Interviewing Skills Research Articles

Promoting the use of simulation-based education in GP surgeries through the development of a new local network of primary care simulation educators

Simulation-Based Education (SBE) is a widely used educational tool in healthcare, but with a skew to secondary care. Our work is part of a growing movement to bring the benefits of SBE into primary care [1]. There is an expanding and diversifying number of staff groups in general practice, with the potential to bring additional expertise and experience to benefit primary care patients; notably the Additional Roles Reimbursement Scheme is bringing new paramedics, pharmacists, physiotherapists, physician’s associates, and social prescribers, among others, into the traditional primary care workforce. There have been significant challenges in embedding these new roles, creating a sense of belonging, forming new ways of multi-disciplinary working, as well as understanding of their strengths and training needs [2]. The aim of the programme is to build a sustainable local network of simulation practitioners to continue to deliver in-situ simulations to the general practice teams. This will contribute to the training and education of clinicians, improving patient experience and safety, and embracing the broadening and expanding primary care workforce. We are training a network of ‘Simulation Ambassadors’ to work in local Primary Care Networks – clusters of practices serving up to 100,000 patients – to bring SBE to primary care teams, enabling training and education targeted to local needs, in multidisciplinary settings, including established and new staff groups. This has the intended benefit of allowing focused training sessions in GP practices, fostering closer working relationships between members of different staff groups while sharing knowledge and learning between these different groups. 6 ‘Simulation Ambassadors’ have received training to deliver and debrief simulation sessions and are further supported by a Primary Care Simulation Fellow, who provides resources, mentoring, and fosters a community of practice. The simulation sessions cover a range of topics including ‘acute’ scenarios (e.g. the unwell patient in a waiting room), as well as scenarios focused on consultation and communication skills (e.g. safeguarding, explanations and diagnoses of chronic pain conditions, paediatric asthma management). We have encountered several challenges during this process, including the novelty and unfamiliarity of simulation in primary care, and the difficulty of asking already stretched staff to dedicate time, either as educators or learners, away from direct clinical care. As the programme rolls out, we intend to demonstrate the value of simulation as an educational medium and will encourage wider use locally within Primary Care. 1. Akram M and Ismail F. Simulation training in primary care. InnovAiT. 2017;10(12):765–767. 2. Baird B, Lamming L, Beech J, Bhatt R, Dale V. Integrating additional roles into primary care networks, Kings Fund report, 2022.

ISPO: A Serious Game to train the Interview Skills of Police Officers

The Interview Simulation for Police Officers (ISPO) is a serious game developed to train police officers in communication competencies related to the interview of victims, witnesses and suspects. It was developed by Gameware Europe in collaboration with the Portuguese Police (Policia Judiciaria) within the RAGE project. The ISPO serious game was created using the modern methodologies and practices that are used in real-life police interviews. The focus of the game is on the training of communication competencies regarding gathering information from both victims and offenders.
 In order to evaluate the training effectiveness of the game, we conducted a study with 194 participants where general subjective learning effectiveness, using the Perceived Competence subscale of the IMI questionnaire, and domain-specific subjective learning effectiveness using the Police Interview Competency Inventory (PICI) were measured. Overall, ISPO improved the self-perceived competence of its players. Additionally, participants changed their opinion about the attitude to conduct a successful interview. Participants’ level of importance attributed to being dominant diminished and the level of importance attributed to being more benevolent and communicative during police interviews increased. Effects were stronger in inexperienced users leading us to believe that the game is an added value for use in a police officer school.

Developing Motivational Interviewing Skills Among Undergraduate Nursing Students.

The current study evaluated changes in undergraduate nursing students' knowledge and self-efficacy in motivational interviewing. Fourth-year undergraduate nursing students completed a hybrid, online curriculum. Changes in knowledge and self-efficacy were assessed using a pretest/posttest design. Repeated measures analysis of variance was used to determine differences between knowledge and self-efficacy mean scores. Of the 144 students who participated in the study, 88.2% were female, 96.5% were non-Hispanic/Latino, 88.9% were White, and mean age was 21.3 years. There were significant increases in knowledge and self-efficacy mean scores between pre-survey and post-survey 1 and 2. There were no differences between post-surveys 1 and 2 scores. A hybrid, online curriculum using asynchronous modules and synchronous simulation training can facilitate nursing students' learning experiences and enhance knowledge and self-efficacy about motivational interviewing. [Journal of Psychosocial Nursing and Mental Health Services, 61(5), 17-24.].

