Motivational Interviewing Training Research Articles

Professional development through motivational interviewing training: Lower secondary school teachers’ views and experiences

ABSTRACT Motivational interviewing (MI) is a collaborative communication style used to increase individuals’ motivation. This study explored teachers’ experiences of implementing school-based MI after participating in a compulsory teacher professional development (PD) programme. 23 teachers, teaching in grades 7–9, received school-based MI training. Four qualitative focus group interviews were conducted and reflexive thematic analysis was used to analyse the data. Four main themes were generated: MI as a useful professional tool, Facilitators for MI implementation, Challenges when applying MI in practice, and Top-down as a barrier to implementation. Findings show that MI provides professional tools that facilitate teachers' relational work, and teachers suggested that MI training should be an element of teacher education. This study highlights the importance of designing PD programmes that are consistent with teachers’ needs in practice. When applying MI in schools, several challenges were identified: to balance the fostering teacher role, lack of time, and students’ lack of maturity. Hence, this study emphasises the need for ongoing training, allocated time, and well-defined objectives when implementing MI in schools. This study provides novel insights into the perceived benefits and challenges of MI training for teachers, thus providing valuable information for teacher educators and school leaders.

Enhancing adapted physical activity training for community organizations: co-construction and evaluation of training modules.

Community-based physical activity programmes benefit persons with disabilities. However, there is a lack of evidence-based tools to support kinesiologists' training in such programmes. This study aimed to co-create and evaluate physical activity training modules for community-based adapted physical activity (APA) programmes. In Phase 1, a working group (n = 8) consisting of staff, kinesiologists from two community-based APA programmes, and researchers met over four online meetings to discuss needs, co-create training modules, and assess usability. In Phase 2, a pre-post quasi-experimental design evaluated changes in capability, opportunity, and motivation of kinesiologists (n = 14) after completing the training modules, which included standardized mock client assessments and participant ratings of module feasibility. Means and standard deviations were computed for feasibility, followed by paired-samples t-tests, along with Hedge's correction effect size. Mock client sessions underwent coding and reliability assessment. The working group meetings generated two main themes: training in (i) motivational interviewing and behaviour change techniques and (ii) optimizing APA prescription. Nine online training modules were created. In Phase 2, medium to large effects of training modules were observed in capability (Hedge's g = 0.67-1.19) for 8/9 modules, opportunity (Hedge's g = 0.77-1.38) for 9/9 modules, and motivation (Hedge's g = 0.58-1.03) for 6/9 modules. In mock client assessments, over 78% of participants appropriately used five behaviour change techniques and, on average, participants demonstrated good use of motivational interviewing strategies. The findings indicate that training kinesiologists was feasible and has the potential to enhance community-based physical activity programmes for persons with disabilities.

Peak Flow Feedback Intervention Improves Under-Perception of Airflow Limitation in Pediatric Asthma: A Randomized Clinical Trial.

Under-perception of asthma symptoms is associated with poor asthma outcomes. We assessed the effects of a behavioral intervention for improving perception of airflow limitation and asthma outcomes. A two-arm randomized controlled trial compared peak expiratory flow (PEF) feedback versus supportive counseling. Latino and Black adolescents with asthma ages 10-17 years old and caregivers were recruited from hospitals in the Bronx, NY. PEF feedback sessions reviewed accuracy of PEF guesses and medication adherence data, and targeted behavior change using motivational interviewing and problem-solving skills training. Supportive counseling received emotional support related to asthma. Both groups received 3 sessions across 6 weeks. All participants were blinded to PEF while guessing PEF during pre-intervention, 1, 6, and 12-month follow-up. Children in PEF feedback saw actual PEF after guesses were locked in during the 6-week intervention. Participants and assessors were blinded to group assignment. The primary outcome was under-perception of airflow limitation (divergence between actual PEF and guesses) on home spirometers. Secondary outcomes included daily PEF and forced expiratory volume in 1 second (FEV1), inhaled corticosteroid adherence measured by electronic monitors, Asthma Control Test, and emergency healthcare use for asthma. The sample comprised 354 children (M = 13.2±2.2 years; 62% Latino, 38% Black) and caregivers. PEF feedback (N = 153 analyzed) demonstrated greater improvements at 1-month follow-up on under-perception of airflow limitation (difference-in-differences, -12.64; 95% CI, -17.54 to -7.74), % personal best PEF (9.89; 95% CI, 7.13 to 12.65), % predicted FEV1 (4.93; 95% CI, 0.95 to 8.90) and ICS adherence (16.02; 95% CI, 7.15 to 24.89) compared with supportive counseling (N = 152 analyzed). At 12-month follow-up PEF feedback maintained improvements on under-perception of airflow limitation (-13.87; 95% CI, -19.03 to -8.71), higher PEF (14.23; 95% CI, 11.37 to 17.08) and %FEV1 (5.62; 95% CI, 1.56 to 9.67), and had smaller declines in ICS adherence (17.51; 95% CI, 7.12 to 27.89) versus pre-intervention than supportive counseling. No between-group differences existed for asthma control or healthcare use. The efficacy and sustainability of PEF feedback was established in improving children's perception of airflow limitation, pulmonary function, and medication adherence. Clinical trial registration available at www. gov, ID: NCT02702687.

