AI-Augmented Motivational Interviewing Training for Primary Care

NCT ID: NCT06597123

Last Updated: 2024-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-01

Study Completion Date

2028-06-30

Brief Summary

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This study will examine the impact of training primary care providers (PCPs) in motivational interviewing (MI) using artificial intelligence (AI) to augment the training process. MI is a patient-centered approach to engaging patients in their own care. There will be a control group and two intervention groups, with the intervention groups receiving a different amount of MI training. The hypothesis is that the AI-augmented MI training will result in improved patient outcomes, improved clinician wellbeing, and reduced behavioral manifestation of clinician biases. This mixed-methods project will also collect qualitative data from structured interviews and focus groups with participating PCPs to examine perceived facilitators and barriers to the use of the MI approach in primary care.

Detailed Description

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Motivational interviewing (MI) is an evidence-based patient-centered approach that has been demonstrated to be effective in increasing patient engagement in their own care. Using MI, a clinician is compassionate curious to understand patients\' perspective on their behavior, and conversationally guides them to discover a need for behavior change. However, MI is not widely utilized in primary care practices and challenging to teach, in part because many primary care providers (PCPs) take a direct approach with their patients by educating and advising them regarding steps to improve their health. However, simply telling patient what to do tends to be ineffective, leading to frustration on the part of both patients and PCPs.

To help implement the MI approach more widely, our team has developed an artificial intelligence (AI) augmented tool for MI skill development, ReadMI™ (Real-time Assessment of Dialogue in Motivational Interviewing). The goal of this project is to: 1) examine the association of AI-measured proficiency in MI to patient outcomes, PCP wellbeing, and PCP manifestations of bias, and 2) to determine the extent to which AI-augmented MI skills training can impact the same outcome, wellbeing, and bias manifestation variables in a randomized controlled trial (RCT). This mixed-methods project will also employ structured interviews and focus groups of participating PCPs to collect qualitative data for better understanding both facilitators and barriers to the implementation of MI in primary care.

The overall hypothesis is that PCPs with the strongest MI proficiencies will have patients with better outcomes, and that those PCPs will also demonstrate less burnout and less manifestation of bias. Additionally, it is hypothesized that making use of AI in MI training will be seen by PCPs as a facilitator to the use of MI in their practices.

Conditions

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Multiple Chronic Conditions Patient Engagement Burnout, Professional Motivational Interviewing Implicit Bias

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary care provider (PCP) participants will be randomly assigned to intervention (IG) or control (CG) groups, with the Basic IG receiving two ReadMI (Real-time Evaluation of Dialogue in Motivational Interviewing)-supported motivational interviewing (MI) trainings and the Plus IG receiving four MI trainings. Plus will receive two MI trainings at the same time as Basic and will receive two additional MI trainings one year later.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Control Group

The control group (CG) will provide survey data and complete role plays with standardized patients for motivational interviewing (MI) assessment at designated project intervals. Premier Physician Network data for these primary care providers (PCPs) will also be obtained at these intervals.

Group Type NO_INTERVENTION

No interventions assigned to this group

BASIC AI-Augmented Motivational Interviewing Training

The Basic intervention group will provide survey data and complete role plays with standardized patients for motivational interviewing (MI) assessment at designated project intervals. Premier Physician Network data for these primary care providers (PCPs) will also be obtained at these intervals. Basic PCPs will participate in a didactics session on MI, and subsequently complete two AI (artificial intelligence)-augmented MI training sessions that involve role-play practice of MI.

Group Type ACTIVE_COMPARATOR

Basic AI (artificial intelligence)-Augmented Motivational Interviewing Training

Intervention Type BEHAVIORAL

Basic participants will participate in two motivational interviewing (MI) training sessions that involve role-play practice of MI. Artificial intelligence (AI) will be used to provide metrics on MI-skills (percentage of the time the clinician talks, use of open-ended questions, use of closed-ended questions, use of reflective statements, use of 0-10 scales) as measured by the ReadMI™ tool (Real-time Evaluation of Dialogue in Motivational Interviewing), and both the spirit of MI and presence of bias as measured by Dougall GPT.

PLUS AI-Augmented Motivational Interviewing Training

The Plus intervention group will provide survey data and complete role plays with standardized patients for motivational interviewing (MI) assessment at designated project intervals. Premier Physician Network data for these primary care providers (PCPs) will also be obtained at these intervals. Plus intervention group PCPs will participate in a didactics session on MI, and subsequently complete four AI (artificial intelligence)-augmented MI training sessions that involve role-play practice of MI.

