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Should we give up on motivational interviewing? Not so fast
  1. Jessica Y Breland1,
  2. Michael V Stanton2
  1. 1 Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, California, USA
  2. 2 Department of Health Sciences, California State University East Bay, Hayward, California, USA
  1. Correspondence to Dr Jessica Y Breland, Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System Menlo Park Division, Menlo Park, CA 94025, USA; jessica.breland{at}

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A large, well-designed, randomised controlled trial found that MOVE IT, a motivational interviewing intervention, did not increase physical activity or lead to weight loss among people at high risk for cardiovascular disease (CVD).1 That means we should give up on motivational interviewing, right?

The trial described in the Heart article by Ismail and colleagues1 provides important information on a known gap in the literature. A recent systematic review found insufficient evidence to make conclusions regarding the utility of motivational interviewing for preventing and/or treating CVD.2 Ismail and colleagues1 found that neither group nor individual MOVE IT improved primary outcomes (physical activity, weight loss), nor did MOVE IT affect other related factors, such as lipids or CVD risk score (secondary outcomes). Further, MOVE IT was not cost-effective compared with usual care.

These findings suggest it may be inefficient to pay for multisession, in-person, low-intensity motivational interviewing-based interventions with the goal of preventing CVD. Unlike many other studies of motivational interviewing interventions,2 3 Ismail and colleagues1 reported therapist training and fidelity measures, noting that therapists were generally proficient. They also reported that most participants set goals that were at least partially achieved. As a result, we know that study therapists provided a form of enhanced motivational interviewing, and that participants engaged in the intervention.

At the same time, there is reason to believe that MOVE IT was not offered to the population most likely to benefit …

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  • Twitter @jessicaybreland, @DrMikeStanton

  • Contributors JB and MS both contributed to conceptualisation, writing and editing of this manuscript.

  • Funding JB is supported by a Career Development Award (CDA 15-257) from the US Department of Veterans Affairs (VA), Health Services Research and Development Service. Support for this project was provided by a 2019–2020 Faculty Support Grant from the Cal State East Bay Division of Academic Affairs.

  • Disclaimer Views presented herein represent those of the authors and do not necessarily represent the views of the VA or the US Government.

  • Competing interests MS is on the advisory boards of Head Health and Ceres.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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