Combining Motivational Interviewing and Cognitive Bias Modification Training for Substances in Detained Youth

Motivation is considered a key factor in successful treatment. Unfortunately, detained youth typically show lower motivation for treatment and behavioral change. This pilot study examined the effects of a brief Motivational Interviewing (MI) protocol in conjunction with a Cognitive Bias Modification (CBM) intervention aimed at reducing substance use in detained youth. An MI protocol for adult parolees was adapted for adolescents. A total of 52 detained youth received the MI intervention, aimed at enhancing their insights into their substance use and its potential relation with their offenses, plus substance use treatment. These youth were matched with controls from similar populations who received the same CBM without MI. Changes in motivation over time were examined with a repeated-measures analysis of variance. Results showed no change in motivation over time, nor a significant effect of condition (MI vs no MI). Although application of the MI protocol was feasible, no effect was found on motivation, in contrast to the original adult-focused protocol. Certain core facets of the original protocol, such as client reflection on their history of substance use, may be less applicable to detained youth whose use history is relatively brief. The severity of their substance use behavior should also be taken into account in any future applications.

Co-designing a motivational interviewing training platform to enhance oncology healthcare professional communication

BackgroundOncology healthcare professionals (HCPs) using motivational interviewing may motivate and support patients with chronic illness to adhere to medications. Research of online motivational interviewing training focusing on medication adherence in cancer is limited. ObjectiveCo-design, develop, and preliminarily evaluate a motivational interviewing training platform (MITP) for oncology HCPs focused on medication adherence. MethodsWe used co-design and design science research methodology to develop and test the MITP in two phases: 1) program co-design and development and 2) interactive platform design and development. ResultsHCPs expressed a high demand for a practical and tailored motivational interviewing training. MITP is an online three-hour training comprising education, roleplay videos, and formative assessments. MITP was reported to be acceptable, usable, and useful by users. InnovationThis study used a novel approach combining co-design and design science research methodology, and digital media to develop a flexible and acceptable online motivational interviewing training focused on medication adherence in cancer. Discussion and conclusionApplied rigorous methodology ensured the MITP was developed to address knowledge gaps and the needs of oncology HCPs for supporting patient adherence, and to be usable and useful. Study findings may inform future research on online motivational interviewing training and its potential impact on medication adherence.

Protocol for a feasibility randomised controlled trial of the 'Outdoor' mobility intervention for older adults after hip fracture.

