Riegel, BarbaraDickson, Victoria VaughanGarcia, Lydia ElenaMasterson-Creber, RuthStreur, Megan2023-05-232023-05-232017-02-012018-08-01https://repository.upenn.edu/handle/20.500.14332/41619Self-care is challenging but we previously demonstrated that motivational interviewing (MI) was effective in improving heart failure (HF) self-care. OBJECTIVE: To identify the mechanisms of intervention effectiveness by elucidating the MI techniques used and the relationship between the techniques and changes in self-care. METHODS: Audiotaped sessions (first and subsequent sessions) from 8 participants were transcribed verbatim and coded to evaluate changes in self-care. Using a sequential mixed method design, quantitative and qualitative self-care data were triangulated; congruence was 97%. The MI techniques used and mechanisms of intervention effectiveness were identified from the qualitative data. RESULTS: Three MI techniques used were related to improved self-care: 1) reflection and reframing, 2) genuine empathy, affirmation, and humor, and 2) individualized problem solving. These techniques stimulated openness to goal setting, positive self-talk, perceived ability to overcome barriers, and change talk. The mechanisms by which the techniques achieved the desired outcomes were the development of discrepancy and self-efficacy, which are consistent with the principles of MI. CONCLUSION: This study contributes to clarifying the mechanism by which MI facilitates behavioral change. PRACTICE IMPLICATIONS: Using MI to discuss self-care can help to overcome barriers and engage HF patients in goal setting for behavior change.© 2017 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license (http://creativecommons.org/licenses/by-nc-nd/4.0/)AdultFemaleHeart FailureHumansLongitudinal StudiesMaleMotivational InterviewingOutcome and Process Assessment (Health Care)Patient ComplianceQualitative ResearchSelf CareTape RecordingAdultFemaleHeart FailureHumansLongitudinal StudiesMaleMotivational InterviewingOutcome and Process Assessment (Health Care)Patient ComplianceQualitative ResearchSelf CareTape RecordingCardiologyCardiovascular DiseasesCirculatory and Respiratory PhysiologyCognitive Behavioral TherapyIntegrative MedicineMedical HumanitiesMedicine and Health SciencesNursingPreventive MedicineArticle