Motivational interviewing for health behavior change among young adults in Canada: Findings from the MOTIVATE pilot randomized controlled trial

Objective : Young adults face rising rates of preventable chronic disease, including obesity and cancer; yet prevention interventions remain limited. Motivational interviewing may support behavior change but few studies have examined its feasibility in preventive settings. This study assessed the feasibility of a behavioral and educational intervention promoting healthy behaviors among young adults and explored secondary clinical outcomes. Methods : We conducted a six-month pilot randomized controlled trial at a Canadian university. Data collection occurred between February 2023 and January 2024. Participants aged 18–29 were randomized to an education-only control or a motivational interviewing intervention (up to seven sessions). All participants received a wearable fitness device. Primary feasibility outcomes included recruitment, retention, data completion, and satisfaction. Secondary outcomes included body mass index, physical activity, sedentary behavior, fruit and vegetable intake, quality of life, and mental health. Results : 101 students were randomized (52 intervention, 49 control), and 80.2% completed follow-up. Feasibility targets were met for recruitment (86.3%), retention (80.2%), data completion (93%), and satisfaction (82.7%). Clinical changes were modest. Most participants recalled early-life health factors, supporting the feasibility of future risk stratification. Conclusions : This trial met all prespecified feasibility thresholds and demonstrated high satisfaction; findings will inform progression to a full-scale trial. • Motivational interviewing for healthy behavior change in young adults is feasible • Recruitment, retention, data completion and satisfaction targets were met • All participants opted for virtual delivery of the intervention • Early-life risk factor data was successfully collected • Larger trials are needed to evaluate clinical outcomes