A high proportion of patients do not regain outdoor mobility after hip fracture. Rehabilitation explicitly targeting outdoor mobility is needed to enable these older adults to recover activities which they value most. The overarching aim of this study is to determine the feasibility of a randomised controlled trial which aims to assess the clinical- and cost-effectiveness of an intervention designed to enable recovery of outdoor mobility among older adults after hip fracture (the OUTDOOR intervention). This is a protocol for a multi-centre pragmatic parallel group (allocation ratio 1:1) randomised controlled assessor-blinded feasibility trial. Adults aged 60 years or more, admitted to hospital from- and planned discharge to- home, with self-reported outdoor mobility in the three-months pre-fracture, surgically treated for hip fracture, and who are able to consent and participate, are eligible. Individuals who require two or more people to support mobility on discharge will be excluded. Screening and consent (or consent to contact) will take place in hospital. Baseline assessment and randomisation will follow discharge from hospital. Participants will then receive usual care (delivered by physiotherapy, occupational therapy, or therapy assistants), or usual care plus the OUTDOOR intervention. The OUTDOOR intervention includes a goal-orientated outdoor mobility programme (supported by up to six in-person visits), therapist-led motivational dialogue (supported by up to four telephone calls), supported by a past-patient led video where recovery experiences are shared, and support to transition to independent ongoing recovery. Therapists delivering the OUTDOOR intervention (distinct from those supporting usual care) will receive training in motivational interviewing and behaviour change techniques. Baseline demographics will be collected. Patient reported outcome measures including health related quality of life, activities of daily living, pain, community mobility, falls related self-efficacy, resource use, readmissions, and mortality will be collected at baseline, 6-weeks, 12-weeks, and 6-months (for those enrolled early in the trial) post-randomisation. Exercise adherence (6- and 12- weeks) and intervention acceptability (12-weeks) will be collected. A subset of 20 participants will also support accelerometery data collection for 10 days at each time point. The trial findings will be disseminated to patients and the public, health professionals and researchers through publications, presentations and social media channels. The trial has been registered at ISRCTN16147125. 3.0.

Medical Students' Efforts to Address COVID-19 Vaccine Hesitancy Through Motivational Interviewing.

Background The coronavirus disease 2019 (COVID-19) pandemic reaffirmed health disparities in the United States (US) and highlighted the need for public health strategies to combat vaccine hesitancy, especially amongst vulnerable populations. The Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP) at Florida International University (FIU) serves a predominantly uninsured population, making it a critical area of opportunity for addressing vaccine hesitancy. Motivational interviewing (MI), a technique that supports individuals in making autonomous health decisions, has shown promise in encouraging vaccine acceptance.Medical students at FIU's Herbert Wertheim College of Medicine (HWCOM) are involved in the longitudinal care of the individuals in NeighborhoodHELP and receive training in MI within their clinical skills curriculum, making them optimally positioned to conduct outreach to encourage COVID-19 vaccination. Project goals There were two primary goals of this project: first, to systematically track and improve COVID-19 vaccination rates among individuals in NeighborhoodHELP, andsecond, to equip future physicians with hands-on experience in MI. Methods The COVID-19 Vaccination Promotion Initiative recruited medical students previously trained in MI to conduct outreach to unvaccinated individuals within NeighborhoodHELP. Students engaged in discussions about the COVID-19 vaccine with NeighborhoodHELP members, assisted in scheduling vaccination appointments, and updated medical records. The student team regularly met with faculty advisors to discuss changes in vaccine and public health data and to discuss challenges and successes with outreach efforts. To incentivize participation and enhance vaccine uptake, $25 gift cards were offered to individuals who agreed to receive the vaccine following the outreach conversations. Results From June 2021 to January 2023, the team made an estimated 720-1516 phone calls to NeighborhoodHELP individuals. The team encountered a challenge of low answering rates, with 35% of individuals being unreachable despite multiple attempts. Among those reached, 20% expressed no interest in receiving the vaccine, while 50% were interested in receiving the vaccine or had already been vaccinated. Vaccination rates among NeighborhoodHELP adults rose from 15.2% to 44.3% during this time. Student experiences with MI were generally positive, with many noting success in engaging hesitant individuals. However, the team also encountered challenges, such as growing vaccine apathy within the community and difficulties in reaching patients via cold calls, which limited the overall impact of their outreach efforts. Conclusions By using MI techniques,medical students engaged with community members in meaningful conversations about the importance and safety of COVID-19 vaccination.However,the initiative fell short of the 50% vaccination target, facing challenges such asreliance on unsolicited phone calls and the complexities of incentivizing vaccinations through this outreach method. Future initiatives could benefit from exploring alternative outreach methods, such as in-person engagement at community events or through partnerships with local organizations, to overcome the limitations of phone-based outreach. Additionally, investigating the relative efficacy of in-person versus telephone-based communication in promoting vaccination could provide valuable insights.

