Background: Counselor behaviors that mediate the efficacy of motivational interviewing (MI) are not well understood, especially when applied to health behavior promotion. We hypothesized that client change talk mediates the relationship between counselor variables and subsequent client behavior change.

Methods: Purposeful sampling identified individuals from a prospective randomized worksite trial using an MI intervention to promote firefighters’ healthy diet and regular exercise that increased dietary intake of fruits and vegetables (n = 21) or did not increase intake of fruits and vegetables (n = 22). MI interactions were coded using the Motivational Interviewing Skill Code (MISC 2.1) to categorize counselor and firefighter verbal utterances. Both Bayesian and frequentist mediation analyses were used to investigate whether client change talk mediated the relationship between counselor skills and behavior change.

Results: Counselors’ global spirit, empathy, and direction and MI-consistent behavioral counts (e.g., reflections, open questions, affirmations, emphasize control) significantly correlated with firefighters’ total client change talk utterances (rs = 0.42, 0.40, 0.30, and 0.61, respectively), which correlated significantly with their fruit and vegetable intake increase (r = 0.33). Both Bayesian and frequentist mediation analyses demonstrated that findings were consistent with hypotheses, such that total client change talk mediated the relationship between counselor’s skills—MI-consistent behaviors [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .02, .12] and MI spirit [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .01, .13]—and increased fruit and vegetable consumption.

Conclusion: Motivational interviewing is a resource- and time-intensive intervention, and is currently being applied in many arenas. Previous research has identified the importance of counselor behaviors and client change talk in the treatment of substance use disorders. Our results indicate that similar mechanisms may underlie the effects of MI for dietary change. These results inform MI training and application by identifying those processes critical for MI success in health promotion domains.

Traditional perspectives on sexual prejudice typically focus on the distinction between heterosexual ingroup and homosexual outgroup. In contrast, I focus on an affordance-management paradigm which views prejudices as resulting not from ingroup/outgroup relations, but instead from perceptions of the threats and opportunities posed by members of different groups. Past research has demonstrated that non-heterosexual target groups are perceived to pose a variety of threats, including threats to the socialization of young children, of child molestation, of disease, and to values. My research, however, suggests sexual prejudices arise for college students from beliefs that certain sexual orientation groups pose threats of unwanted sexual interest. For young adults, mating concerns are salient and should define relevant threats and opportunities--including those that might drive prejudices. For individuals with different active motivations, however, different threats and opportunities and threats are salient, and so the threats driving sexual prejudices may also differ. I extend my past research to consider how activating different fundamental goals (e.g., disease avoidance, parenting) alters patterns of sexual prejudice. I posit that activating disease concerns will increase prejudice specifically toward non-heterosexuals associated with disease (gay and bisexual me)--but not other non-heterosexuals (lesbians and bisexual women)--whereas activating offspring care will increase prejudice toward all non-heterosexual target groups, as all are perceived to pose socialization threats. To test this, heterosexual participants were randomly assigned to a parenting or disease-avoidance goal activation, or control condition, and then rated their general negativity towards heterosexual, bisexual, and homosexual male and female targets. They also rated their perceptions of the extent to which each target posed unwanted sexual interest, socialization, and disease threats. Contrary to predictions, activating parenting and disease avoidance systems failed to affect sexual prejudices. Furthermore, although the pattern of observed data was largely consistent with previously observed patterns, women's attitudes towards gay men in the control condition were more negative than that found in previous studies, as were men's attitudes towards bisexual and lesbian women. Multiple mechanisms underlie sexual prejudices, and research is needed to better understand the circumstances under which alternative mechanisms are engaged and have their effects.