Clinical trial NCT06597123: AI-Augmented Motivational Interviewing Training for Primary Care
Official title: AI-Augmented Motivational Interviewing Training for Primary Care
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Multiple Chronic Conditions
Patient Engagement
Burnout, Professional
Motivational Interviewing
Implicit Bias
Keywords: Motivational Interviewing
Artificial Intelligence
Multiple Chronic Conditions
Clinician Wellbeing
Biases
Patient Engagement
Lead sponsor: Wright State University
Sponsor class: OTHER
Collaborators: name: Premier Health
First posted: 2024-09-19
Enrollment: 150
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: 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 purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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: 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\&#39; 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.

Eligibility criteria: 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.

Primary outcomes:
measure: MI Communication Metrics
timeFrame: Months 4-7, Months 16-20, Months 30-33
measure: MI Spirit
timeFrame: Months 4-7, Months 16-20, Months 30-33
Secondary outcomes:
measure: Bias Manifestation
timeFrame: Months 4-7, Months 16-20, Months 30-33
measure: Mini Z (Zero) Burnout Scale 2.0
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: Aggregated Patient Data for Each Participating PCP
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: Perceived Stress Scale (PSS)
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: Brief Resilience Scale (BRS)
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: Clinician Support for Patient Activation Measure (CS-PAM)
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: Stress Mindset Measure (SMM)
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: MI Survey Measure
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
measure: Diversity Awareness Self-Reflection Tool (DASRT)
timeFrame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
Other outcomes:
Locations:
city: Dayton
country: United States
facility: Premier Health
state: Ohio
city: Dayton
country: United States
facility: Wright State University
state: Ohio
Study officials:
affiliation: Wright State University Boonshoft School of Medicine
name: Paul J Hershberger, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.
citation: 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.
citation: 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.
citation: 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.
citation: 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.