The Impact of Motivational Interviewing and MOTIVE Tool Use by Pharmacists on Vaccine Acceptance.

Vaccines have played a significant role in reducing infectious disease burden. However, vaccine hesitancy remains a persistent challenge in public health, including for pharmacists who often interact with patients regarding vaccines. Thus, this study assesses the impact of motivational interviewing (MI) training and the MI-based vaccine hesitancy discussion tools (MOTIVE) on pharmacists' management of vaccine hesitancy. Pharmacists in eight Midwestern pharmacy practices who completed MI and MOTIVE training and engaged with vaccine-hesitant patients participated in this study. The pharmacist participants completed post-encounter surveys identifying the vaccine discussed, the tool utilized, and the outcome of the conversation. Descriptive results from 362 encounters indicated that the primary reasons for hesitancy were safety (39%), care coordination (31.5%), and efficacy (30.4%). Post encounter, 35.4% of patients received vaccines, 26% planned to, 25.1% considered it, and 13.5% were uninterested. The findings highlight the importance of patient-centered communication, such as MI, between patients and pharmacists to identify and address reasons for vaccine hesitancy. Pharmacists, equipped with conversation tools such as the MOTIVE tools, may effectively influence vaccine acceptance. Future research should evaluate the utility of MI and the MOTIVE tools in other settings and regions.

Development of Promising Interventions to Improve Human Papillomavirus Vaccination in a School-Based Program in Quebec, Canada: Results From a Formative Evaluation Using a Mixed Methods Design.

Despite the availability of school-based human papillomavirus (HPV) vaccination programs, disparities in vaccine coverage persist. Barriers to HPV vaccine acceptance and uptake include parental attitudes, knowledge, beliefs, and system-level barriers. A total of 3 interventions were developed to address these barriers: an in-person presentation by school nurses, an email reminder with a web-based information and decision aid tool, and a telephone reminder using motivational interviewing (MI) techniques. Here we report on the development and formative evaluation of interventions to improve HPV vaccine acceptance and uptake among grade 4 students' parents in Quebec, Canada. In the summer of 2019, we conducted a formative evaluation of the interventions to assess the interventions' relevance, content, and format and to identify any unmet needs. We conducted 3 focus group discussions with parents of grade 3 students and nurses. Interviews were recorded, transcribed, and analyzed for thematic content using NVivo software (Lumivero). Nurses received training on MI techniques and we evaluated the effect on nurses' knowledge and skills using a pre-post questionnaire. Descriptive quantitative analyses were carried out on data from questionnaires relating to the training. Comparisons were made using the proportions of the results. Finally, we developed a patient decision aid using an iterative, user-centered design process. The iterative refinement process involved feedback from parents, nurses, and experts to ensure the tool's relevance and effectiveness. The evaluation protocol and data collection tools were approved by the CHU (Centre Hospitalier Universitaire) de Québec Research Ethics Committee (MP-20-2019-4655, May 16, 2019). The data collection was conducted from April 2019 to March 2021. Following feedback (n=28) from the 3 focus group discussions in June 2019, several changes were made to the in-person presentation intervention. Experts (n=27) and school nurses (n=29) recruited for the project appreciated the visual and simplified information on vaccination in it. The results of the MI training for school nurses conducted in August 2019 demonstrated an increase in the skills and knowledge of nurses (n=29). School nurses who took the web-based course (n=24) filled out a pretest and posttest questionnaire to evaluate their learning. The rating increased by 19% between the pretest and posttest questionnaires. Several changes were made between the first draft of the web-based decision-aid tool and the final version during the summer of 2019 after an expert consultation of experts (n=3), focus group participants (n=28), and parents in the iterative process (n=5). More information about HPV and vaccines was added, and users could click if more detail is desired. We developed and pilot-tested 3 interventions using an iterative process. The interventions were perceived as potentially effective to increase parents' knowledge and positive attitudes toward HPV vaccination, and ultimately, vaccine acceptance. Future research will assess the effectiveness of these interventions on a larger scale.

