Tailored Motivational Interviewing Implementation-Effectiveness Trial in Multidisciplinary Adolescent HIV Care Settings

Summary

The goal of this study is to test a multi-faceted Tailored Motivational Interviewing Implementation intervention (TMI), based on the Dynamic Adaptation Process (DAP) to scale up an Evidence-based Practice (EBP) in multidisciplinary adolescent HIV care settings while balancing flexibility and fidelity.

A mixed-methods design will be used, in which the dominant method is quantitative (a dynamic wait-listed design; DWLD) to determine the impact of TMI on the integration of MI with fidelity in 10 adolescent HIV clinics with an average of 15 providers and 100 patients each.

Conditions

• HIV Infections
• Adolescent Development
• Care Eliciting Behavior
• Patient Non-Compliance
• Patient Refusal of Treatment

Interventions

BEHAVIORAL

Competency: 12-Item Motivational Interviewing (MI) Coach Rating Scale (CRS)

Coaching feedback will be triggered by a provider falling below the competency threshold on the standardized patient interaction. Everyone will receive coaching for two assessments in the month following training. After that, if mean scores fall below competency, then the provider will receive a 45-minute coaching session by the external Motivational Interviewing Network of Trainers (MINT) facilitator. Feedback on two highest and two lowest ratings, review of the audio recording and interactive coaching activities (e.g., fidelity assessments) targeting the lowest ratings. While many aspects of this implementation strategy are adaptable, organizational leadership will review data on completion of coaching feedback sessions and will determine corrective action for suboptimal adherence.

BEHAVIORAL

Randomized Guided Development of COPs with an internal facilitator after one year of implementation.

Development of the CoP will be guided by scheduling and assisting in setting the agenda for the first three meetings to encourage MI practice, peer coaching and potentially fidelity monitoring, and prevent drift. In addition to CoP, half the sites will be randomized to receive an internal facilitator who will be trained to continue quarterly fidelity monitoring and coaching feedback when scores fall below competency.

BEHAVIORAL

CoP development without internal facilitation.

Development of the CoP will be guided by scheduling and assisting in setting the agenda for the first three meetings to encourage MI practice, peer coaching and potentially fidelity

Sponsors & Collaborators

• University of Alabama at Birmingham

  collaborator OTHER

• University of South Florida

  collaborator OTHER

• Children's Hospital Los Angeles

  collaborator OTHER

• St. Jude Children's Research Hospital

  collaborator OTHER

• Children's Hospital of Philadelphia

  collaborator OTHER

• State University of New York

  collaborator OTHER

• University of Miami

  collaborator OTHER

• Johns Hopkins University

  collaborator OTHER

• University of California, San Diego

  collaborator OTHER

• Children's National Research Institute

  collaborator OTHER

• City University of New York, School of Public Health

  collaborator OTHER

• Wayne State University

  collaborator OTHER

• Florida State University

  lead OTHER

Principal Investigators

• Lisa Todd, MS, JD · Wayne State University

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2017-08-28

Primary Completion

2021-12-31

Completion

2021-12-31

Countries

• United States

Study Locations