Development and Piloting of a Web-based Adaptation of Motivational Interviewing to Promote Oral Health

This paper describes the development and user evaluation of a web-delivered oral health behavior change intervention grounded in the spirit and methods of motivational interviewing (MI).

The current project builds on prior research in which MI delivered by oral health professionals was found to be efficacious in promoting changes in oral health behavior. The incorporation of MI features into a web-based adaptation was guided by input from key stakeholders (dental patients, dental hygienists, and dentists) and feedback obtained during an iterative process of testing with patients. A pilot trial was conducted to assess the program's usability, acceptability, and inclusion of MI-consistent elements that promote behavior change.

Twenty-two dental patients used the web-based program and completed evaluative measures. Ratings confirmed that the program was perceived as user friendly, helpful, engaging, relevant, and characterized by MI-consistent features that research suggests will motivate and prepare patients for changes in oral health-related behavior. The participants reported that the program made use of MI-consistent strategies and satisfied basic needs for autonomy, competence, and relatedness. The participants also expressed a strong likelihood of recommending the program to family and friends and of using it again if they had the chance.

Including specific MI elements such as evocative questions, affirmations, reflections, and a collaborative style that emphasizes patient autonomy yielded a web-delivered program that embodies both the technical and the relational aspects of human-delivered MI. Additional research is needed to evaluate the program's ability to promote changes in oral health-related behavior.

This study developed the first comprehensive, web-based motivational interviewing (MI) program for oral health, targeting multiple behaviors (interdental cleaning, diet, tobacco avoidance) in a scalable tool. It advances beyond didactic or single-behavior digital tools by translating MI's relational techniques into responsive web delivery. Innovations include user-needs tailoring, self-determination theory integration (autonomy, competence, relatedness), and stakeholder design for dental settings-pioneering MI for oral health disparities via permission-based education and change plans.