Dorien Brouwer

123 Motivational interviewing to support lifestyle behavior change PART 2 reduced the sample size. We also experienced a high percentage of lost to follow up (32%). Drop out was evenly distributed over both groups. However there were significant fewer patients with a TIA in the drop out group, and significant more smokers and patients who used more alcohol than recommended (data in supplemental file). This selective missing may be clinical relevant for the feasibility of using motivational interviewing, however given the width of the confidence intervals at six months follow up (Table 2) it is unlikely that final conclusions thereby would be affected. High drop out and distractions in conversations affected the feasibility of using motivational Interviewing in this group. The extra visit to the hospital may be a to high threshold to take for patients. Because a relatively large number of smokers and alcohol users dropped out, having conversations at home or in primary settings can possibly increase the feasibility of the intervention. In summary, the strong support in the control group, the timing and duration of the intervention, and cognitive problems may partially explain the lack of effect of motivational interviewing in our study. Therefore the role of motivational interviewing in supporting lifestyle behavior after TIA or ischemic stroke might be still possible and a keyrole for nurses in lifestyle behavior change in these patients could be considered. At present, there is no strong evidence of the effectiveness of motivational interviewing on behavior change after a TIA or ischemic stroke. However, overall lifestyle behavior change was high in both groups and may be explained by the keyrole of specialized nurses in this study. Future studies should therefore focus on the role of nurses in behavioral change processes after stroke or TIA . Conclusion Our results do not support the effectiveness of motivational interviewing in supporting lifestyle behavior change after TIA or minor ischemic stroke. However, the overall lifestyle behavior change was high and might be explained by the key role of specialized nurses in both groups.