Barriers and facilitators to scaling up Healthy Choices, a motivational interviewing intervention for youth living with HIV

• Main Authors: Karen MacDonell (Author), Veronica Dinaj-Koci (Author), Juline Koken (Author), Sylvie Naar (Author)
• Format: Book
• Published: BMC, 2022-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12913-022-08453-w; 1472-6963
• Keywords: Adolescents and emerging adults; HIV/AIDS; Implementation science; Community health workers; Thematic analysis; Motivational interviewing; Public aspects of medicine; RA1-1270
• Source: BMC Health Services Research, Vol 22, Iss 1, Pp 1-8 (2022)

Abstract Background This study included Community Health Workers and their supervisors from HIV clinical care teams who participated in the Healthy Choices intervention program. Healthy Choices is a Motivational Interviewing-based intervention aimed at improving medication adherence and reducing alcohol use for adolescents and emerging adults ages 16-24 living with HIV. In this study, the intervention was "scaled up" for delivery by local HIV care providers in real-world clinic settings. Methods Providers (N = 21) completed semi-structured interviews (N = 29) about their experiences with intervention scale-up. Rigorous thematic analyses were conducted within discussions of barriers and facilitators of intervention implementation. Results Three dominant thematic areas emerged from the data: (1) perceptions of the Healthy Choices intervention, (2) engaging high risk YLH in in-person behavior interventions, and (3) perspectives on implementation of the intervention using local staff. Results offer insights into implementation of MI-based interventions for adolescents and emerging adults in clinic settings using local clinical staff instead of dedicated research staff. Conclusions Overall, scaled-up intervention programs for youth are challenged to maintain scientific rigor, provide rigorous training and supports, and offer an attractive and engaging program.