Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: A randomized controlled trial.

Monti, Peter M.; Mastroleo, Nadine R.; Barnett, Nancy P.; Colby, Suzanne M.; Kahler, Christopher W.; Operario, Don

doi:10.1037/ccp0000097

Cited by 42 publications

(48 citation statements)

References 49 publications

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“…This study is based on analysis of data from a randomized controlled trial of a brief (one session) MI intervention, compared to a brief advice control (Monti et al, 2016). Patients were not treatment seeking, but were recruited during visits to two Emergency Departments (EDs).…”

Section: Methodsmentioning

confidence: 99%

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A sequential analysis of motivational interviewing technical skills and client responses

Laws

Magill

Mastroleo

et al. 2018

Journal of Substance Abuse Treatment

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Background: The technical hypothesis of Motivational Interviewing (MI) proposes that: (a) client talk favoring behavior change, or Change Talk (CT) is associated with better behavior change outcomes, whereas client talk against change, or Sustain Talk (ST) is associated with less favorable outcomes, and (b) specific therapist verbal behaviors influence whether client CT or ST occurs. MI consistent (MICO) therapist behaviors are hypothesized to be positively associated with more client CT and MI inconsistent (MIIN) behaviors with more ST. Previous studies typically examine session-level frequency counts or immediate lag sequential associations between these variables. However, research has found that the strongest determinant of CT or ST is the client's previous CT or ST statement. Therefore, the objective of this paper was to examine the association between therapist MI skills and subsequent client talk, while accounting for prior client talk. Methods: We analyzed data from a manualized MI intervention targeting both alcohol misuse and sexual risk behavior in 132 adults seen in two hospital emergency departments. Transcripts of encounters were coded using the Motivational Interviewing Skills Code (MISC 2.5) and an additional measure, the Generalized Behavioral Intervention Analysis System (GBIAS). Using these measures, we analyzed the association between client talk following specific classifications of MICO skills, with the client's prior statement as a potential confounder or effect modifier. Results: With closed questions as the reference category, therapist simple reflections and paraphrasing reflections were associated with significantly greater odds of maintaining client talk as CT or ST. Open questions and complex reflections were associated with significantly greater odds of CT following ST, were not associated significantly with more ST following ST, and were associated with more ST following CT (i.e., through an association with less Follow Neutral). Conclusions: Simple and paraphrasing reflections appear to maintain client CT but are not associated with transitioning client ST to CT. By contrast, complex reflections and open questions appeared to be more strongly associated with clients moving from ST to CT than other techniques. These results suggest that counselors may differentially employ certain MICO technical skills to elicit continued CT and move participants toward ST within the MI dialogue.

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Section: Methodsmentioning

confidence: 99%

“…It was also associated with lower odds of reporting condomless sex with a casual partner, and fewer days of sex under the influence of alcohol and/or other drugs (Monti et al, 2016). …”

Section: Methodsmentioning

confidence: 99%

A sequential analysis of motivational interviewing technical skills and client responses

Laws

Magill

Mastroleo

et al. 2018

Journal of Substance Abuse Treatment

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“…This study demonstrated application of the newly developed Generalized Behavioral Intervention Analysis System (GBIAS) to the coding of sessions of an efficacious MI intervention that reduced both alcohol use and sexual risk behaviors [23]. Using the GBIAS, we reliably coded categories and subcategories of topics on which alcohol- and sex-related conversations focused.…”

Section: Discussionmentioning

confidence: 99%

“…Data were drawn from a randomized clinical trial of an MI intervention targeting both alcohol and sex-risk behaviors, which demonstrated efficacy for reducing both behaviors relative to a brief advice control [23]. The project was approved by hospital and university institutional review boards.…”

Section: Methodsmentioning

confidence: 99%

Using topic coding to understand the nature of change language in a motivational intervention to reduce alcohol and sex risk behaviors in emergency department patients

Kahler

Caswell

Laws

et al. 2016

Patient Education and Counseling

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Objective To elucidate patient language that supports changing a health behavior (change talk) or sustaining the behavior (sustain talk). Methods We developed a novel coding system to characterize topics of patient speech in a motivational intervention targeting alcohol and HIV/sexual risk in 90 Emergency Department patients. We further coded patient language as change or sustain talk. Results For both alcohol and sex, discussions focusing on benefits of behavior change or change planning were most likely to involve change talk, and these topics comprised a large portion of all change talk. Greater discussion of barriers and facilitators of change also was associated with more change talk. For alcohol use, benefits of drinking behavior was the most common topic of sustain talk. For sex risk, benefits of sexual behavior were rarely discussed, and sustain talk centered more on patterns and contexts, negations of drawbacks, and drawbacks of sexual risk behavior change. Conclusions Topic coding provided unique insights into the content of patient change and sustain talk. Practice Implications Patients are most likely to voice change talk when conversation focuses on behavior change rather than ongoing behavior. Interventions addressing multiple health behaviors should address the unique motivations for maintaining specific risky behaviors.

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“…Considering the fact the ED is the primary source of medical care for many patients (Tang, Stein, Hsia, Masalli, & Gonzales, 2010), it presents an opportune setting to intervene on heavy drinking and associated sexual risk taking. Brief motivational intervention (MI) conducted in person with a combined focus on alcohol and sex has been shown to reduce heavy drinking and condomless sex among ED patients (Monti et al, 2016). However, the competing demands placed on staff in ED settings (and health care settings, in general) makes the implementation of in-person MIs logistically challenging (Miller et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Using video conferencing to deliver a brief motivational intervention for alcohol and sex risk to emergency department patients: a proof-of-concept pilot study

Celio

Mastroleo

DiGuiseppi

et al. 2017

Addiction Research & Theory

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Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; Mage = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings.

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Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: A randomized controlled trial.

Cited by 42 publications

References 49 publications

A sequential analysis of motivational interviewing technical skills and client responses

A sequential analysis of motivational interviewing technical skills and client responses

Using topic coding to understand the nature of change language in a motivational intervention to reduce alcohol and sex risk behaviors in emergency department patients

Using video conferencing to deliver a brief motivational intervention for alcohol and sex risk to emergency department patients: a proof-of-concept pilot study

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