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

Abstract

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.

Telehealth interventions to reduce alcohol use in men with HIV who have sex with men: Protocol for a factorial randomized controlled trial

“…Recent evidence suggests that videoconferencing can be used to deliver evidence-based behavioral counseling at home [[102], [103], [104], [105]], with preliminary results suggesting promise for home-based interventions [106,107]. In a pilot study, we found that we were able to deliver MI with high fidelity using videoconferencing [108]. We believe that using a combination of both videoconferencing and telephone counseling—which allows for easy scheduling of sessions that maximizes patient convenience—may be especially practical and effective.…”

A randomized pilot trial of a mobile delivered brief motivational interviewing and behavioral economic alcohol intervention for emerging adults.

“…However, considering that mHealth intervention efficacy is mixed (Hutton et al, 2020; Kaner et al, 2017; Kazemi et al, 2017) and that this may be due, at least in part, to reduced participant attention and engagement (Lewis & Neighbors, 2015), counselor time allocated to delivering synchronous text-based interventions may be a worthwhile investment. Future research is required to explicitly evaluate how CoAST delivery impacts participant engagement and retention compared to fully automated (text message or web-based), telephone (IVR or one-on-one), videoconference (Celio et al, 2017; King et al, 2020; Lee et al, 2021), and in-person BMIs. Lastly, future research should also seek to understand the impact of these various modes of delivery on intervention utilization, costs, and efficacy outcomes by comparing equivalent content across in-person, videoconference, guided synchronous text-based systems (e.g., CoAST), and fully automated intervention approaches.…”

Brief motivational intervention delivered in the emergency department can reduce hazardous drinking and risky sexual behaviour

“…In addition, those considering implementation might consult a follow-up article in which the study's authors offer suggestions for counsellors derived from content analyses of recorded intervention sessions 2. Planners also should take note of a pilot study in which this intervention was delivered via video-conferencing technology, rather than in person 3. The use of such technology has the potential to increase the utility of the intervention by eliminating the need to train large numbers of staff.…”