Collective motivational interviewing (CMI) is a novelty motivational approach which optimises the motivational interviewing (MI) for individuals from collectivistic cultures. While MI has been empirically tested as an effective intervention for addictive disorders and has had a positive effect on facilitating lifestyle changes, CMI has retained the potency of MI as an individualistic intervention, and it further invites the social network resources to strengthen the level of motivation and cultivate a joint change partnership. This pilot study was the first clinical study of CMI to work with individuals with drug use problems (IDUPs) by involving concerned significant others (CSOs) in the three-session intervention, and the fidelity control was assessed by the Collective Motivational Interviewing Treatment Integrity (CMITI) scale. This pre-post−follow-up and uncontrolled feasibility study was conducted between 2017 and 2019, with dyads of 20 IDUPs and their CSOs. The potential impacts of CMI were examined by measures at baseline, post-intervention, and 1-month and 3-month post-intervention. All clinical sessions were audio-recorded, and four cases were randomly selected for fidelity review by two trained coders. The normality of data at the baseline was checked by a Shapiro−Wilk test. Non-parametric Wilcoxon-signed-rank test and repeated-measures ANOVA were employed for quantitative analysis. The results showed that six IDUPs had reduced drug use, and ten maintained drug abstinence with the support of CSOs, whereas four IDUPs remained unchanged or increased drug use. Overall, at the 3-month follow-up, drug use was reduced (p > 0.05), social support was strengthened (p < 0.05), and the IDUPs’ motivation for change was enhanced (p < 0.05). However, the small sample sizes, non-random sampling, and lack of control group may limit the generalizability and confirmation of the outcomes and of the “real effects”. This finding of the study suggests that the CMI is a feasible and acceptable therapeutic tool to motivate IDUPs with the support of CSOs to achieve mutually agreed-upon goals. Further development and evaluation with robust methodology are warranted.

Alcohol screening and brief intervention (SBI) is recommended to be implemented in primary care settings to intervene against hazardous/harmful drinking. However, studies showed that the uptake rate was low in many regions/countries. This systematic review presented current findings on the facilitators and barriers of SBI implemented by health professionals in primary care settings using the Consolidated Framework for Implementation Research (CFIR).
We included qualitative, quantitative, and mixed-method studies identified through four electronic databases (PubMed, MEDLINE, PsycInfo, and Web of Science) from inception to June 2020. Included articles had to address barriers and facilitators of SBI implementation and provide sufficient details that the CFIR domains could be identified and data were abstracted using a standardized extraction form.
A total of 74 studies published from 1985 to 2019 were finally analysed and summarized. The most common facilitators were knowledge and positive beliefs about SBI (characteristics of the individuals) and available resources (inner setting). In contrast, the most common barriers were cost related to implementing SBI (intervention characteristics), negative beliefs about SBI (characteristics of the individuals), and lack of self-efficacy in implementing SBI (characteristics of the individuals). It could be observed that factors related to the inner setting and characteristics of individuals were extensively studied whilst the process received the least attention.
Most of the facilitators and barriers are modifiable. Additionally, most literature focused on various kinds of available assets to implement SBI. To promote the spread of SBI implementation, more high-quality studies on the implementation process are needed. This systematic review could serve as a reference framework for health authorities to devise strategies for improving the implementation of SBI in primary care settings.
This systematic review was registered in PROSPERO ( CRD42021258833 ).

This article reports on the feasibility and effect of the brief hope intervention (BHI) in terms of increasing the hope level and psychological and physical health outcomes of rehabilitating cancer patients (RCP). Chinese RCP living in the community were invited to join the study. The BHI consisted of four one-on-one sessions: two (1-hour) face-to-face sessions and two (30-minute) telephone follow-up sessions in between. There were three core features in the hope therapy: (a) goal thoughts: finding workable goals, (b) pathway thoughts: finding ways to reach the targets, and (c) agency thoughts: positive self-talk to optimize their motivation to accomplish the set goals. A one-group pre- and postintervention design was used. Outcome measures included the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression Scale (CES-D), and the State Hope Scale. Recruitment, attrition, and qualitative feedback were collected to understand their comments on BHI. A total of 40 participants were recruited (female 92.3%). The mean age was 57.2 years (SD = 6.7). The participants had significant improvement in all aspects of the Memorial Symptom Assessment Scale, with moderate-to-large effect sizes (d = 0.49-0.74). The changes in present hope and depression scores were insignificant, with small effect sizes (d = 0.17-0.34). The BHI seemed to be promising in producing both physical and psychological benefits in RCP.

Mindfulness training (MT) has shown preliminary efficacy as a behavioral treatment for smoking cessation. We examined the effect of a brief-MT intervention on smoking cessation for Chinese women in workplaces in Hong Kong, China.
In this pilot randomized controlled trial, 213 daily smokers were recruited from workplaces and computer-randomized into the intervention (n = 114) or control (n = 99) groups. Participants in both groups received a self-help booklet. Participants in the intervention group additionally attended 2 sessions of a brief-MT workshop. The primary outcome was self-reported 7-day point-prevalence abstinence (PPA) at 6 months. Secondary outcomes were biochemically validated abstinence (exhaled CO < 4 ppm and salivary cotinine < 10 ng/mL) and smoking reduction at 6 months. Analyses were done by intention to treat. We conducted a post-trial qualitative evaluation on participants in the intervention group (n = 14). Data were analyzed thematically.
At 6-month follow-up, self-reported 7-day PPA were similar between the intervention and control groups (18.4% vs. 21.2%; P = 0.61). Very few participated in biochemical validation (n = 17), and validated abstinence and smoking reduction rates showed no significant difference (5.3% vs. 11.1%, P = 0.12 and 20.2% vs. 20.2%, P = 1.00, respectively). A posteriori analysis showed that brief-MT participants who were psychologically engaged with the intervention had greater 6-month PPA. Qualitative evaluation showed brief-MT reduced stress but its effectiveness was restrained by the insufficient home practice.
This pilot trial on a brief-MT intervention for smoking cessation on Chinese women in workplaces showed feasibility, but improving compliance is needed to maximize the efficacy in future fully powered trials.