Motivational Interviewing: Addressing Interest Among Health Professions Students.

Motivational interviewing (MI) is a patient-centered approach to behavior change counseling that is used among health professionals across multiple disciplines. However, MI training has yet to be broadly offered to health professional (HP) students. This study aimed to evaluate student interest in MI and the efficacy of an MI workshop to assess whether MI training should be incorporated into HP curricula. We conducted a needs assessment to evaluate HP student interest in learning MI. We then hosted a 6.5-hour MI workshop, followed by optional standardized patient encounters (SPEs). SPE performance was evaluated with a scored competency assessment. Needs assessment respondents (N=93) were predominantly medical students (53%), of which 49% were interested in primary care-related fields. Most (58%) reported receiving 0 to 2 hours of MI training in their required curricula, yet 87% intended to use MI and were interested in receiving training. Nineteen students attended the MI workshop. Postworkshop knowledge assessment (N=11) improved by an average of 34% (premean [±SD], 41% [±12]; postmean [±SD], 75% [±10]; P<.001). The SPE mean competency score (5.09) surpassed the threshold for competence of 5. HP students reported receiving minimal MI training in their curricula despite being highly interested in MI. Interested students responded to our interdisciplinary MI workshop and SPEs with high satisfaction, suggesting that HP schools may benefit from incorporating MI into their curricula. Nevertheless, response rates were low, and selection bias may have skewed responses toward more favorable perceptions of MI.

Assessing the Training for Certified Peer Support Specialists Who Provide Mental Health and Substance Use Services.

The behavioral health system's peer support workforce must be adequately trained to perform peer support services, but evidence of the adequacy of their training needs to be improved. With survey data from 667 certified peer support specialists (CPSS) from North Carolina, Kentucky, Virginia, and Tennessee, this study used (a) binomial probability test to assess perceptions about the adequacy of the workforce's training, (b) latent profile analysis to identify patterns and predictors of perceptions about the SAMHSA core competencies covered in their training, and (c) thematic analysis to identify additional training needs. Most respondents identified as White (72%), female (73%), and had some college education (83%). Most of the workforce (> 90%) felt prepared to provide services, regardless of their state. Highly and moderately sufficient coverage emerged as two distinct response patterns regarding coverage of the SAMSHA core competencies, with respondents' years of experience, state of residence, education level, race, and sense of preparedness predicting the probability of fitting into either profile. Participants desired additional training in trauma-informed practices, motivational interviewing, and new treatment approaches. Peers' experiences and perspectives were similar across different states. The findings suggest booster training sessions or continuing education opportunities are needed to maintain a robust and well-prepared peer support workforce. States should consider reciprocity agreements to enable the trained workforce to practice across states. A key implication for the training content is the need to incorporate contemporary issues relating to mental health and substance use disorders to better meet behavioral health needs.

Motivational interviewing from the paediatricians’ perspective: assessments after a 2-day training for physicians caring for adolescents with chronic medical conditions (CMCs)

BackgroundCounselling adolescents with chronic medical conditions (CMCs) can be challenging regarding suitable interviewing skills and clinicians’ attitudes toward the patient. Successful communication can be a key element of treatment. Motivational Interviewing (MI) is broadly applicable in managing behavioural problems and diseases by increasing patient motivation for lifestyle changes. However, data concerning the applicability, feasibility and implementation of MI sessions in everyday practice are missing from the physicians’ point of view.MethodThe present study was conducted as a mixed methods design. Twenty paediatricians were randomized to a 2-day MI course followed by MI consultations. Data were collected through a questionnaire one year after MI training. Factors for effective training and possible barriers to successful use of MI were examined.ResultsCompleted questionnaires were returned by 19 of 20 paediatricians. The paediatricians’ experiences with MI demonstrate that MI is regarded as a valuable tool when working with adolescents with CMCs. 95% of all respondents reported that they found MI education necessary for their clinical work and were using it also outside the COACH-MI study context. 73.7% percent saw potential to strengthen the connection to their patients by using MI. The doctors were already using more MI conversation techniques after a 2-day MI course. Obstacles were seen in the short training, the lack of time and missing undisturbed environment (interruptions by telephone, staff, etc.) during clinical flow.ConclusionsMI techniques are not yet a regular part of medical training. However, a 2-day MI course was rated effective and provided a lasting impact by physicians caring for children and adolescents with chronic medical conditions (CMCs), although booster sessions should be offered regularly.Trial registrationThe study was registered in the German Clinical Trials Register (DRKS00014043) on 26/04/2018.

