Interactive Internet-based Motivational Interviewing Training for HIV Counseling Support Staff to Improve Health Communication in HIV Care Interactions

PROJECT SUMMARY
The overall goal of the proposed study is to develop and pilot an interactive, gamified, online, training program
in Motivational Interviewing (MI) specifically for HIV counseling support staff (CSS), which includes HIV
counselors and community health workers, to improve health communication in status-neutral HIV care
interactions. MI is an empathic, collaborative, counselling and communication approach that has demonstrated
efficacy in improving outcomes across the HIV Care Continuum (HCC) in adults and adolescents. It is embedded
in HIV care guidelines and training in MI is often provided to CSS by state and regional agencies. However,
achieving competency in MI is not easy and the training typically provided to CSS is insufficient to achieve
competence in MI. To ensure that MI retains its demonstrated efficacy in improving HCC outcomes, we must
develop scalable MI training approaches that can both reach CSS working in HIV care settings and effectively
increase their MI skills. To address this dual need, this study seeks to develop iMI4HIV, an interactive, gamified,
online, MI training program specifically tailored for CSS in HIV care settings to improve their MI skills in HIV care
communications. The goal is to train CSS to deliver MI competently so they can integrate MI into all of their
healthcare communications with individuals receiving or seeking HIV related services (status-neutral). CSS will
be able to access iMI4HIVs after completing a live virtual MI introductory workshop, providing additional skills
training that specifically targets MI skills shown by research to affect behavior change outcomes. Thus, iMI4HIV
will fill that critical need for additional post-workshop training that is rarely available to community providers. The
Specific Aims of this study are to: 1) Develop iMI4HIV, an interactive, online, gamified MI training program
specifically tailored towards CSS in HIV care settings to improve their MI skills with HIV care clients; 2) Conduct
a pilot randomized controlled trial (RCT) of Virtual MI training workshop + iMI4HIV vs. Virtual MI training workshop
+ waitlist control (N=30 CSS) to: a) assess the feasibility and acceptability of iMI4HIV as measured by the percent
of participants who complete iMI4HIV and retrospective acceptability ratings of iMI4HIV (Primary Aim), and b)
explore preliminary findings on the effects of iMI4HIV on MI skills acquisition (Exploratory Aim); and 3) Explore
experiences (including obstacles and facilitators) of completing iMI4HIV via in-depth interviews. As designed,
this study specifically responds to the Notice of Special Interest: Advancing Health Communication Research on
HIV Prevention, Treatment and Cure (NOT-MH-21-105) announced by NIH, which includes an interest in studies
that seek to “optimize effective communication and engagement practices between PLHIV and healthcare
providers.” If successful in building CSS MI skills, iMI4HIV has the potential to shift how MI training is provided
to CSS who work in HIV care settings and capitalize on the demonstrated efficacy of MI to improve HIV care
outcomes.

Grant Number: 1R34MH133468-01A1
NIH Institute/Center: NIH
Principal Investigator: Ivan Balan