The only chance for a 'bird's-eye view': General practice registrar experiences of direct observation.

Direct observation is a teaching and assessment method in general practice training, providing important and timely feedback to registrars on their clinical and consultation skills. Registrar perspectives on direct observation are essential for understanding its utility for learning. The aim of this study was to explore registrar experiences of direct observation to identify key considerations for using direct observation in general practice training. In-depth semi-structured interviews were conducted with seven general practice registrars in Victoria, across different stages of training. Data were analysed thematically RESULTS: The main themes identified related toregistrar engagement, supervisor engagement, practice engagement andtraining organisation engagement. Using the principles of adult learning and work-based learning, this study offers an understanding of the individual and workplace-based factors that affect registrar experience of direct observation and suggests some strategies for achieving best outcomes for registrar learning.

Motivational interviewing for loved ones: Randomized controlled trial of brief training for first episode psychosis caregivers

BackgroundResearch shows that family involvement in psychosis treatment leads to better patient outcomes. Interventions that involve and counsel family members may improve patient outcomes by addressing barriers to treatment adherence and lowering family expressed emotion, thereby creating a less stressful and more supportive home environment. Learning to use motivational interviewing communication skills may help caregivers to decrease conflict and expressed emotion and improve treatment adherence. MethodsThe current study is a pilot randomized controlled trial testing the impact of “Motivational Interviewing for Loved Ones” (MILO), a brief five-hour psychoeducational intervention for caregivers, in a sample of family members of individuals with early course psychosis (N = 40). Using a randomized crossover design, caregivers were randomized to either immediate MILO or a six-week waitlist control condition; all participants eventually received the intervention. ResultsCaregiver participants experienced large (d = 1.08–1.43) and significant improvements in caregiver wellbeing, caregiver self-efficacy, family conflict, and expressed emotion. There was no change over time in caregiver-reported patient treatment adherence. Relative to waitlist, MILO had significant effects on family conflict and expressed emotion, a trending effect on perceived stress, and no effect on parenting self-efficacy or treatment adherence. ConclusionsMILO showed benefits for caregivers of FEP patients in this small, controlled trial. Further testing in a larger randomized controlled trial is warranted to better characterize MILO's effects for caregivers and patients across a range of diagnoses.

Fidelity and maintenance of motivational interviewing skills in diabetes prevention program coaches: a pilot study

ABSTRACT Motivational interviewing (MI) is an effective counseling style for changing lifestyle behaviors. The purpose of this study was to pilot a brief MI workshop on non-healthcare practitioners to deliver a community-based diabetes prevention program. Participants (n = 5) attended a two-day MI workshop, shadowed an expert coach delivering the diabetes prevention program, and finally, were shadowed by the expert coach and received feedback. Participants pre- and post-workshop MI skills were assessed, participants’ satisfaction with the workshop was recorded, and their delivery of the program using MI was assessed using a random selection of participants’ audio recordings of interactions with client. The primary outcome was whether coaches were able to maintain a level of client-centered MI skills for the six months post-training, as assessed by the Motivational Interviewing Competency Assessment (MICA). One session with one client per month for coaches’ first six months post-training was coded. Counseling scores were generated using the MICA. In general, coaches showed improvements from pre- to post-workshop, were satisfied with the training, and were using client-centered care over the six-month study period. The majority (80%) of all sessions were client-centered for all the MICA categories. This pilot study offers preliminary evidence that non-healthcare practitioners attending a brief MI training were able to deliver client-centered coaching in a community-based diabetes prevention program up to six months post-training without the use of any booster training sessions. This suggests that the training used within this study may be sufficient to train future non-healthcare practitioner diabetes prevention program coaches in the community.

