Integrating Motivational Interviewing Within HIV Service Organizations: Preliminary Findings from a Type 3 Hybrid Trial

BRYAN GARNER, PhD
Ohio State University

As part of the Substance Abuse Treatment to HIV Care (SAT2HIV) Project, Garner and colleagues (2020) found empirical support for the project’s Implementation and Sustainment Facilitation (ISF) Strategy, as well as the project’s motivational interviewing-based brief intervention (MIBI) for substance use disorders. Building on the SAT2HIV Project and our prior research supporting pay-for-performance (P4P) as an effective (Garner et al., 2011, 2012) and cost-effective (Garner et al., 2018) strategy, the SAT2HIV-II Project was funded (R01-DA052294) to test the incremental effectiveness and cost-effectiveness of P4P as a strategy to improve MIBI integration by HIV service organizations (HSOs) and their staff. The current presentation will provide an overview of the SAT2HIV-II Project (i.e., a type 3 hybrid design), as well as present findings from the project’s initial cohort.

U.S.-based HSOs, HSO staff prepared to implement a motivational interviewing-based brief intervention for SUDs, and HSO clients with a comorbid SUD.

As part of this three-cohort, cluster-randomized, type 3 implementation-effectiveness hybrid trial, an initial cohort of 12 HSOs and their staff (n = 45) were randomized to one of two conditions. In the control condition, HSOs and their participating staff received the team-focused ISF Strategy, with the HSO’s MIBI staff also receiving a 4-hour online introductory training in motivational interviewing, a 11.5-hour live virtual training workshop in the project’s MIBI protocol, ongoing fidelity feedback, and monthly virtual group MIBI consultation meetings with a MIBI expert. In addition to these strategies, MIBI staff working in HSOs randomized to the project’s experimental condition had the opportunity to earn P4P bonuses (i.e., $10 per MIBI implemented and $10 per MIBI rated as having high-fidelity). Current analyses focused on the time (post-training, mid-implementation, end-of-implementation) by condition interaction for each of the three implementation outcome measures developed by Weiner and colleagues (2017; acceptability, appropriateness, feasibility), as well as a single-item assessing intentions to implement the MIBI (0 = not at all to 6 = highest intentions possible).

Consistent with prior research (Garner et al., 2011), P4P significantly increased implementation intentions.