Lessons Learned: Why Motivational Interviewing Should Be Adapted to Socio-Cultural Contexts

The literature shows inconclusive results from utilizing motivational interviewing (MI) in indigenous populations to address early childhood caries (ECC). Great Beginnings for Healthy Native Smiles (GBHNS) (NIDCR U01DE028508), a community focused oral health (OH) intervention, was utilized alongside adapted MI techniques to promote OH care and education at home.

The intervention was conducted by local Community Health Representatives (CHRs) from the two partnered indigenous communities. Reflecting on the years-long MI training and CHRs' concerns, GBHNS conducted post-intervention semi-structured interviews with all MI staff regarding their experiences with MI. This paper uses participant observation, semi-structured interviewing, and inductive and deductive qualitative coding and analysis.

Thematic analysis was used to explore lessons learned and future research recommendations for interventions considering the use of MI. Generally considered a person-centered approach, MI reinforces Western psychological frameworks and practices which may disrupt local communicative practices and values.

Specifically, interdisciplinary pre-intervention community assessments are recommended to ensure acceptability, relevance and appropriateness through attention to local communicative practices.