“No One Told Me”

Libraries are being called upon to assist with a variety of social problems including everything from housing and food insecurity to disaster recovery. In response, some public libraries have called on social workers to help. These developments beg the question of whether information professionals are being prepared for the realities of public library careers. This presentation reports findings from a series of 28 interviews with public librarians and branch managers to explore their views on how library and information science programs can ensure that students are prepared to respond to their community’s social service needs. Findings reveal that the inclusion of social work interview skills, de-escalation training, knowledge of social service resources, and instruction on how to collaborate with and supervise social workers would better prepare students for the realities of working in public libraries.

Mechanisms of change for a family intervention in Kenya: An Integrated Clinical and Implementation Mapping approach

To increase cultural relevance and maximize access for historically underserved populations, there is a need to explore mechanisms underlying treatment outcomes during piloting. We developed a mixed-method approach, Integrated Clinical and Implementation Mapping (ICIM), to explore clinical and implementation mechanisms to inform improvements in content and delivery. We applied ICIM in a pilot of Tuko Pamoja, a lay counselor-delivered family intervention in Kenya (10 families with adolescents ages 12–17). ICIM is a 3-phase process to triangulate data sources to analyze how and why change occurs within individual cases and across cases. We synthesized data from session and supervision transcripts, fidelity and clinical skills ratings, surveys, and interviews. Outputs included a comprehensive narrative and visual map depicting how content and implementation factors influenced change. For Tuko Pamoja, ICIM results showed common presenting problems, including financial strain and caregivers’ distress, triggering negative interactions and adolescent distress. ICIM demonstrated that active treatment ingredients included communication skills and facilitated, prescribed time together. Families improved communication, empathy, and hope, facilitated improved family functioning and mental health. Key implementation mechanisms included provider clinical competencies, alliance-building, treatment-aligned adaptations, and consistent attendance. Results guided manual and training refinements and generated hypotheses about mechanisms to test in larger trials.

The role of the relational context and therapists' technical behaviors in brief motivational interviewing sessions for heavy alcohol consumption: Findings from a sample of Latinx adults

IntroductionMotivational interviewing (MI) theory and process research highlights the role of therapist technical and relational behaviors in predicting client in-session statements for or against behavior change (i.e., change and sustain talk, respectively). These client statements, in turn, have been shown to predict intervention outcomes. The current study examines sequential associations between therapist behaviors and client change and sustain talk in a sample of Latinx individuals who engage in heavy alcohol consumption. DataData are from a completed randomized clinical trial of a culturally adapted (CAMI) versus unadapted MI targeting alcohol use and consequences among Latinx individuals. MethodThe study collected observational coding data with the Motivational Interviewing Skill Code (MISC 2.5, i.e., therapist behaviors and global ratings) and the Client Language Assessment – Proximal/Distal (CLA-PD, i.e., client language). Frequentist and Bayesian sequential analyses examined the relationship among nine different categories of therapist behaviors and three different categories of client language (i.e., change talk, sustain talk, neutral). We examined odds ratios and conditional probabilities for the direction, magnitude, and significance of the association between the use of MI technical behaviors and subsequent client statements about change. The study compared these same transitional associations between low/average (i.e., <4) and high (i.e., ≥4) MI Spirit sessions. ResultsThe pattern of results was replicated across both analytic frameworks. Questions and reflections about change talk versus sustain talk versus neutral statements showed greater odds of predicting the intended client response (i.e., change talk, sustain talk, neutral, respectively) compared to other possible client responses. Conditional probabilities for these transitions were high, ranging from 0.55 to.88. The magnitude of certain technical transitions significantly differed between low/average and high MI Spirit sessions. ConclusionsAnalyses supported the hypothesized associations between therapist use of technical MI behaviors and client change language within this Latinx sample. Analyses of MI Spirit as a moderator of these transitions showed partial support.