Counsellors' verbal behaviours and skills that elicit participants' change or sustain talk in virtual motivational interviewing for physical activity among older adults.

Exploring the influence of counsellors' verbal behaviours on participants' utterances in virtual motivational interviewing (MI) could broaden our understanding of how MI works. This study aims to determine counsellors' behaviours that are more or less likely than chance to elicit participants' change talk and sustain talk during a virtual MI intervention to promote physical activity among older adults. A sequential analysis was used to examine the transitional probability between the counsellors' and participants' behaviours. Thirty-five MI sessions were analysed from the virtual motivational interviewing (VIMINT) trial. MI-consistent behaviours (MICO) were significantly more likely than chance to be followed by change talk, sustain talk and follow/neutral talk. MI-inconsistent behaviours (MIIN) were more likely than chance to be followed by change talk, and 'other' counsellors' behaviours were more likely than chance to be followed by change talk and follow/neutral talk. In conclusion, all three types of counsellors' behaviours elicited change talk. This study re-emphasizes the link between MICO, change and sustain talk. The influence of MIIN and 'other' behaviours on change talk needs to be explored further. This study has implications for MI training and the need for counsellors to continuously develop skills or behaviours consistent with MI principles.

Effects of Training in Cognitive Behavioural Therapy and Motivational Interviewing on Mental Health Practitioner Behaviour: A Systematic Review and Meta-Analysis.

Effective training of mental health professionals is crucial for bridging the gap between research and practice when delivering cognitive behavioural therapy (CBT) and motivational interviewing (MI) within community settings. However, previous research has provided inconclusive evidence regarding the impact of training efforts. The current study aimed to systematically search, review and synthesize the literature on CBT and MI training to assess its effect on practitioner behavioural outcomes. Following prospective registration, a literature search was conducted for studies where mental health practitioners were exposed to training in face-to-face CBT or MI, reporting on at least one quantitative practitioner behavioural outcome. A total of 116 studies were eligible for the systematic review, and 20 studies were included in four meta-analyses. The systematic review highlights the need to establish psychometrically valid outcome measures for practitioner behaviour. Results of the meta-analyses suggest that training has a greater effect on practitioner behaviour change compared to receiving no training or reading a treatment manual. Training combined with consultation/supervision was found to be more effective than training alone, and no differences were found between face-to-face and online training. Results should be interpreted with caution due to methodological limitations in the primary studies, large heterogeneity, and small samples in the meta-analyses. Future directions are discussed.

Improving patient-centred counselling skills among lay healthcare workers in South Africa using the Thusa-Thuso motivational interviewing training and support program.

