Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Developing the Moti-4 intervention, assessing its feasibility and pilot testing its effectiveness

Authors: Hans B. Dupont, Paul Lemmens, Gerald Adriana, Dike van de Mheen, Nanne K. de Vries

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

The Moti-4 intervention was developed to prevent addiction and other health problems among vulnerable adolescent cannabis users. The aims of Moti-4 are to reduce the use of cannabis among adolescents and to encourage their motivation to change their behavior.

Methods

Intervention Mapping, a systematic approach to developing theory- and evidence-based interventions, was used to develop a protocol for the intervention. The process of developing the intervention also used the method of responsive evaluation to explore the opinions of the immediate target group and intermediaries (N = 31). Feasibility was assessed in 9 interviews and analyzed in grids.
A quantitative pilot analysis involving a pre- and post-assessment in 31 subjects assessed whether the intervention was able to reduce drug use and would change intentions to change drug use behavior.

Results

Using Intervention Mapping resulted in the development of a substantial four-session intervention with a clear manual and training for prevention workers. The choice of 12 consecutive steps was based on the Trans Theoretical Model of Behavior Change, Motivational Interviewing, Theory of Planned Behavior and the Self Determination Theory.
Positive aspects of working with Moti-4 were assessed in a feasibility study. Criticism by users has led to improvements to the manual.
In the pilot study, the average weekly amount spent on cannabis decreased significantly from an average €17.77 to €11,95 in the period after the intervention, with a medium effect size (d = 0.36). Likewise, a significant decrease was found in the frequency of use during the past week, from 4.3 to 2.4 (d = .52). As to motivation to change, a statistically significant increase was found in planning (d = .44) and a large increase in the desire to stop (d = .76). The change in the motivation to smoke less cannabis was small.

