Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 21, 2018
Date Accepted: Apr 23, 2019
Acceptability of Brief Motivational Interviewing Delivered by Clinician or Computer to Reduce Sexual Risk Behaviors in Adolescents
ABSTRACT
Background:
Clinicians are expected to screen their adolescent patients for an increasing number of health behaviors and intervene when they uncover risky behaviors yet the clinic time allotted to screen, intervene and provide resources is insufficient. Brief motivational interviewing offers succinct behavior change counseling however, for implementation clinicians need training, skill, and time. Computerized screening and counseling adjuvants may help clinicians increase their scope of behavioral screening, especially with sensitive topics such as sexual health, and provide risk reduction interventions without consuming provider time during visits.
Objective:
The objectives of this study were to: 1) understand the extent to which healthcare providers use brief motivational interviewing for sexual health discussions with adolescent patients and 2) assess the acceptability of incorporating a brief motivational interviewing (MI)-based intervention to reduce sexual risk behaviors into their clinical practice delivered by either themselves or a computer.
Methods:
At a national medical conference, surveys were administered to clinicians who provide sexual healthcare to adolescents. They were asked about their current use of MI for sexual risk behavior discussions and their willingness to implement computerized sexual health screening and computerized sexual risk behavior interventions into their clinical practice.
Results:
The large majority (87% 170/194) of clinicians already used MI with their patients with less than half (48% 72/148) reporting they had been formally trained in MI. Despite all (100% 195/195) clinicians feeling very or completely comfortable discussing sexual risk behaviors with their patients, the large majority (82% 160/195) reported it would be useful, very or extremely useful for a computerized program to do it all: screen their patients, generate risk profiles and provide the risk-reduction counseling rather than doing it themselves.
Conclusions:
In this study, most clinicians use some form of brief MI or client-centered counseling when discussing sexual risk behaviors with adolescents and are very comfortable doing so. However, the large majority would prefer to implement computerized sexual health screening, risk assessment and sexual risk behavior interventions into their clinical care of adolescents.
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