A Survey of Vascular Surgery Program Directors: Perspectives following USMLE Step 1 Conversion to Pass/Fail and Virtual Only Interviews

Step 1 of the United States Medical Licensing Examination (USMLE), a historically important factor in the selection of vascular surgery residents and fellows, transitioned to completely pass/fail on January 26, 2022. Due to the COVID-19 pandemic, residency and fellowship interviews were conducted virtually during the 2020-21 and 2021-22 application cycles. Given these significant changes in the evaluation of candidates for residency training, we sought to understand vascular surgery program directors' (PDs) perspectives regarding the change in step 1 scoring and use of virtual interviews as well as determine which factors will assume importance when applying to vascular surgery training programs in the future. A 26-item survey questionnaire was created using Qualtrics survey tools with questions regarding attitudes toward the change in step 1 scoring and virtual interviews, the importance of additional factors utilized by programs in selecting candidates for interviews and ranking applicants for residency/fellowship selection, and programmatic demographics. This was distributed anonymously to all vascular surgery training programs over a 2-week period using a comprehensive list of 249 unique email addresses created by cross-referencing the Accreditation Council for Graduate Medical Education list of certified vascular training programs with email addresses from individual program websites identifying current program leadership. Responses were analyzed with descriptive statistics with values listed as average Likert scale weight±standard deviation (SD) or percentages. Sixty-eight of 249 (27.3%) program and associate PDs responded to the survey. Of which, 33.9% of respondents strongly disagreed with step 1 going completely pass/fail. In the absence of a scored USMLE step 1, letters of recommendation (average Likert scale weight±SD, 4.43±0.92), dedication to specialty (4.14±1.03), and USMLE step 2 CK (4.06±0.92) had the highest average scores for deciding which applicants to interview for integrated vascular surgery residency. For determining which candidates to interview for vascular surgery fellowship, letters of recommendation (4.51±0.84), dedication to specialty (4.12±0.90), and research (4.10±0.80) had the highest average scores. For ranking residency candidates, the interviewee's perceived "fit" (4.61±0.55), letters of recommendation (4.53±0.76), and an overall interview experience (4.47±0.62) had the highest average scores. Similarly, the factors with the highest average Likert scores for ranking fellowship candidates included the interviewee's perceived "fit" (4.69±0.51), letters of recommendation (4.65±0.52), and an overall interview experience (4.51±0.59). The majority (72.2%) of PDs preferred in-person interviews; however, 50% of respondents were at least "somewhat satisfied" with virtual interviews during the 2021-22 application cycle as they could judge applicants' interview skills at least "moderately well." The minority (18.8%) who preferred virtual interviews most commonly noted a "reduction of the financial burden for applicants" as the reason for this preference. Most vascular surgery program and associate PDs were dissatisfied with USMLE step 1 going pass/fail with most indicating prescreening applicants using both step 1 and step 2 clinical knowledge (CK) during the residency and fellowship selection processes. In the absence of a scored step 1, the top factors for interviewing and ranking integrated vascular surgery residency and fellowship candidates included letters of recommendation, dedication to specialty, research, USMLE step 2 CK, the interviewee's perceived "fit," and overall interview experience. Though most PDs preferred face-to-face interviews, they were overall at least "somewhat satisfied" with the virtual format that took place during the 2021-22 cycle.

Tailored interviewing to uncover the perspectives of children with multiple disabilities on daily activities: A qualitative analyses of interview methods and interviewer skills.

Uncovering the perspective of children with multiple disabilities is important in health care to enable person-centred health care. For occupational therapists, uncovering the child perspective on meaningful activities is necessary to set appropriate goals for treatment. It is not always evident that children with multiple disabilities can express themselves in an interview. The interviewer should adapt his communication to the child. In literature, alternative communication is widely studied, but a clear algorithm for deciding what to use to successfully gain insight into the child perspective is missing. This study aims to identify helpful interview techniques and interviewer skills and how they can be used to effectively uncover the perspective of children. Videos of nine interviews with children with a mitochondrial disorder, conducted by an occupational therapist, were analysed by five researchers. The interviews were analysed to see how well the interviewee had obtained the child's perspectives followed by observation of communicative abilities of the child and the types of questions the interviewer asked. A qualitative directed content analysis of the semi-structured interviews followed. An interview pattern was observed in the children's communication leading to six successful interviews. Children communicated verbally on four different levels and also used non-verbal communication. The interviewer used five types of questions, which varied between and within the children. The content analysis resulted in two themes: parental influences and interviewer skills. Results show the importance of matching the type of questions to the verbal communication level of the child and revealed several interviewer skills and techniques. An overview to guide tailor-made interviewing is presented. The interviewer has a major role in successful interviewing and thus in enabling the inclusion of the child perspective in research and care.