Conclusion

Intervention Mapping proved to be a useful approach for the development of the intervention, using a productive combination of theory and community knowledge. The pre- and post-test pilot study showed that the intervention generally brought about a considerable positive change in the two principle targets, cannabis use and motivation. There is a need for further (controlled) research into its effectiveness and implementation as a standard method in addiction prevention services.
Literature
2.
go back to reference EMCDDA. 2014 Annual report on the state of the drugs problem in Europe. Lisbon: EMCDDA; 2014. EMCDDA. 2014 Annual report on the state of the drugs problem in Europe. Lisbon: EMCDDA; 2014.
3.
go back to reference Laar van MW, Cruts AAM, van Ooyen-Houben MMJ, Meijer RF, Croes EA, Ketelaars APM et al.: Netherlands National Drug Monitor, Annual Report 2013. Trimbos Utrecht; 2014. Laar van MW, Cruts AAM, van Ooyen-Houben MMJ, Meijer RF, Croes EA, Ketelaars APM et al.: Netherlands National Drug Monitor, Annual Report 2013. Trimbos Utrecht; 2014.
5.
go back to reference Copeland J, Swift W. Cannabis use disorder: Epidemiology and management. International Review of Psychiatry. 2009;21(2):96–103.CrossRefPubMed Copeland J, Swift W. Cannabis use disorder: Epidemiology and management. International Review of Psychiatry. 2009;21(2):96–103.CrossRefPubMed
6.
go back to reference Montanari L, Taylor C, Griffith P. Cannabis users in drug treatment in Europe: an analysis from treatment demand data. In: Report: A cannabis reader: global issues and local experiences, Monograph series 8, Volume 2. Lisbon: European Monitoring Centre for Drugs and Drug Addiction; 2008. p. 261–79. Montanari L, Taylor C, Griffith P. Cannabis users in drug treatment in Europe: an analysis from treatment demand data. In: Report: A cannabis reader: global issues and local experiences, Monograph series 8, Volume 2. Lisbon: European Monitoring Centre for Drugs and Drug Addiction; 2008. p. 261–79.
7.
go back to reference Niesink R, Rigter S. THC-concentraties in wiet, nederwiet en hasj in Nederlandse coffeeshops (2011–2012), Trimbos instituut Utrecht, Drugs Informatie en Monitoring Systeem (DIMS). 2012. Niesink R, Rigter S. THC-concentraties in wiet, nederwiet en hasj in Nederlandse coffeeshops (2011–2012), Trimbos instituut Utrecht, Drugs Informatie en Monitoring Systeem (DIMS). 2012.
8.
go back to reference Fischer B, Rehm J, Hall W. Cannabis use in Canada: the need for a “Public Health”approach. Can J Public Health. 2009;100(2):100–3. Fischer B, Rehm J, Hall W. Cannabis use in Canada: the need for a “Public Health”approach. Can J Public Health. 2009;100(2):100–3.
9.
go back to reference Solowij N. Commentaries on Macleod & Hickman, Harms to Body and Soul - an Ideological Balancing Act For Preventing and Reducing Cannabis Use. Addiction. 2010;105:1331–2.CrossRefPubMed Solowij N. Commentaries on Macleod & Hickman, Harms to Body and Soul - an Ideological Balancing Act For Preventing and Reducing Cannabis Use. Addiction. 2010;105:1331–2.CrossRefPubMed
10.
go back to reference Horwood LJ, Fergusson DM, Hayatbakhsh MR, Najman JM, Coffey C, Patton GC, et al. Cannabis use and educational achievement: Findings from three Australian cohort studies. Drug Alcohol Depend. 2010;110:247–53.CrossRefPubMed Horwood LJ, Fergusson DM, Hayatbakhsh MR, Najman JM, Coffey C, Patton GC, et al. Cannabis use and educational achievement: Findings from three Australian cohort studies. Drug Alcohol Depend. 2010;110:247–53.CrossRefPubMed
11.
go back to reference Kuepper R, van Os J, Lieb R, Wittchen HU, Hofler M, Henquet C. Continued Cannabis Use and Risk of Incidence Persistence of Psychotic Symptoms: 10 Year Follow-up Cohort Study. BMJ. 2011;342:373.CrossRef Kuepper R, van Os J, Lieb R, Wittchen HU, Hofler M, Henquet C. Continued Cannabis Use and Risk of Incidence Persistence of Psychotic Symptoms: 10 Year Follow-up Cohort Study. BMJ. 2011;342:373.CrossRef
12.
go back to reference Pope Jr HG, Gruber AJ, Hudson JI, Cohane G, Hustis MA, Yurgelin-Todd D. Early-onset cannabis use and cognitive deficits: what is the nature of the association? Drug Alcohol Depend. 2003;69:303–10.CrossRefPubMed Pope Jr HG, Gruber AJ, Hudson JI, Cohane G, Hustis MA, Yurgelin-Todd D. Early-onset cannabis use and cognitive deficits: what is the nature of the association? Drug Alcohol Depend. 2003;69:303–10.CrossRefPubMed
13.