We developed a motivational interviewing (MI) counselling training and support program for lay counsellors in South Africa-branded "Thusa-Thuso-helping you help", commonly referred to as Thusa-Thuso. We present the results of a pilot study to determine the program's impact on MI technical skills and qualitatively assess the feasibility of a training-of-trainers (TOT) scale-up strategy among counselling staff of non-governmental (NGO) support partners of the human immunodeficiency virus (HIV) treatment program in South Africa. We enrolled adult (≥ 18 years) lay counsellors from ten primary healthcare clinics in Johannesburg (South Africa) selected to participate in the Thusa-Thuso training and support program. Counsellors attended the ten-day baseline and quarterly refresher training over 12 months (October 2018-October 2019). Each counsellor submitted two audio recordings of mock counselling sessions held during the ten-day baseline training and two additional recordings of sessions with consenting patients after each quarterly contact session. We reviewed the recordings using the MI treatment integrity (MITI) coding system to determine MI technical (cultivating change talk and softening sustain talk) and relational (empathy and partnership) competency scores before and after training. After 12 months of support with pilot site counsellors, we were asked to scale up the training to NGO partner team trainers in a once-off five-day Training of trainers (TOT) format (n = 127 trainees from November 2020 to January 2021). We report TOT training experiences from focus group discussions (n = 42) conducted six months after the TOT sessions. Of the 25 enrolled lay counsellors from participating facilities, 10 completed the 12-month Thusa-Thuso program. Attrition over the 12 months was caused by death (n = 3), site exclusion/resignations (n = 10), and absence (n = 2). MI competencies improved as follows: the technical skills score increased from a mean of 2.5 (standard deviation (SD): 0.8) to 3.1 (SD: 0.5), with a mean difference of 0.6 (95% confidence interval (CI): 0.04, 0.9). The MI relational skills score improved from a mean of 3.20 (SD: 0.7) to 3.5 (SD: 0.6), with a mean difference of 0.3 (95% CI: -0.3, 8.5). End-point qualitative data from the counsellors highlighted the value of identifying and addressing specific skill deficiencies and the importance of counsellors being able to self-monitor skill development using the MITI review process. Participants appreciated the ongoing support to clarify practical MI applications. The TOT program tools were valuable for ongoing on-the-job development and monitoring of quality counselling skills. However, the MITI review process was perceived to be too involved for large-scale application and was adapted into a scoring form to document sit-in mentoring sessions. The Thusa-Thuso MI intervention can improve counsellor motivation and skills over time. In addition, the program can be scaled up using an adapted TOT process supplemented with fidelity assessment tools, which are valuable for skills development and ongoing maintenance. However, further studies are needed to determine the effect of the Thusa-Thuso program on patient ART adherence and retention in care. Trial registration: Pan African Clinical Trials Registry No: PACTR202212796722256 (12 December 2022).

Implementation of an Innovative Learning Experience to Address Vaccine Hesitancy.

The COVID-19 pandemic and subsequent vaccine hesitancy highlighted the need for additional learning experiences for nursing students to address person-centered care and communication. This project aimed to employ a three-step service-learning experience consisting of town hall meetings, motivational interviewing training, and rural health fairs to address vaccine hesitancy in communities surrounding the college. Evaluation of the project revealed satisfaction and increased confidence among participating nursing students.

Motivation to Motivate: Pilot of motivational interview training in a tertiary university hospital

IntroductionMotivational interviewing (MI) is an evidence-based communication style that is effective in facilitating behaviour change and patient engagement. Originally developed in the field of addiction, MI can be applied to address a range of health behaviours including smoking cessation, medication adherence and diabetes and weight management. Given its demonstrated efficacy, training clinicians in medical and psychiatry specialties in MI has potential to enhance patient outcomes.Objectives1. Enhance awareness and understanding of the basic concepts and methods of MI among NCHDs (Non-Consultant Hospital Doctors) and hospital staff.1. Assess the perceived effectiveness of the training and help foster a culture of teaching and learning within the hospital.MethodsMI training was organised by the psychiatry department and delivered by a certified external trainer. The training was structured into 2 sessions, each lasting three hours, with a six-week gap between sessions. The training was integrated into the regular academic teaching for psychiatry trainees and a circular email invite was sent to the medical NCHD cohort and psychology department. Pre and post-training questionnaires were collected from participants with five-point Likert scales used to gather responsesResultsThere were 40 attendees across the two sessions. In total, 25 questionnaire responses were collected for the pre training (62.5%) and 30 responses were collected post-training (75%).Prior to training 48% (12/25) indicated they were familiar with MI, 48% felt confident in using MI and 88% (22/25) felt it was applicable to their practice. Post-training, 73% (22/30) felt confident in using MI, 90% (27/40) felt MI was applicable to their practice and 100% indicated they would use MI in their practice. The perception of applicability (p=0.011) and likely utilisation of MI skills (p&lt;0.001) significantly increased over the course of the training as measured by paired t-test (n=23). Ninety-seven percent of responders stated they would recommend the training and 57% (17/30) indicated that they would use MI on a weekly basis in the future.ConclusionsNCHDs and other staff welcomed this training and indicated the training was relevant to their practice. MI demonstrated a positive effect on staff perceptions of applicability and future utilisation of MI skills. Increasing clinician self-perceived efficacy through training events may help contribute to a culture of learning and teaching in hospital settings.Disclosure of InterestNone Declared

