JMIR Publications

ABSTRACT

Background:

Motivational Interviewing (MI) is an evidence-based, patient-centered communication method shown to be effective in helping persons with serious mental illness (SMI) 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 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 two 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 three implementation projects in an 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 were trained to deliver three distinct evidence-based physical health lifestyle interventions focused on weight loss, smoking cessation, and CVD risk reduction to consumers with SMI using an MI approach. We plan to assess practitioners’ attitudes and beliefs about MI and evaluate the impact of the two MI training approaches on MI skills at 3, 6, and 12 months after training using the Motivational Treatment Integrity (MITI) 4.2.1 coding tool and data generated by the avatar automated scoring system.

Results:

We have implemented the MI training for 126 practitioners who currently are delivering the three implementation projects. We expect the studies to be complete in May 2023.

Conclusions:

If shown to be effective from MITI scoring, briefer trainings supplemented with avatar skills practice could be used to train community mental health practitioners to use an MI approach when implementing physical health interventions.