go back to reference Snoek A, Wits E, van der Stel J: Vulnerable groups and (problematic) alcohol and drug use: vision and intervention matrix. Kwetsbare groepen jeugdigen en (problematisch) middelengebruik: visie en interventiematrix. Rotterdam: IVO; 2010 (also on http://www.resultatenscoren.nl). Snoek A, Wits E, van der Stel J: Vulnerable groups and (problematic) alcohol and drug use: vision and intervention matrix. Kwetsbare groepen jeugdigen en (problematisch) middelengebruik: visie en interventiematrix. Rotterdam: IVO; 2010 (also on http://​www.​resultatenscoren​.​nl).
14.
go back to reference Henry K. Skipping school and using drugs: A brief report. Informa healthcare, Drugs: education, prevention and policy. 2010;17(5):650–7. Henry K. Skipping school and using drugs: A brief report. Informa healthcare, Drugs: education, prevention and policy. 2010;17(5):650–7.
15.
go back to reference Dupont HB, Kaplan CD, Braam RV, Verbraeck HT, de Vries NK: The Application of the Rapid Assessment Methodology for Cannabis Prevention Research in the Netherlands. Int J Drug Policy, 2014. Open Access, available online 14 nov. 2014 Dupont HB, Kaplan CD, Braam RV, Verbraeck HT, de Vries NK: The Application of the Rapid Assessment Methodology for Cannabis Prevention Research in the Netherlands. Int J Drug Policy, 2014. Open Access, available online 14 nov. 2014
16.
go back to reference Spits, M, Dupont HB & Oudejans S: Verslavingspreventie Jeugd; de basis is gelegd, TsVerslaving nr 3 2014 in press. Spits, M, Dupont HB & Oudejans S: Verslavingspreventie Jeugd; de basis is gelegd, TsVerslaving nr 3 2014 in press.
17.
go back to reference Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison intake and 6 months later. Drug Alcohol Depend. 2009;99(1–3):280–95.CrossRefPubMed Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison intake and 6 months later. Drug Alcohol Depend. 2009;99(1–3):280–95.CrossRefPubMed
18.
go back to reference Conrod PJ, Stewart SH, Pihl RO, Cote S, Fontaine V, Dongier M. Efficacy of brief coping skills interventions that match different personality profiles of female substance abusers. Psychol Addict Behav. 2000;14:231–42.CrossRefPubMed Conrod PJ, Stewart SH, Pihl RO, Cote S, Fontaine V, Dongier M. Efficacy of brief coping skills interventions that match different personality profiles of female substance abusers. Psychol Addict Behav. 2000;14:231–42.CrossRefPubMed
19.
go back to reference Sussman S, Ames SL: Drug Abuse: Concepts Prevention, and Cessation. Cambridge Press; 2008. ISBN 978-0-521-85892-2. Sussman S, Ames SL: Drug Abuse: Concepts Prevention, and Cessation. Cambridge Press; 2008. ISBN 978-0-521-85892-2.
20.
go back to reference Martin G, Copeland J. The Adolescent Cannabis Check-up: Randomized Trial of a brief Intervention for young Cannabis Users. J Subst Abus Treat. 2008;34:407–14.CrossRef Martin G, Copeland J. The Adolescent Cannabis Check-up: Randomized Trial of a brief Intervention for young Cannabis Users. J Subst Abus Treat. 2008;34:407–14.CrossRef
21.
go back to reference De Gee EA, Verdurmen JEE, Bransen E, De Jonge JM, Schippers GM: A randomized controlled trial of a brief motivational enhancement for non-treatment-seeking adolescent cannabis users. J Substance Abuse Treatment (2014). De Gee EA, Verdurmen JEE, Bransen E, De Jonge JM, Schippers GM: A randomized controlled trial of a brief motivational enhancement for non-treatment-seeking adolescent cannabis users. J Substance Abuse Treatment (2014).
22.
go back to reference Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Fernandez ME. Planning health promotion programmes: An Intervention Mapping Approach. 3rd ed. San Francisco: Jossey-Bass; 2011. Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Fernandez ME. Planning health promotion programmes: An Intervention Mapping Approach. 3rd ed. San Francisco: Jossey-Bass; 2011.
23.
go back to reference Van Os J, Kenis G, Rutten BPF. The environment and schizophrenia. Nature. 2010;468:203-2-12. Van Os J, Kenis G, Rutten BPF. The environment and schizophrenia. Nature. 2010;468:203-2-12.
24.
go back to reference Fishbein M, Ajzen I. Predicting and Changing Behaviour: The Reasoned Action Approach. New York: Taylor and Francis; 2010. Fishbein M, Ajzen I. Predicting and Changing Behaviour: The Reasoned Action Approach. New York: Taylor and Francis; 2010.
25.
go back to reference De Vries H, Backbier E, Kok G, Dijkstra M. The impact of social influences in the context of attitude, self-efficacy, intention and previous behaviour as predictors of smoking onset. J Appl Soc Psychol. 1995;25:237–57.CrossRef De Vries H, Backbier E, Kok G, Dijkstra M. The impact of social influences in the context of attitude, self-efficacy, intention and previous behaviour as predictors of smoking onset. J Appl Soc Psychol. 1995;25:237–57.CrossRef
