HENRIETTA FAWOLE

Background/Aim: Motivational interviewing (MI) is increasingly recognised as a valuable communication approach in healthcare because it addresses key challenges such as patient engagement and sustained behaviour change. Although evidence supports MI as an effective strategy for promoting health behaviour change across conditions such as substance use and medication adherence, its implementation faces several barriers and facilitators that influence uptake and long-term success. This study therefore aimed to identify the barriers and facilitators to MI utilisation among healthcare providers.
Methods: To identify eligible studies, the following electronic databases were used for literature search: EMBASE, MEDLINE via OVID, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, and Web of Science Core Collections. Furthermore, AJOL, ProQuest thesis and dissertation, Motivational Interviewing Network of Trainers (MINT) website and Google Scholar were also searched for grey literature. The reference lists of included studies were further screened for eligible studies. The inclusion criteria comprised of studies published in English Language, involving all healthcare (physicians, pharmacists, psychologists, nurses, physiotherapists and social workers), articles addressing the barriers and facilitators to the utilisation of MI and in context of healthcare settings. Screening and data extraction were conducted independently by two reviewers, with disagreements resolved with a consensus. Results were summarized using narrative synthesis following PRISMA-Scr framework.
Result: A total of 19 studies including 456 participants were included in this review. Majority of the participants were nurses as 11 out of the 19 studies included nurses as participants. Out of the included studies, 14 were qualitative studies, 1 randomised controlled trial (RCT), 1 mixed methods design, 1 quantitative design, 1 practice change project and 1 descriptive study. The narrative synthesis identified several barriers and facilitators to the use of motivational interviewing (MI). The most common barrier was the lack of time required to deliver MI effectively. Other identified barriers included insufficient provider training, high workload, patient-related challenges, and practitioner-related factors. Key facilitators reported were the availability of training, practice, support, and supervision, effective communication, readiness or tension for change, alignment of MI with existing practices (goodness of fit), and a supportive work environment.
Conclusion: This scoping review highlights key barriers and facilitators to healthcare providers’ use of MI. Barriers include time constraints, inadequate training, and heavy workloads, while facilitators include adequate training, organizational support, supervision, and positive work environments. Addressing these challenges can enhance MI’s effectiveness in improving patient outcomes.
Registration: The review protocol was developed, registered and made publicly available through the Open Science Framework database with the protocol registration link- https://osf.io/5pqh8
Keywords: Motivational interviewing, barriers, facilitators, healthcare providers, scoping review.

Background: The number of persons suffering from low back pain will rise in the future, especially in low- and middle-income countries. The treatments available for low-back pain are not sufficient enough to cause an effective change in the long-term. Hence, there is a growing recognition of the need for a more comprehensive, patient-centered and behavioral-changing approach.
Objective: To determine the effectiveness of motivational interview on patients with low back pain.
Method: Included in this review were study population of adults aged 18 and above. Randomized Controlled Trials (RCTs) and Non-Randomized Controlled Trials (non-RCTs) that explored the effectiveness of Motivational Interview on Low Back Pain. A detailed search of 7 databases was conducted. Data were selected and extracted using the Microsoft Excel Spreadsheet 2010 version following the eligibility criteria. To assess the potential risk of bias in each study, two assessors independently assessed the eligible studies using the revised Cochrane risk of bias tool for parallel RCTs. A review protocol was developed and registered in the PROSPERO database (IDCRD42023444806). A narrative synthesis was used to present findings.
Results: 2 RCTs and 1 non-RCT was eligible from the narrative synthesis. Motivational interview
interventions included counselling, motivational programs and group/individual discussion sessions. Motivational interview had a significant effect on pain among patients with low back pain relative to the control interventions. All the studies had a good methodological quality.
Conclusion: Motivational Interview shows a beneficial effect in reducing low back pain and in increasing functional status in patients with low-back pain in comparison with other interventions used in the systematic review. However, current evidence is insufficient on the effect of motivational interview on pain in patients with low back pain. More large scale RCTs are needed to evaluate motivational interview on pain in patients with low back pain.
Keywords: Low back pain, motivational interview, quality of life, functional status.