit from health behavior change interventions targeting multiple health behaviors, which are delivered remotely, and that the specific delivery modality (e.g., telephone, interactive website, or emailed factsheets) of health information may be less important than was originally thought. Study implications and future research areas are discussed.