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Updated: Jul 17, 2026

Virtual Agent for Real-Time Motivational Interviewing by Integrating Adaptive Nonverbal Behavior and Language Models
Published on: December 23, 2025
Training dietitians in basic motivational interviewing skills results in changes in their counseling style and in
Johannes Brug1, Femke Spikmans, Cora Aartsen
1Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands. j.brug@erasmusmc.nl
Objective:
To test if basic training for dietitians in motivational interviewing (MI) resulted in changes in dietitians' counseling style and improvements in their patients' diet and risk parameters.
Design:
A randomized controlled trial.
Setting:
9 home-care organizations in the Netherlands.
Participants:
37 dietitians, 209 baseline patients, and 142 follow-up diabetes patients.
Intervention:
Dietitians were randomly allocated to receive basic training in motivational interviewing (MI dietitians, n=18) or not (control dietitians, n=19).
Main Outcome Measures:
Counseling style of dietitians; total self-reported saturated fat, fruit, and vegetable intake, measured body mass index (BMI), waist circumference, and glycated hemoglobin (Hemoglobin A(1c), HbA(1c)) of patients.
Analysis:
Analyses of variance and multiple linear regression analyses. Alpha = .05
Results:
MI dietitians were significantly more empathetic, more often showed reflection during consultations, and were more likely than control dietitians to let their patients talk for the majority of the consultation. Patients of MI dietitians had significantly lower saturated fat intake levels at posttest compared to patients of control dietitians. No effects on HbA(1c), BMI, and waist circumference were found.
Conclusions And Implications:
Basic training in MI changed the dietitians' counseling style and resulted in lower saturated fat intakes in their patients.
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