Breakthrough Findings from the MOTIVATE Pilot RCT at McMaster University

Recent research from McMaster University in Hamilton, Ontario, has shed new light on how motivational interviewing can help young adults adopt healthier lifestyles. The MOTIVATE pilot randomized controlled trial (RCT), published in Preventive Medicine Reports, tested a behavioral intervention aimed at university students aged 18 to 29. This study addresses a critical gap in preventive health strategies for this demographic, who often face unique challenges like irregular schedules and academic stress that hinder sustained health behaviors.

Over six months, 101 participants were randomized into two groups: one receiving up to seven sessions of motivational interviewing (MI) alongside a wearable fitness tracker like a Fitbit, and the other getting education-only materials plus the tracker. The trial met all feasibility benchmarks, paving the way for larger-scale implementation in Canadian higher education settings.

Understanding Motivational Interviewing: A Client-Centered Approach

Motivational interviewing (MI) is a evidence-based counseling technique developed in the 1980s by psychologists William Miller and Stephen Rollnick. It emphasizes collaboration between the counselor and client, evoking the person's own motivations for change rather than prescribing advice. Core principles include expressing empathy, developing discrepancy (highlighting gaps between current behaviors and goals), rolling with resistance, and supporting self-efficacy.

In the context of university students, MI helps navigate ambivalence about diet, exercise, and screen time. Unlike traditional health education, which often fails due to low engagement, MI fosters intrinsic motivation, making it ideal for time-strapped young adults transitioning to independent living.

The MOTIVATE Trial: Design and Methodology

Conducted from February 2023 to January 2024, the MOTIVATE trial was led by Principal Investigator Dr. Laura N. Anderson from McMaster's Department of Health Research Methods, Evidence, and Impact. Co-authors include Taylor Incze, Matthew Kwan, and others from McMaster's Faculty of Health Sciences.

Participants, recruited via McMaster's campus, were randomized 1:1. The MI arm involved personalized sessions delivered by trained coaches, focusing on physical activity, diet, sedentary behavior, and sleep. All received a fitness tracker for objective data. Primary outcomes measured feasibility: recruitment (target 85%, achieved 86.3%), retention (80%, achieved 80.2%), data completion (90%, 93%), and satisfaction (80%, 82.7%). Secondary outcomes tracked body mass index (BMI), fruit/vegetable intake, and activity levels.

Impressive Feasibility Results Signal Scalability

The trial's success in feasibility metrics is a green light for expansion. High retention and satisfaction rates (over 80%) indicate MI resonates with busy students. Participants reported the sessions as empowering, with 82.7% rating them helpful. This is crucial for Canadian universities, where wellness programs often struggle with dropout rates exceeding 50%.

• Recruitment exceeded targets via social media and campus flyers.
• Data adherence was strong, thanks to tracker integration.
• No serious adverse events; minor issues like tracker discomfort were rare.

Modest but Promising Changes in Health Behaviors

While feasibility was the focus, secondary outcomes showed encouraging trends. The MI group reported increased physical activity (steps up ~10%) and fruit/vegetable servings (+0.5 daily), with BMI stabilization versus slight gains in controls. Sedentary time decreased modestly. These align with meta-analyses showing MI's small-to-moderate effects on diet and exercise (effect size 0.2-0.5).

Longer trials could amplify these, especially with booster sessions.

Photo by naillul autar on Unsplash

Health Challenges Among Canadian University Students

Canadian post-secondary students face alarming health trends. Post-pandemic, adult obesity hit 33%, with youth physical activity declining. University data shows 32-44% overweight, 55% insufficiently active, and diets high in ultra-processed foods. Mental health stressors exacerbate poor habits, raising chronic disease risks like obesity and cancer.

McMaster's study targets this 'missing middle' in prevention, where traditional lectures fall short.

Expert Views: MI's Role in Campus Wellness

Matthew Kwan, co-author and McMaster researcher, notes MI's adaptability for diverse students. Reviews confirm MI boosts adherence in student populations, outperforming controls by 20-30% in behavior change.

Canadian programs like UBC's MI courses and UPEI certificates already train staff. Experts advocate integrating MI into peer wellness initiatives for scalability.

Implications for Canadian Higher Education

MOTIVATE positions universities as health hubs. With rising obesity (25% pre-pandemic to 33%), scalable MI could cut future costs. Provinces like Ontario fund wellness; McMaster's model offers a blueprint. Link to Rate My Professor for health educators leading change.

Stakeholders: admins for policy, students for engagement, faculty for integration.

Future Outlook: From Pilot to Nationwide Rollout

Authors plan a full RCT with 400+ participants. Broader adoption could mirror MI's success in addictions (50%+ quit rates). Challenges: trainer certification, funding. Solutions: online MI modules, peer delivery.

Actionable Insights for Students, Staff, and Institutions

• Students: Seek MI-trained counselors via campus health services.
• Staff: Train in MI for advising; check higher ed jobs in wellness.
• Institutions: Pilot MI in residence programs.

MI empowers autonomy, key for lifelong habits.

Photo by Pasqualino Capobianco on Unsplash

Conclusion: A Step Forward for Student Wellness

MOTIVATE proves MI's feasibility for Canadian university students, tackling obesity and inactivity head-on. As rates climb, this intervention offers hope. Explore opportunities at higher ed jobs, rate your professors, or get career advice in health promotion. Share your thoughts below.