26.
go back to reference Ryan RM, Deci EL. Self-Determination Theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.CrossRefPubMed Ryan RM, Deci EL. Self-Determination Theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.CrossRefPubMed
27.
go back to reference Miller WR, Rollnick S. Motivational Interviewing. In: Helping People Change. 3rd ed. New York: Guilford Press; 2012. ISBN 978-1-60918-2274. Miller WR, Rollnick S. Motivational Interviewing. In: Helping People Change. 3rd ed. New York: Guilford Press; 2012. ISBN 978-1-60918-2274.
28.
go back to reference Prochaska JO, DiClemente CC. The transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin; 1984. Prochaska JO, DiClemente CC. The transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin; 1984.
29.
go back to reference Barnett E, Sussman S, Smith C, Rohrbach LA, Spruijt-Metz D. Motivational interviewing for Adolescent Substance Use: a Review of the Literature. Addict Behav. 2012;37(12):1325–34.CrossRefPubMedPubMedCentral Barnett E, Sussman S, Smith C, Rohrbach LA, Spruijt-Metz D. Motivational interviewing for Adolescent Substance Use: a Review of the Literature. Addict Behav. 2012;37(12):1325–34.CrossRefPubMedPubMedCentral
31.
go back to reference Czobor P, Bácakai E, Oberg D, Haack MJ, Gerevich J. The European Adolescent Assessment Dialogue (EuroADAD): A Psychometric Evaluation. Eur Addict Res. 2011;17:302–15.CrossRefPubMed Czobor P, Bácakai E, Oberg D, Haack MJ, Gerevich J. The European Adolescent Assessment Dialogue (EuroADAD): A Psychometric Evaluation. Eur Addict Res. 2011;17:302–15.CrossRefPubMed
32.
go back to reference Abma TA, Widdershoven GAM: Responsieve methodologie: interactief onderzoek in de praktijk. Responsive methodology: interactive research in practice. Lemma The Hague; 2006. ISBN 978-90-5931-477-1. Abma TA, Widdershoven GAM: Responsieve methodologie: interactief onderzoek in de praktijk. Responsive methodology: interactive research in practice. Lemma The Hague; 2006. ISBN 978-90-5931-477-1.
33.
go back to reference Brown SA. Facilitating change for adolescent alcohol problems: A multiple options approach. In: Wagner EF, Waldron HB, editors. Innovations in adolescent substance abuse intervention. Oxford: Elsevier science; 2001. p. 169–87.CrossRef Brown SA. Facilitating change for adolescent alcohol problems: A multiple options approach. In: Wagner EF, Waldron HB, editors. Innovations in adolescent substance abuse intervention. Oxford: Elsevier science; 2001. p. 169–87.CrossRef
34.
go back to reference D’Amico EJ, Ellickson PL, Wagner EF, Turrisi R, Fromme K, Ghosh-Dastidar B, et al. Developmental considerations for substance use interventions from middle school through college. Alcohol Clin Exp Res. 2005;29:474–83.CrossRefPubMed D’Amico EJ, Ellickson PL, Wagner EF, Turrisi R, Fromme K, Ghosh-Dastidar B, et al. Developmental considerations for substance use interventions from middle school through college. Alcohol Clin Exp Res. 2005;29:474–83.CrossRefPubMed
35.
go back to reference Masterman PW, Kelly AB. Reaching adolescents who drink harmfully: Fitting intervention to developmental reality. J Subst Abus Treat. 2003;24:347–55.CrossRef Masterman PW, Kelly AB. Reaching adolescents who drink harmfully: Fitting intervention to developmental reality. J Subst Abus Treat. 2003;24:347–55.CrossRef
36.
go back to reference Jensen CD, Cushing CC, Aylward BS, Craig JT, Sorell DM, Steele RG. Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review. J Consult Clin Psychol. 2011;79:433–40.CrossRefPubMed Jensen CD, Cushing CC, Aylward BS, Craig JT, Sorell DM, Steele RG. Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review. J Consult Clin Psychol. 2011;79:433–40.CrossRefPubMed
37.
go back to reference Apodaca TR, Longabaugh R. Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence. Addiction. 2009;104(5):705–15. doi:10.1111/j.1360-0443.2009.02527.x.CrossRefPubMedPubMedCentral Apodaca TR, Longabaugh R. Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence. Addiction. 2009;104(5):705–15. doi:10.1111/j.1360-0443.2009.02527.x.CrossRefPubMedPubMedCentral
38.
go back to reference Moyers TB, Martin T, Christopher PJ, Houck JM, Tonigan JS, Amrhein PC. Client language as a mediator of motivational interviewing efficacy: Where is the evidence? Alcohol Clin Exp Res. 2007;31(S3):40S–7.CrossRefPubMed Moyers TB, Martin T, Christopher PJ, Houck JM, Tonigan JS, Amrhein PC. Client language as a mediator of motivational interviewing efficacy: Where is the evidence? Alcohol Clin Exp Res. 2007;31(S3):40S–7.CrossRefPubMed