BACKGROUND: Healthcare information systems (HIS) are used to aid healthcare providers delivering brief smoking cessation interventions. However, evidence regarding the effectiveness of intervention models in developing countries remains limited. A smoking cessation intervention model based on a decision support tool embedded in HIS (an \'e-information model\', including Ask, Advise, Assess, Inform, Refer and Print components) was applied in a large urban general hospital in Beijing, China. The current study was a preliminary evaluation of the implementation and effectiveness of this model.
METHODS: We conducted a retrospective investigation in the outpatient department of the hospital in the period June-July 2017. Using a paper questionnaire, patients\' self-reported receipt of the e-information model in the past 2 months and their plans to quit within 1 month were collected. Multivariate logistic regression analysis was used to examine the association between receiving the e-information model and patients\' plans to quit.
RESULTS: Among 656 currently smoking patients, the proportion of patients receiving the Ask, Advise, Assess, Refer and Print components were 73.2%, 65.4%, 49.8%, 16.0% and 10.4%, respectively. The results revealed a dose-response relationship between the number of components received and the proportion of patients planning to quit (p-trend=0.006). The likelihood of patients planning to quit within 1 month was highest among those receiving all five components (OR=2.79, 95% CI: 1.31-5.94). Moreover, a simplified model composed of two or three components also revealed a potential effect on increasing the proportion of patients planning to quit.
CONCLUSIONS: The e-information model was applied effectively in the study hospital and appeared to encourage patients to plan to quit smoking. This model could be generalized to other hospitals in China and other developing countries. However, many components of this model were less utilized, and comprehensive measures will be required to improve its application in the future.

A brief intervention using Zero-time Exercise (ZTEx), a foot-in-the-door approach, was developed to reduce sedentary behaviour and increase physical activity. ZTEx refers to the integration of simple strength- and stamina-enhancing physical activity into daily life, which can be done anytime, anywhere and by anyone. This paper presents the development, feasibility, and preliminary evidence for the effectiveness of this intervention under the Hong Kong Jockey Club FAMILY Project. Needs assessments were conducted with social workers from the Christian Family Services Center(CFSC) and the Social Welfare Department (SWD). This single group prospective ZTEx intervention trial, guided by the Health Action Process Approach, included a 3-hr core session at baseline and a 1-hr booster session at 1-month follow-up. Fifty-six participants (social and service-related workers) from CFSC (n = 28) and SWD (n = 28) received the intervention and completed the self-administered questionnaires at baseline. Forty-nine and 43 participants completed the 1-month and 3-month self-administered questionnaires, respectively. Fifteen participants attended the focus group interviews to share their feedback on ZTEx intervention after implementing their community-based ZTEx activities. Intention-to-treat analysis was conducted with missing data replaced by baseline values. Participants reported significant decreases in sitting time by 27 (2, 52) minutes (mean [95% confidence interval]) and 36 (0.2, 71) minutes on a weekday, increases in physical activity while seated by 0.7 (0.2, 1.4) days and 1.1 (0.6, 1.7) days in a week, and improvements in perceived knowledge, outcome expectancies and plan on doing ZTEx at the 1-month and 3-month follow-up, respectively. Balance and muscle strength significantly improved at the 1-month follow-up. The effect ranged from small to large (Cohen\'s d: 0.27-1.05, all p < 0.05). The qualitative feedbacks support the quantitative findings. Our findings show early evidence that ZTEx effectively reduced sedentary behaviour and enhanced physical activity and fitness. Further trials on this simple and low-cost intervention as the first step to promote higher intensity exercise are warranted.

OBJECTIVE: Motivational interviewing (MI) is a commonly used intervention approach to promote reduction or cessation of substance abuse. Effects may be different for adolescents, so it is useful to assess the state of the evidence in this subpopulation. This paper aimed to assess evidence for MI effectiveness in adolescents.
METHODS: EBSCOhost, ProQuest and Digital Dissertation Consortium were searched using keywords. Ten randomized trials from the United Kingdom, United States and Taiwan, including 1466 participants, were identified and analysed using a random effects model. Primary outcome measures captured were: the extent of drug use, intention to use drugs and readiness to change. Each study received a high-quality score based on the Miller Quality Scoring Coding System. Moderator analyses were also conducted to examine the impacts of follow-up period, delivery setting and study design on the effectiveness of MI.
RESULTS: No statistically significant effect of MI on was found change of drug use behaviours [d = 0.05, 95% confidence interval (CI) = -0.06, 0.17, P = 0.36]. A significant effect was found on attitude change (d = 0.44, 95% CI = 0.20, 0.67, P = 0.0002). The funnel plot was asymmetrical, suggesting publication bias favouring small studies with higher effect sizes.
CONCLUSIONS: Motivational interviewing has not been found thus far to reduce adolescent use of illicit drugs. It may influence intentions to change, but evidence of publication bias weakens confidence in this conclusion.