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Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

ABSTRACT: Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors.We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds of beta testing. Staff were 3 men and 3 women who were residential support staff (i.e., case managers and administrators). Residents were 8 men (7 African American, 1 Hispanic) and 3 women (2 African American, 1 Hispanic) who had histories of AOD and HIV risk behaviors. We conducted a focus group with staff who gave input on how to improve the delivery of the intervention to enhance understanding and receptivity among new residents. We conducted semi-structured qualitative interviews and collected self-report satisfaction data from residents.Three themes emerged over the course of the resident interviews. Residents reported that the intervention was helpful in discussing their social network, that seeing the visualizations was more impactful than just talking about their network, and that the intervention prompted thoughts about changing their AOD use and HIV risk networks.This study is the first of its kind that has developed, with input from Housing First staff and residents, a motivational interviewing intervention that targets both the structure and composition of one's social network. These results suggest that providing visual network feedback with a guided motivational interviewing discussion is a promising approach to supporting network change. ClinicalTrials.gov Identifier NCT02140359.

SUBMITTER: Osilla KC

PROVIDER: S-EPMC5015231 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

Osilla Karen Chan KC Kennedy David P DP Hunter Sarah B SB Maksabedian Ervant E

Addiction science & clinical practice 20160907 1

<h4>Background</h4>Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors.<h4>Methods</h4>We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds ...[more]

PMID: 27604543

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Project description:BackgroundSocial networks may play positive and negative roles in the lives of young adults experiencing homelessness (YEH) who are transitioning into housing. Social networks can influence their alcohol and/or other drug (AOD) use, as well as provide immediate and long-term support necessary for a successful transition.MethodsWe adapted a four-session computer-assisted motivational interviewing social network intervention (MI-SNI) for YEH transitioning into housing. We iteratively adapted and beta tested the intervention for delivery by case managers at an organization that provides supportive housing to YEH. We conducted a focus group with agency staff (n = 6), role-play exercises with case managers (n = 3), and semi-structured interviews with residents (n = 6). Interview data were thematically analyzed with open coding. This study presents the first adaptation of an innovative social network-based motivational intervention to reduce AOD use and increase stable, prosocial supportive connections via visualizations of the structure and composition of the individual's social network.ResultsParticipants rated sessions as "moderately" to "very" helpful and "good" quality on average. Participants agreed that the sessions were helpful, understandable, and satisfying and would work for new residents. Themes emerged in four broad categories: (1) Acceptability, (2) Positive benefits, (3) Visualization reactions, and (4) MI-SNI interface reactions. For the acceptability category, three sub-themes emerged: (1) understandability, (2) enjoyability and ease of use, (3) and barriers to acceptability. Five sub-themes emerged about the intervention's likelihood to trigger positive benefits: (1) learning/new insights, (2) enhancement to motivation to change, (3) making AOD changes, (4) building social support, and (5) the intervention's usefulness to some but not others. Five sub-themes also emerged from comments about the social network visualizations: (1) general positive comments, (2) understandability, (3) new insights, (4) triggering changes in social support, and (5) triggering changes in AOD use. When discussing the MI-SNI intervention interface beyond the visualizations, discussions emerged in three thematic categories: (1) discussion of name listing, (2) discussion of screen wording, and (3) the use of a computer interface to deliver the intervention.ConclusionsResults suggest that the MI-SNI is acceptable to YEH and can be feasibly delivered by case managers during case management sessions. Trial registration ClinicalTrials.gov Identifier: NCT04637815. Registered November 10, 2020.

Project description:IntroductionCaries experience among preschool-age children has remained relatively unchanged for the past 2 decades, despite recently documented decreases in untreated decay.ObjectivesIn a community-based cluster-randomized controlled trial, a motivational interviewing (MI) intervention administered to primary caregivers was hypothesized to reduce caries increment over 2 y as compared with controls, among children aged 0 to 5 y at baseline living in public housing.MethodsPublic housing residents, who served as interventionists, were trained in MI with a focus on early childhood caries prevention. All 26 eligible public housing developments were randomized to either control (quarterly clinical examinations, fluoride varnish applications, toothbrush/toothpaste, and educational brochures) or intervention (same procedures as control plus MI counseling). Quarterly MI sessions were delivered in English or Spanish over 2 y, audio recorded, and assessed for treatment fidelity. The primary outcome was the increment in dmfs (decayed, missing, and filled tooth surfaces) as assessed by clinical examination at baseline, 12 mo, and 24 mo. Secondary outcomes included caregiver oral health knowledge and child oral health behaviors (child toothbrushing and sugar-sweetened beverage intake). Baseline characteristics were compared between groups and adjusted for housing-site clusters. Longitudinal outcomes were analyzed with mixed models.ResultsA total of 1,065 children (49% female, 55% non-White, 61% Hispanic, 89% below poverty level, n = 686 control) and their caregivers were enrolled. During 2 y of follow-up, the mean dmfs increment increased in both groups; however, there were no statistically significant group differences at 24 mo or group × time interactions. The mean increase in intervention caregivers' knowledge was significantly greater than that of control, F(2, 1,593) = 3.48, P = 0.0310, but there were no significant intervention effects on caregiver-reported child sugar-sweetened beverage intake or child toothbrushing.ConclusionMI counseling plus intensive caries prevention activities resulted in knowledge increases but did not improve oral health behaviors or caries increment (ClinicalTrials.gov NCT01205971).Knowledge transfer statementWhen viewed in light of the findings from the companion Pine Ridge study and other recent MI studies, the results of this study suggest that when the complex disease of early childhood caries is addressed in high-risk populations, MI is not effective, and alternative approaches are warranted.

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Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

Publications

Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

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