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Ultra-Brief Personal Action Planning (UB-PAP) and Motivational Interviewing: A Comprehensive Approach to Activation and Behavior Change in the Clinical Setting

• Steven Cole, MD, Professor of Psychiatry and Head, Division of Medical and Geriatric Psychiatry, Stony Brook University Medical Center
• Nancy Knapp, MPH, Program Director, WISEWOMAN Women's Health, Southeast Alaska Regional Health Consortium
• Martha Pearson, MA, WISEWOMAN Intervention Specialist, Southeast Alaska Regional Health Consortium
• Litia Garrison, BS, WISEWOMAN Patient Educator, Southeast Alaska Regional Health Consortium
• Moderator: Patricia Ferry, LMSW, CDC Contractor/Columbus Technologies, Inc.

Session Objective

The objectives for this session are to:

• Describe the purpose, evidence-base and potential usefulness of UB-PAP (Ultra-Brief Personal Action Planning) to support and motivate patient self-management.
• Describe the relationship of UB-PAP to the 5As of Self-Management Support and the theory and practice of Motivational Interviewing.
• Explain the three question framework of UB-PAP.
• Demonstrate the use of UB-PAP in practice with colleagues.
• Discuss potential mechanisms to implement UB-PAP on the local level, including training and systems change.

Session Summary

Developed by Steven Cole, UB-PAP (Ultra-Brief Personal Action Planning) is a highly focused adaptation of motivational interviewing designed to help busy clinicians support patient self-management and encourage healthier lifestyle behaviors. Organized around three core questions, UB-PAP is relatively easy to teach and learn and rests on the powerful evidence base of motivational interviewing and self-management support theory and research. Clinicians can use UB-PAP to help patients reduce risk of heart disease and stroke. In this session, Dr. Cole demonstrates the tool and discusses its conceptual relationship to the 5 As of self-management support and the more subtle techniques of motivational interviewing. A tribal organization presents its experiences adopting the tool for local use and demonstrates its clinical implementation. Participants have the opportunity to practice using the tool in small groups and develop action plans for implementation. Time for questions and discussion is provided, and Dr. Cole is available to review his experiences with training and system implementation.

During Dr. Cole’s presentation, participants are given 10 minutes to practice using the three core questions of UB-PAP in small groups of 2. This helps them experience the patient-centered nature of the invitation for behavior change as well as the motivational impact of the exercise.

At the end of the session, participants spend time identifying steps they can take upon returning to their jobs to explore the promotion and adoption of UB-PAP by health care providers in their community/state. This is done individually (completing the worksheet) and in small group discussions. The participants are given 20 minutes to complete the worksheet and discuss in small groups of 3-4; followed by 20 minutes in plenary to present and discuss plans of the group as a whole.

Resources/References/Web Sites/Tools

• Physician Guide to Patient Self-Management Support:
  http://www.ama-assn.org/ama1/pub/upload/mm/433/phys-resource-guide.pdf
• Motivational Interviewing Website:
  http://www.motivationalinterview.org/
• Steven Cole Website:
  http://www.stevencolemd.com/
• Ultra-Brief Personal Action Planning (UB-PAP) and Motivational Interviewing:
  A Comprehensive Approach to Activation and Behavior Change in the Clinical Setting -
  Handout (PDF, 16k)