Key result
This protocol describes the implementation of brief real-time motivational interviewing workshops and asynchronous avatar training for 126 community mental health practitioners.
Why the study?
Extensive training time and coaching requirements present major barriers to incorporating motivational interviewing into scalable lifestyle interventions for CVD risk reduction in serious mental illness.
Does brief real-time MI training augmented with asynchronous avatar skills practice improve MI skills among community mental health practitioners?
Does brief real-time MI training augmented with asynchronous avatar skills practice improve MI skills among community mental health practitioners?
Brief videoconference trainings supplemented with avatar skills practice may offer a scalable approach to train community mental health practitioners in motivational interviewing for physical health interventions.
Protocol for scalable MI training; leaves open whether avatar-augmented workshops improve practitioner skills in community settings.
BACKGROUND Motivational interviewing (MI) is an evidence-based, patient-centered communication method shown to be effective in helping persons with serious mental illness (SMI) to improve health behaviors. In clinical trials where study staff conducted lifestyle interventions incorporating an MI approach, cardiovascular disease (CVD) risk profiles of participants with SMI showed improvement. Given the disproportionate burden of CVD in this population, practitioners who provide somatic and mental health care to persons with SMI are ideally positioned to deliver patient-centered CVD risk reduction interventions. However, the time for MI training (traditionally 16-24 hours), follow-up feedback, and the coaching required to develop and maintain patient-centered skills are significant barriers to incorporating MI when scaling up these evidence-based practices. OBJECTIVE We describe the design and development of the following 2 scalable MI training approaches for community mental health practitioners: real-time brief workshops and follow-up asynchronous avatar training. These approaches are being used in 3 different pilot implementation research projects that address weight loss, smoking cessation, and CVD risk reduction in people with SMI who are a part of ALACRITY Center, a research-to-practice translation center funded by the National Institute of Mental Health. METHODS Clinicians and staff in community mental health clinics across Maryland were trained to deliver 3 distinct evidence-based physical health lifestyle interventions using an MI approach to persons with SMI. The real-time brief MI workshop training for ACHIEVE-D weight loss coaches was 4 hours; IMPACT smoking cessation counselors received 2-hour workshops and prescribers received 1-hour workshops; and RHYTHM CVD risk reduction program staff received 4 hours of MI. All workshop trainings occurred over videoconference. The asynchronous avatar training includes 1 common didactic instructional module for the 3 projects and 1 conversation simulation unique to each study’s target behavior. Avatar training is accessible on a commercial website. We plan to assess practitioners’ attitudes and beliefs about MI and evaluate the impact of the 2 MI training approaches on their MI skills 3, 6, and 12 months after training using the MI Treatment Integrity 4.2.1 coding tool and the data generated by the avatar-automated scoring system. RESULTS The ALACRITY Center was funded in August 2018. We have implemented the MI training for 126 practitioners who are currently delivering the 3 implementation projects. We expect the studies to be complete in May 2023. CONCLUSIONS This study will contribute to knowledge about the effect of brief real-time training augmented with avatar skills practice on clinician MI skills. If MI Treatment Integrity scoring shows it to be effective, brief videoconference trainings supplemented with avatar skills practice could be used to train busy community mental health practitioners to use an MI approach when implementing physical health interventions. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/44830
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Dalcin et al. (2022) studied Serious mental illness (practitioner training) (n=126). Brief real-time motivational interviewing workshops and asynchronous avatar training was evaluated on Practitioners' attitudes and beliefs about MI and MI skills at 3, 6, and 12 months after training. This protocol describes the implementation of brief real-time motivational interviewing workshops and asynchronous avatar training for 126 community mental health practitioners.
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