Craig Lewis

Campaigns & Resource coordinator

Steps in producing a motivational interviewing inspired workbook for HIV negative gay men

Outline:

• Background - Why this booklet?

• Process

• Use

• Content

• Evaluation

• Challenges

Background:

• High rates & frequency of HIV testing among gay men – need to identify HIV HP interventions to support clinicians.

• QAHC commissioned a review of opportunities for HP interventions with gay men at time of HIV testing.

Review results:

• Mostly focused on intensive prevention counselling – shown to be effective

• Brief counselling effective in short term

• Many effective interventions involved Motivational interviewing

• THT ‘The heat of the moment’ booklet effective

But...

• Intensive counselling is expensive – GPs and sexual health clinics don’t have the staff, time, expertise or money to implement

• Differing skills of brief intervention counselling with clinicians

• Decided on adaptation of ‘The Heat of the Moment’

Why MI booklet? What is MI?

• Works with clients to get them to realise the differences between actual and desired behaviour

• Focuses on where client is at• Clients reflect on their risk behaviour and

future behaviour• Relatively low cost intervention,

especially compared to counselling

Process

• QAHC engaged consultant experienced in MI techniques to develop & focus test booklet based on THT ‘The Heat of the Moment’ booklet

• Consultant drafted copy

• Copy reviewed/input given by QAHC

• QAHC in-house GD produced mock up

Focus testing

• Target group– Questionnaires– Focus group in Brisbane (7 guys)– Individual phone interviews in regional

areas (6 guys)

• Health Workers– Questionnaires (17 agreed, 3 returned

questionnaire)

Process continued

• Changes made to booklet

• Booklet printed & distributed– Distributed to sexual health clinics & high

gay men caseload GPs for use during pretest discussion

Use

• Clinician gives booklet to client as part of pretest discussion

• Clinicians asked to provide brief explanation of content

• Client asked to write responses in booklet

• Client encouraged to discuss responses in post test discussion

Use cont...

• Reinforces commitment to change by– Process of client writing – Thinking deeply about issues– Writing increases commitment and

likelihood of change

• Gives clinicians more to discuss in post test

Evaluation plan

• Evaluate for: Acceptability, Accessibility & Effectiveness– Sexual health workers recruit participants

who have completed the booklet– QAHC staff contact clients to administer

qualitative evaluation survey– QAHC staff analyse data, making

recommendations for changes as required

Challenges

• Recruiting adequate gay men & clinicians for focus testing

• Handing out at pre or post test?– THT evaluation & focus testing conflicted

Acknowledgments

• Troy Hakala – former QAHC staff

• Aldo Spina & David Fowler consultancy – review of HP opportunities at the time of HIV testing

• Kerri Allwood, Allwood & Associates – development of the booklet

• Focus testing participants