A roadmap beyond dispensing for educating and training community pharmacists on key mental health competencies: A mixed-methods national study

BackgroundIncluding pharmacists in collaborative mental healthcare models has yielded positive results. Establishing processes to enhance pharmacists' mental health care capabilities is crucial for addressing the increasing burden and improving access to mental health services. ObjectivesThis study evaluated community pharmacists' mental health competencies and analyzed associated factors using a rigorous international framework. Additionally, it sought to identify pharmacists' training needs and support requirements as the first stop in creating a roadmap for enhancing mental healthcare through community pharmacies. MethodsA large-scale national study employing a mixed-methods approach was conducted with community pharmacists in United Arab Emirates. Semi-structured individual interviews and a cross-sectional survey were conducted. Pharmacists' core competencies were assessed using the Core Mental Health Competencies Framework for all Pharmacy Professionals. Generalized linear models were utilized to identify predictors of pharmacists' competency levels. Thematic analysis was used to analyze qualitative data. ResultsIn total 650 community pharmacists completed the survey (93.7% response rate). Eight pharmacists participated in semi-structured interviews. Nearly two-thirds (63.7%) received general communication skills training, while training in motivational interviewing (44.7%), shared decision-making (37.2%), and mental illness stereotyping/stigma (23.9%) were less common. Pharmacists reported lower perceived competence in their relationship with multidisciplinary teams (M = 3.02, SD = 0.89), stigma recognition (M = 3.02, SD = 1.04), and identifying mental health crises and aiding in the person's safety (M = 3.01, SD = 1.05). Poor communication skills (p < 0.001) and working in pharmacies that do not stock psychotropic medications (p = 0.023) were associated with lower perceived competence. Qualitative analysis identified training needs in various domains, including attitudes, values, and beliefs about mental health; relationships with multidisciplinary teams; communication skills; pharmaceutical knowledge; and personal and service development. ConclusionsMental health-related training is needed for community pharmacists. Addressing these needs through an intentional roadmap approach will enable pharmacists to better engage with patients with mental illness and increase access to care.

Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI

BackgroundFinding time in the medical curriculum to focus on motivational interviewing (MI) training is a challenge in many medical schools. We developed a software-based training tool, “Real-time Assessment of Dialogue in Motivational Interviewing” (ReadMI), that aims to advance the skill acquisition of medical students as they learn the MI approach. This human-artificial intelligence teaming may help reduce the cognitive load on a training facilitator.MethodsDuring their Family Medicine clerkship, 125 third-year medical students were scheduled in pairs to participate in a 90-minute MI training session, with each student doing two role-plays as the physician. Intervention group students received both facilitator feedback and ReadMI metrics after their first role-play, while control group students received only facilitator feedback.ResultsWhile students in both conditions improved their MI approach from the first to the second role-play, those in the intervention condition used significantly more open-ended questions, fewer closed-ended questions, and had a higher ratio of open to closed questions.ConclusionMI skills practice can be gained with a relatively small investment of student time, and artificial intelligence can be utilized both for the measurement of MI skill acquisition and as an instructional aid.

Implementation Model for Motivational Interviewing Training in a Community College Human Services Program

Motivational interviewing (MI) is an evidence-supported style of communication used across many fields of human services, including addiction treatment, social work, healthcare, education, and criminal justice. MI can be utilized by a variety of human service professionals and requires no special licensure or educational degree. In 2016, our Human Services program at LaGuardia Community College, CUNY began to implement MI training as a core part of our curriculum to provide students with this micro-credential to increase their career readiness. This paper outlines our ongoing approach for implementing MI in a community college human services program, including the training model we used for preparing faculty and staff to implement this approach, as well as some reflections from graduates.