Application and Adaptation of Motivational Interviewing for Health Behaviours in Sub‐Saharan Africa: A Scoping Review

Background Motivational interviewing (MI) is a client‐based approach used for strengthening a person's own motivation for change. The use of MI to address health behaviours has begun to gain attention in sub‐Saharan Africa (SSA). Adapting MI to relevant sociocultural settings could improve its accessibility and effectiveness for addressing behavioural change. Therefore, this review aimed to map the evidence on the use and cultural adaptation of MI for health behaviours in SSA. Method We searched seven databases from inception to July 2024. Studies were eligible if MI was used to improve health behavioural outcomes, reported MI training in adults aged ≥ 18 years, and used any study design. Result Of the 4586 studies identified, we included 81 studies in this review. More than half (57.1%) of the studies used MI to address substance or alcohol use. Training was described in only 61.7% of the studies, with less than one‐third (30.9%) assessing competence. MI was primarily delivered face to face (92.6%) and combined with other behavioural interventions (55.6%). MI sessions ranged from 1 to 10 sessions, lasting 5 min to 2 h. Only 38.75% of the studies reported cultural adaptation of MI with the use of lay counsellors as the most common adaptation. Conclusion The application of MI for substance or alcohol use as reported in most studies reflects its original purpose. The number and duration of sessions vary significantly across studies, demonstrating MI's flexibility. However, gaps remain in reporting training, competence assessment and cultural adaptation of MI.