Comparing Motivational Interviewing with Education for Later Life Planning: A Two-arm Randomised Controlled Trial

TL;DR

This study compares motivational interviewing and education in helping older adults plan for later life, finding that motivational interviewing leads to better outcomes in empowerment and planning.

Contribution

The study introduces a strengths-based motivational interviewing intervention that reframes later-life planning as an empowering process.

Findings

Motivational interviewing showed sustained improvements in planning stages and preparedness at 3 months compared to education.

Improvements were most significant in social participation and health planning domains.

Both interventions improved psychosocial outcomes like attitudes toward ageing and life satisfaction.

Abstract

The prevalent view of ageing as a period of decline often obscures opportunities for growth, agency, and continued contribution. Reframing ageing requires moving beyond simply providing knowledge and instead empower individuals to take proactive action in planning for a thriving later life. This study developed and evaluated a theory-informed intervention designed to reframe later-life planning as an empowering process across health, financial, social participation, family life, and long-term care domains through a randomised controlled trial. Community-dwelling adults (aged 50-75) in Hong Kong (63.0±3.9 years, 72.9% female, 74.6% retired) were randomised to a 4-session strength-based motivational interviewing (MI, n = 30) intervention resolving ambivalence, or a structured education intervention (n = 29) for knowledge/skill-building. Outcomes included attitudes, preparedness, stage of change and confidence in multidimensional later-life planning and psychosocial well-being, assessed at baseline (T0), immediately post-intervention (T1), and 1- (T2) and 3-month (T3) follow-ups. Generalised estimating equations examined differential changes in outcomes over time and groups. Overall, MI demonstrated sustained improvements in planning stages (p < 0.001, d = 0.77) and preparedness (p = 0.049, d = 0.33) at T3, outperforming Education. Such effects were particularly significant among social participation (planning stage: p = 0.02, d = 0.52) and health (preparedness: p = 0.03, d = 0.41) planning. Financial, family life, or long-term care planning, often requiring household-level consensus, were less responsive, warranting future family-based interventions. Both groups improved psychosocial outcomes (e.g., attitudes toward ageing, life satisfaction, self-efficacy; p < 0.05). This strengths-based model effectively empowers adults to engage with their later-life. By reframing planning from a burden to an opportunity for self-determination, it provides a tool for practitioners to advance equitable ageing.