Community Pharmacist Consultation Service: A Survey Exploring Factors Facilitating or Hindering Community Pharmacists' Ability to Apply Learnt Skills in Practice.

Background: The NHS Community Pharmacist Consultation Service (CPCS) offers patients requiring urgent care a consultation with a community pharmacist, following referral from general practice or urgent care. The study explored the impact of undertaking a Centre for Pharmacy Postgraduate Education (CPPE) CPCS learning programme, and barriers and enablers to CPCS delivery. Methods: CPPE distributed an online survey to those who had undertaken their CPCS learning. The survey explored participants’ knowledge, confidence and application of taught skills/tools, including clinical history-taking, clinical assessment, record keeping, transfer of care, and Calgary-Cambridge, L(ICE)F and SBARD communication tools. Details on barriers and enablers to CPCS delivery were also included. Results: One-hundred-and-fifty-nine responses were received (response rate 5.6%). Knowledge of, and confidence in, taught skills were high and respondents reported applying skills in CPCS consultations and wider practice. Barriers to CPCS included a lack of general practice referrals, staffing levels, workload, and GP attitudes. Enablers included a clear understanding of what was expected, minimal concerns over indemnity cover and privacy, and positive patient attitudes towards pharmacy. Conclusion: This study demonstrates that community pharmacists can extend their practice and contribute to the enhanced provision of urgent care in England. This study identified barriers, both interpersonal and infrastructural, that may hinder service implementation.

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology

Assessment of training of general practice interns in motivational interviews about vaccination

ABSTRACT The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.

Interview skills training for people with neurodevelopmental disorders receiving vocational services: A pilot study

BACKGROUND: People with neurodevelopmental disorders often face significant challenges to finding and keeping employment including engaging in a job interview. Successfully navigating a job interview is a complex and essential stage to finding employment and requires skillful behaviors. OBJECTIVE: The study aimed to determine the feasibility of the Presenting Qualifications intervention for people with neurodevelopmental disorders. METHODS: Direct skills teaching (DST) is a researched method that can be utilized to help people learn a new skill. The current study implemented a multi-session, group based work-related soft skills intervention (“Presenting Qualifications”) for 76 people with various neurodevelopmental disorders via a DST approach. RESULTS: Participants reported increased perceived interview preparedness from pre to post intervention. Participants also reported satisfaction with the intervention. CONCLUSIONS: This suggests soft skills interventions delivered in group settings can be successfully implemented among people with neurodevelopmental disabilities. Implications of the findings and future research directions are discussed.

Rudolf Dreikurs as I Remember Him

This article recounts 2 years of intensive mentoring by Rudolf Dreikurs from our first meeting until his death. It includes remembrances of his lectures, live demonstrations of interview and therapy skills, observation of his diagnostic skill in nonclinical settings, and training in his private practice. It concludes with personal reflections on the impact of this mentoring.

Hoarding: Ownership Gone Awry

Hoarding: Ownership Gone Awry

Influence Of Financial Literacy on Personal Investment Decisions Among Kenya Football Premier League Players in Kenya