39.
go back to reference Moyers TB, Miller WR. Hendrickson: How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions. J Consult Clin Psychol. 2005;73:590–8.CrossRefPubMed Moyers TB, Miller WR. Hendrickson: How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions. J Consult Clin Psychol. 2005;73:590–8.CrossRefPubMed
40.
go back to reference McNally AM, Palfai TP, Kahler CW: Motivational interventions for heavy drinking college students: examining the role of discrepancy-related psychological processes. Department of Psychology, Boston University, Boston, MA 02215, USA. 2005 Mar;19 (1):79–87. McNally AM, Palfai TP, Kahler CW: Motivational interventions for heavy drinking college students: examining the role of discrepancy-related psychological processes. Department of Psychology, Boston University, Boston, MA 02215, USA. 2005 Mar;19 (1):79–87.
41.
go back to reference LaBrie J, Feres N, Kenney S, Lac A. Family history of alcohol abuse moderates effectiveness of a group motivational enhancement intervention in college women. Addict Behav. 2009;34:415–20.CrossRefPubMed LaBrie J, Feres N, Kenney S, Lac A. Family history of alcohol abuse moderates effectiveness of a group motivational enhancement intervention in college women. Addict Behav. 2009;34:415–20.CrossRefPubMed
43.
go back to reference D’Onofrio G, Becker B, Woolard RH. The impact of alcohol, tobacco, and other drug use and abuse in the emergency department. Emerg Med Clin North Am. 2006;24(4):925–67.CrossRefPubMed D’Onofrio G, Becker B, Woolard RH. The impact of alcohol, tobacco, and other drug use and abuse in the emergency department. Emerg Med Clin North Am. 2006;24(4):925–67.CrossRefPubMed
44.
go back to reference Kaner EF, Beyer F, Dickinson HO, Pienaar E, Campbell F, Schlesinger C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007;2:CD004148. Kaner EF, Beyer F, Dickinson HO, Pienaar E, Campbell F, Schlesinger C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007;2:CD004148.
45.
go back to reference Bertholet N, Daeppen J, Wietlisbach V, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005;165(9):986–95.CrossRefPubMed Bertholet N, Daeppen J, Wietlisbach V, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005;165(9):986–95.CrossRefPubMed
46.
go back to reference Ballesteros J, González-Pinto A, Querejeta I, Ariño J. Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women. Addiction. 2004;99(1):103–8.CrossRefPubMed Ballesteros J, González-Pinto A, Querejeta I, Ariño J. Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women. Addiction. 2004;99(1):103–8.CrossRefPubMed
47.
go back to reference Rooke S, Copeland J, Norberg M, Hine D, McCambridge J. Effectivenies of a Self-Guided, Web-Based Cannabis Treatment Program: Randomized Clinical Trial. J Med Internet Res. 2013;15(2):e26. doi:10.2196/jmir.2256. Rooke S, Copeland J, Norberg M, Hine D, McCambridge J. Effectivenies of a Self-Guided, Web-Based Cannabis Treatment Program: Randomized Clinical Trial. J Med Internet Res. 2013;15(2):e26. doi:10.2196/jmir.2256.
48.
go back to reference Kilmer JR, Walker DW, Lee CM, Palmer RS, Mallet KA, Fabiano P, et al. Misperceptions of College Student Marijuana Use: Implications for Prevention. J Stud Alcohol and Drugs. 2006;67:277–81.CrossRef Kilmer JR, Walker DW, Lee CM, Palmer RS, Mallet KA, Fabiano P, et al. Misperceptions of College Student Marijuana Use: Implications for Prevention. J Stud Alcohol and Drugs. 2006;67:277–81.CrossRef
49.
go back to reference Braam R, Verbraeck H, Trautmann F. RAR Handboek Problematisch Middelengebruik. Rapid Assessment and Response Methode voor Doelgroepen Met Problematisch Middelengebruik. Utrecht: CVO/Trimbos instituut; 2013. Braam R, Verbraeck H, Trautmann F. RAR Handboek Problematisch Middelengebruik. Rapid Assessment and Response Methode voor Doelgroepen Met Problematisch Middelengebruik. Utrecht: CVO/Trimbos instituut; 2013.
50.
go back to reference West R. Time for a change: Putting the Trantheoretical (Stages of Change) Model to rest. Addiction. 2005;100:1036–9.CrossRefPubMed West R. Time for a change: Putting the Trantheoretical (Stages of Change) Model to rest. Addiction. 2005;100:1036–9.CrossRefPubMed
Metadata
Title
Developing the Moti-4 intervention, assessing its feasibility and pilot testing its effectiveness
Authors
Hans B. Dupont
Paul Lemmens
Gerald Adriana
Dike van de Mheen
Nanne K. de Vries
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1826-y

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue