Trial Outcomes & Findings for Three Strategies for Implementing Motivational Interviewing on Medical Inpatient Units (NCT NCT01825057)
NCT ID: NCT01825057
Last Updated: 2021-03-25
Results Overview
The percentage of audio recorded Motivational Interviewing sessions conducted by providers for their 40 consecutively enrolled study-eligible patients
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
1211 participants
Primary outcome timeframe
Provider participants will be followed for the duration of the trial period, an expected average of 24 weeks to see 40 study-enrolled patients per provider.
Results posted on
2021-03-25
Participant Flow
The study's primary outcome and secondary outcomes are only collected and reported at the provider level - not at the patient level.
Participant milestones
| Measure |
See One
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
|---|---|---|---|
|
Patient Study Flow
STARTED
|
336
|
379
|
458
|
|
Patient Study Flow
COMPLETED
|
336
|
379
|
458
|
|
Patient Study Flow
NOT COMPLETED
|
0
|
0
|
0
|
|
Provider Study Flow
STARTED
|
13
|
12
|
13
|
|
Provider Study Flow
COMPLETED
|
13
|
12
|
13
|
|
Provider Study Flow
NOT COMPLETED
|
0
|
0
|
0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
Baseline characteristics by cohort
| Measure |
See One
n=349 Participants
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=391 Participants
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=471 Participants
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
Total
n=1211 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Continuous
Providers
|
39.2 years
STANDARD_DEVIATION 13.2 • n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
34.4 years
STANDARD_DEVIATION 8.9 • n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
32.2 years
STANDARD_DEVIATION 10.1 • n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
35.3 years
STANDARD_DEVIATION 11.0 • n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Age, Continuous
Patients
|
46.8 years
STANDARD_DEVIATION 14.0 • n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
46.3 years
STANDARD_DEVIATION 14.5 • n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
46.9 years
STANDARD_DEVIATION 14.5 • n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
46.7 years
STANDARD_DEVIATION 14.3 • n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Sex: Female, Male
Providers · Female
|
11 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
10 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
12 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
33 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Sex: Female, Male
Providers · Male
|
2 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
2 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
1 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
5 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Sex: Female, Male
Patients · Female
|
152 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
182 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
200 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
534 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Sex: Female, Male
Patients · Male
|
184 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
197 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
258 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
639 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Providers · non-Hispanic White
|
10 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
11 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
8 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
29 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Providers · non-Hispanic African American
|
1 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
1 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
1 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
3 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Providers · non-Hispanic Asian
|
2 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
0 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
1 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
3 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Providers · Hispanic White
|
0 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
0 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
2 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
2 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Providers · non-Hispanic Other Race
|
0 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
0 Participants
n=12 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
1 Participants
n=13 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
1 Participants
n=38 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Patients · non-Hispanic White
|
193 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
224 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
249 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
666 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Patients · non-Hispanic African American
|
98 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
105 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
149 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
352 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Patients · non-Hispanic Asian
|
0 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
0 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
0 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
0 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Patients · Hispanic White
|
44 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
47 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
53 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
144 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Race/Ethnicity, Customized
Patients · non-Hispanic Other Race
|
1 Participants
n=336 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
3 Participants
n=379 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
7 Participants
n=458 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
11 Participants
n=1173 Participants • The number analyzed in the rows represented are for two distinct participant groups in this study crossing the three conditions (See One, Do One, Order One), namely 38 providers and 1173 patients, which equals an overall number equal to 1211 participants.
|
|
Type of provider
Registered Nurse
|
6 Participants
n=13 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
6 Participants
n=12 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
7 Participants
n=13 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
19 Participants
n=38 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
|
Type of provider
Physician's Assistant
|
5 Participants
n=13 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
4 Participants
n=12 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
5 Participants
n=13 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
14 Participants
n=38 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
|
Type of provider
Medical Doctor
|
2 Participants
n=13 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
2 Participants
n=12 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
1 Participants
n=13 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
5 Participants
n=38 Participants • This baseline data was only collected for provider participants. Patient participants are not included.
|
PRIMARY outcome
Timeframe: Provider participants will be followed for the duration of the trial period, an expected average of 24 weeks to see 40 study-enrolled patients per provider.Population: A percentage of MI sessions audio recorded was calculated for each provider, and a mean percentage was calculated by group.
The percentage of audio recorded Motivational Interviewing sessions conducted by providers for their 40 consecutively enrolled study-eligible patients
Outcome measures
| Measure |
See One
n=13 Participants
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=12 Participants
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=13 Participants
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
|---|---|---|---|
|
Percentage of Motivation Interviewing Sessions Audio Recorded
|
0.8 percentage of MI sessions audio recorded
Standard Deviation 2.3
|
3.0 percentage of MI sessions audio recorded
Standard Deviation 5.4
|
20.5 percentage of MI sessions audio recorded
Standard Deviation 17.9
|
SECONDARY outcome
Timeframe: All sessions conducted and recorded by providers with study-enrolled patients during the trial period, an expected 24 weeks per provider.Population: Analysis sample includes the N=114 MI sessions completed by providers with study-enrolled patients across all training groups.
The Independent Tape Rater Scale assessed the integrity of MI interviews. The Independent Tape Rater Scale includes 5 fundamental MI items important for building rapport and understanding patients' experiences (e.g. reflections), rated for adherence (i.e. the extent/frequency of intervention delivery) on a scale from 1 (not at all) to 7 (extensively). The fundamental adherence score is the average of these 5 items, with scores ranging from 1-7 and higher scores indicating greater adherence. Only MI sessions conducted within each study arm by the providers with patient participants were included in this analysis. Since 3 MI sessions were conducted by providers in See One, 11 sessions were conducted by providers in Do One, and 100 sessions were conducted by providers in Order One, this analysis includes 114 MI sessions as the unit of analysis.
Outcome measures
| Measure |
See One
n=3 MI Sessions completed by providers
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=11 MI Sessions completed by providers
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=100 MI Sessions completed by providers
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
|---|---|---|---|
|
The Independent Tape Rater Scale - Fundamental Adherence Score
|
4.00 score on a scale
Standard Deviation 0.35
|
4.60 score on a scale
Standard Deviation 0.80
|
5.22 score on a scale
Standard Deviation 0.58
|
SECONDARY outcome
Timeframe: All sessions conducted and recorded by providers with study-enrolled patients during the trial period, an expected 24 weeks per provider.Population: Analysis population includes the N=114 MI sessions that were completed by providers across all training groups.
The Independent Tape Rater Scale assessed the integrity of MI interviews. The Independent Tape Rater Scale includes 5 fundamental MI items important for building rapport and understanding patients' experiences (e.g. reflections), rated for competency (i.e., the skill/quality of intervention delivery) on a scale of 1 (not at all) to 7 (excellent). The fundamental competence score is the average of these 5 items, for which there was adherence, with higher scores indicating greater competence. Only MI sessions conducted within each study arm by the providers with patient participants were included in this analysis. Since 3 MI sessions were conducted by providers in See One, 11 sessions were conducted by providers in Do One, and 100 sessions were conducted by providers in Order One, this analysis includes 114 MI sessions as the unit of analysis.
Outcome measures
| Measure |
See One
n=3 MI Sessions completed by providers
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=11 MI Sessions completed by providers
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=100 MI Sessions completed by providers
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
|---|---|---|---|
|
The Independent Tape Rater Scale- Fundamental Competence Score
|
3.67 score on a scale
Standard Deviation 0.61
|
4.27 score on a scale
Standard Deviation 0.43
|
4.71 score on a scale
Standard Deviation 0.45
|
SECONDARY outcome
Timeframe: All sessions conducted and recorded by providers with study-enrolled patients during the trial period, an expected 24 weeks per provider.Population: Analysis population includes the N=114 MI sessions that were completed by providers across all training groups.
The advanced adherence score is the average of these 5 items. The Independent Tape Rater Scale assessed the integrity of MI interviews. The Independent Tape Rater Scale includes 5 advanced MI items critical for eliciting patients' motivations for change (e.g., asking for reasons for change), rated for adherence (i.e., the extent/frequency of intervention delivery) on a scale of 1 (not at all) to 7 (extensively). The advanced adherence score is the average of these 5 items, with scores ranging from 1-7 and higher scores indicating greater adherence. Only MI sessions conducted within each study arm by the providers with patient participants were included in this analysis. Since 3 MI sessions were conducted by providers in See One, 11 sessions were conducted by providers in Do One, and 100 sessions were conducted by providers in Order One, this analysis includes 114 MI sessions as the unit of analysis.
Outcome measures
| Measure |
See One
n=3 MI Sessions completed by providers
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=11 MI Sessions completed by providers
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=100 MI Sessions completed by providers
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
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|---|---|---|---|
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The Independent Tape Rater Scale- Advanced Adherence Score
|
3.93 score on a scale
Standard Deviation 0.58
|
4.38 score on a scale
Standard Deviation 0.95
|
4.81 score on a scale
Standard Deviation 0.65
|
SECONDARY outcome
Timeframe: All sessions conducted and recorded by providers with study-enrolled patients during the trial period, an expected 24 weeks per provider.Population: Analysis population includes the N=114 MI sessions that were completed by providers across all training groups.
The Independent Tape Rater Scale assessed the integrity of MI interviews. The Independent Tape Rater Scale includes 5 advanced MI items critical for eliciting patients' motivations for change (e.g., asking for reasons for change), rated for competency (i.e., the skill/quality of intervention delivery) on a scale of 1 (not at all) to 7 (excellent). The advanced competence score is the average of these 5 items, for which there was adherence, with higher scores indicating greater competence. Only MI sessions conducted within each study arm by the providers with patient participants were included in this analysis. Since 3 MI sessions were conducted by providers in See One, 11 sessions were conducted by providers in Do One, and 100 sessions were conducted by providers in Order One, this analysis includes 114 MI sessions as the unit of analysis.
Outcome measures
| Measure |
See One
n=3 MI Sessions completed by providers
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=11 MI Sessions completed by providers
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=100 MI Sessions completed by providers
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
|---|---|---|---|
|
The Independent Tape Rater Scale- Advanced Competence Score
|
3.92 score on a scale
Standard Deviation 0.88
|
4.25 score on a scale
Standard Deviation 0.52
|
4.49 score on a scale
Standard Deviation 0.46
|
SECONDARY outcome
Timeframe: All sessions conducted and recorded by providers with study-enrolled patients during the trial period, an expected 24 weeks per provider.The Independent Tape Rater Scale includes 5 fundamental MI items and 5 advanced MI items. Items are rated for adherence on a scale of 1 (not at all) to 7 (extensively) and competency on a scale of 1 (not at all) to 7 (excellent). Higher scores are better adherence or competence. An adequately performed MI session occurs when at least half the MI consistent items are rated average or above (i.e., score of 4, 5, 6, or 7) for both adherence and competence. Percentage of MI sessions reaching this adequate performance threshold, per arm, served as the secondary outcome measure. Only MI sessions conducted within each study arm by the providers with patient participants were included in this analysis. Since 3 MI sessions were conducted by providers in See One, 11 sessions were conducted by providers in Do One, and 100 sessions were conducted by providers in Order One, this analysis includes 114 MI sessions as the unit of analysis.
Outcome measures
| Measure |
See One
n=3 MI Sessions completed by providers
Providers in See One only receive MI workshop training, giving them an opportunity to "see" the MI intervention and learn how to conduct it. The trainer encourages them to screen their patients for substance misuse and apply MI as indicated.
|
Do One
n=11 MI Sessions completed by providers
Following workshop training, MI-trained CL clinicians directly supervise providers' live bedside provision of MI to patients twice before beginning the trial and once midstream. In addition, providers have the option to request additional live supervision from CL clinicians during the trial, consistent with the apprenticeship model.
|
Order One
n=100 MI Sessions completed by providers
Following the workshop, providers either administer MI themselves or "order" a MI for delivery by one of the MI-trained CL clinicians. Only providers in Order One can specifically request MI through a separate CL order in the electronic health record. The physicians or PAs directly place MI orders. Nurses contact physicians or PAs to place the MI order. The CL clinicians are trained in MI via a clinical trials training approach: 1) a 2-day skill-building workshop; 2) three post-workshop supervised practice cases based on review of audio recorded sessions; and 3) follow-up monthly group supervision to maintain and monitor the CL clinicians' MI practice. CL clinicians also learned supervisory practices to provide live supervision to providers in Do One.
|
|---|---|---|---|
|
Adequately Performing MI
|
2 MI Sessions completed by providers
|
11 MI Sessions completed by providers
|
100 MI Sessions completed by providers
|
Adverse Events
See One
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Do One
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Order One
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place