Group Type ACTIVE_COMPARATOR

Plus AI (artificial intelligence)-Augmented Motivational Interviewing Training

Intervention Type BEHAVIORAL

Plus participants will participate in four motivational interviewing (MI) training sessions that involve role-play practice of MI. Artificial intelligence (AI) will be used to provide metrics on MI-skills (percentage of the time the clinician talks, use of open-ended questions, use of closed-ended questions, use of reflective statements, use of 0-10 scales) as measured by the ReadMI™ tool, and both the spirit of MI and presence of bias as measured by Dougall GPT.

Interventions

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Basic AI (artificial intelligence)-Augmented Motivational Interviewing Training

Basic participants will participate in two motivational interviewing (MI) training sessions that involve role-play practice of MI. Artificial intelligence (AI) will be used to provide metrics on MI-skills (percentage of the time the clinician talks, use of open-ended questions, use of closed-ended questions, use of reflective statements, use of 0-10 scales) as measured by the ReadMI™ tool (Real-time Evaluation of Dialogue in Motivational Interviewing), and both the spirit of MI and presence of bias as measured by Dougall GPT.

Intervention Type BEHAVIORAL

Plus AI (artificial intelligence)-Augmented Motivational Interviewing Training

Plus participants will participate in four motivational interviewing (MI) training sessions that involve role-play practice of MI. Artificial intelligence (AI) will be used to provide metrics on MI-skills (percentage of the time the clinician talks, use of open-ended questions, use of closed-ended questions, use of reflective statements, use of 0-10 scales) as measured by the ReadMI™ tool, and both the spirit of MI and presence of bias as measured by Dougall GPT.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Primary care providers (physicians, physician assistants, and nurse practitioners) employed in primary care practices of the Premier Physician Network of Premier Health (southwest Ohio) are eligible to participate.

Exclusion Criteria

* Eligible PCPs who opt to not provide informed consent for participation will be excluded from the study.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Premier Health

OTHER

Sponsor Role collaborator

Wright State University

OTHER

Sponsor Role lead

Responsible Party

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Paul J Hershberger, PhD

Professor of Family Medicine; Associate Dean for Research Affairs

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paul J Hershberger, PhD

Role: PRINCIPAL_INVESTIGATOR

Wright State University Boonshoft School of Medicine

Locations

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Premier Health

Dayton, Ohio, United States

Site Status

Wright State University

Dayton, Ohio, United States

Site Status

Countries

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United States

Central Contacts

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Paul J Hershberger, PhD

Role: CONTACT

937-245-7223

Mary Crane, MBA

Role: CONTACT

937-245-7218

Facility Contacts

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Joseph P Allen, MD

Role: primary

Brian M Schulze

Role: backup

Paul J Hershberger, PhD

Role: primary

937-245-7223

Mary Crane, MBA

Role: backup

937-245-7218

References

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Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler C, Rollnick S. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns. 2013 Nov;93(2):157-68. doi: 10.1016/j.pec.2013.07.012. Epub 2013 Aug 1.

Reference Type BACKGROUND
PMID: 24001658 (View on PubMed)

Hershberger PJ, Pei Y, Bricker DA, Crawford TN, Shivakumar A, Castle A, Conway K, Medaramitta R, Rechtin M, Wilson JF. Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI. BMC Med Educ. 2024 Mar 5;24(1):237. doi: 10.1186/s12909-024-05217-4.

Reference Type BACKGROUND
PMID: 38443862 (View on PubMed)

Hershberger PJ, Bricker DA, Conway K, Torcasio MH. Turning "Lose-Lose" into "Win-Win": What Is Good for Them Is Good for Us! Med Sci Educ. 2021 Mar 30;31(3):1177-1181. doi: 10.1007/s40670-021-01280-4. eCollection 2021 Jun.

Reference Type BACKGROUND
PMID: 34457961 (View on PubMed)

Chapman EN, Kaatz A, Carnes M. Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities. J Gen Intern Med. 2013 Nov;28(11):1504-10. doi: 10.1007/s11606-013-2441-1. Epub 2013 Apr 11.

Reference Type BACKGROUND
PMID: 23576243 (View on PubMed)

Hershberger PJ, Martensen LS, Crawford TN, Bricker DA. Promoting Motivational Interviewing in Primary Care: More Than Intention. PRiMER. 2021 Feb 4;5:7. doi: 10.22454/PRiMER.2021.287928. eCollection 2021.

Reference Type BACKGROUND
PMID: 33860162 (View on PubMed)

Other Identifiers

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25-0047-P0001

Identifier Type: -

Identifier Source: org_study_id

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