Financial literacy plays an essential role in the process of making financial decisions, as it represents a systematic effort aimed at the development of positive knowledge, and attitude. Extant literature indicates that the financial literacy among football players is low which ultimately affects their investment decisions. Therefore, the purpose of this study was to determine the influence of financial literacy on personal investment decisions among KPL players in Nairobi. The study was guided by the following specific objectives; to determine the influence of savings decisions, financial knowledge and skills, financial awareness and financial attitude on personal investment decisions among KPL players in Nairobi. The study adopted dual process theory, the exchange theory and the goal setting theory. The study employed a descriptive research design. The target population was 396 football players from the 18 teams playing the KPL for the season 2020/2021. The study covered a period of one year from November 2020 to August 2021. This study used a sample of 30% from each of the 18 KPL teams. Therefore, from each of the 18 teams, 7 football players were randomly selected making up a sample size of 126 football players. A self-administered structured questionnaire was given to the respondents for data collection. Quantitative data collected was analyzed using descriptive and inferential statistics. Statistical Package for Social Sciences (SPSS V. 23.0) was used for data analysis. Regression model was used to establish the relationship between the study variables. Before conducting the regression analysis, diagnostic tests was conducted. These tests included the multicollinearity and normality tests. The findings were presented in form of tables and figures. The findings were of importance to the football teams in Kenya as it emphasized on the need for financial literacy training. The study established that savings decisions, financial knowledge and skills, financial awareness and financial attitudes had a positive and significant influence on personal investment decisions among Kenya football premier league players in Kenya. The study concluded that the most important reason why one should start planning at an early stage of making saving decision is the power of compounding, which allows you to earn extra money on the interest received from investments. Being financially knowledgeable and skilled allows an individual to be better prepared for specific financial roadblocks, which, in turn, decreases the chances of personal economic distress. Financial awareness enables players to gain the ability to use knowledge and skills to effectively manage financial resources efficiently at a personal-level and through the lifecycle. In this era of dynamic financial markets and turbulent economic environment it is very important for every individual to keep a positive mindset towards his/her finances. A positive financial attitude helps an individual strike a right balance between the utilization of money and other aspects of life, not become overly conservative and achieve long-term financial goals. The study recommended that an individual should make a financial plan by making his or her own list and then think about which goals are the most important to him or her. The players should be encouraged to subscribe to financial newsletters. The players needs a basic understanding of financial concepts to make good financial decisions. every individual needs to keep a positive outlook about personal finances and the key to this is to develop financial skills in consultation with an expert like a certified financial planner (CFP) professional, who is equipped to take one on the path to attain freedom from financial worries.

A consistent definition of cultural safety within Australian health professional education: a scoping review

This scoping review aims to explore how cultural safety is defined in the Australian literature with health professional learners in clinical interactions. It maps how the components of the Australian Health Practitioner Regulation Agency definition of cultural safety align with this evidence. Databases were systematically searched for original, peer-reviewed research that included Australian Aboriginal and Torres Strait Islander peoples, health professional learners who were eligible for registration in Australia, teaching and assessment. Many elements of cultural safety lacked Indigenous input and had no patient involvement. General consultation and communications skills were key components of culturally safe interactions. The Australian Health Practitioner Regulation Agency consensus statement on cultural safety provides a consistent definition for teaching and learning cultural safety within health professions in Australia. The findings suggest that developing an approach for cultural safety requires incorporation of Indigenous voices, patient-centred care metrics, patient feedback, learner self-assessment and attitude measures.

Impact of community health worker intervention on PrEP knowledge and use in Rakai, Uganda: A mixed methods, implementation science evaluation.

Effective models of support for HIV pre-exposure prophylaxis (PrEP) are needed for populations at elevated risk. In a hyperendemic Ugandan fishing community, PrEP counseling was provided through a situated Information, Motivation, and Behavioral Skills (sIMB)-based community health worker (CHW) intervention. We evaluated the intervention using a mixed-methods, implementation science design. We surveyed all community members aged 15-49 through the Rakai Community Cohort Study. We used multivariable logistic regressions with generalized estimating equations to estimate the intervention's effect on PrEP knowledge and utilization. To understand intervention experiences and mechanisms, we conducted 74 qualitative interviews with 5 informant types (clients, CHWs, program staff, community leaders, health clinic staff) and analyzed data using an iterative, deductive approach. A mobile phone application provided intervention process implementation data. Individuals self-reporting receipt of the CHW intervention showed significantly higher PrEP knowledge (N = 1848, PRR: 1.10, 95% CI: 1.06-1.14, p = <.0001), PrEP ever use (N = 1176, PRR: 1.77, 95% CI: 1.33-2.36, p = <.0001), and PrEP current use (N = 1176, PRR: 1.86, 95% CI: 1.22-2.82, p = 0.0039) compared to those who did not. Qualitative findings attributed positive PrEP outcomes to CHW counseling and effective use of motivational interviewing skills by CHWs. Salient themes across the RE-AIM framework included support for the CHW intervention and PrEP across clients, community, and implementers. Mobile application data demonstrated consistent delivery of the PrEP module throughout implementation. CHWs improved PrEP knowledge and use among clients in an HIV hyperendemic fishing community. Mixed-methods, implementation science evaluations can inform adaptation of similar PrEP implementation strategies.