NURSE-LED MOTIVATIONAL INTERVIEWING FOR HEALTH BEHAVIOR CHANGE IN PRIMARY CARE A SYSTEMATIC REVIEW OF ITS EFFECTIVENESS FOR WEIGHT LOSS AND SMOKING CESSATION
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Background: Motivational interviewing (MI) is a patient-centered counseling approach that aims to enhance intrinsic motivation for behavior change through empathetic communication and collaborative goal-setting. Within primary care, nurse-led MI has emerged as a promising strategy for promoting health behavior changes, particularly for weight management and smoking cessation. Objective: This systematic review aims to evaluate the effectiveness of nurse-led motivational interviewing interventions in promoting weight loss and smoking cessation among adults in primary care settings. Methods: A comprehensive literature search was conducted across PubMed, CINAHL, Scopus, and Cochrane Library databases for studies published between 2010 and 2025. Inclusion criteria encompassed randomized controlled trials (RCTs), quasi-experimental, and cohort studies assessing nurse-led MI interventions targeting weight loss or smoking cessation. Data extraction focused on study design, intervention characteristics, outcomes, and follow-up duration. Quality appraisal was performed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: Fifteen studies met the inclusion criteria, comprising over 3,500 participants. Most interventions involved multiple MI sessions integrated into routine primary care visits. Nurse-led MI was associated with significant short- to mid-term improvements in weight reduction (mean difference: 2.1–3.8 kg; p < 0.05) and smoking cessation rates (relative risk range: 1.3–2.0 compared to standard counseling). Enhanced patient engagement, self-efficacy, and satisfaction with care were frequently reported qualitative outcomes. However, long-term sustainability of effects varied, with some studies indicating relapse beyond six months. Conclusion: Nurse-led motivational interviewing is an effective approach for promoting weight loss and smoking cessation in primary care. Its success is largely attributed to the therapeutic relationship, communication style, and consistent follow-up provided by nurses. Future research should explore optimal training protocols, intervention frequency, and digital integration to enhance long-term outcomes and scalability.
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