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Lassemo E, Rodd HD, Skeie MS, Johnsen JAK, Nermo H, Sand K, Eftedal RK, Fagerhaug TN, Jasbi A, Marshman Z, Dahllöf G, Høiseth M. Dental professionals' views on motivational interviewing for the prevention of dental caries with adolescents in central Norway. BMC Oral Health 2023; 23:889. [PMID: 37986160 PMCID: PMC10662639 DOI: 10.1186/s12903-023-03649-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Establishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients. METHODS As part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level. RESULTS A total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists. CONCLUSIONS A high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.
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Affiliation(s)
- Eva Lassemo
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway.
| | - Helen D Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Hege Nermo
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kari Sand
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway
| | - Randi Krog Eftedal
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Tone Natland Fagerhaug
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Arefe Jasbi
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Göran Dahllöf
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Dental Medicine, Division of Orthodontics and Paediatric Dentistry, Karolinska Institutet, Stockholm, Sweden
| | - Marikken Høiseth
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Malefo MA, Ayo-Yusuf OA, Mokgatle MM. A Qualitative Study of the Benefits and Utility of Brief Motivational Interviewing to Reduce Sexually Transmitted Infections among Men Who Have Sex with Men. Behav Sci (Basel) 2023; 13:654. [PMID: 37622794 PMCID: PMC10451619 DOI: 10.3390/bs13080654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/13/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
Several studies have demonstrated the effectiveness of motivational interviewing (MI) in reducing sexual risk behaviors. However, limited information is available on the acceptability of brief MI among men who have sex with men (MSM) in poor resource settings like sub-Saharan Africa. The objective of this study was to assess the views of MSM about the benefits and utility of brief MI (bMI) in changing their risky behavior. A qualitative study among men who have sex with men (MSM) who were enrolled in a longitudinal observational study between December 2021 and May 2023. The setting was in Tshwane North and participants were scheduled for baseline, 6-month, and 12-month visits. All participants received 20 min one-on-one face-to-face brief motivational interview (bMI) sessions during their follow-up visits. At month 12, an exit interview was conducted with consenting conveniently sampled participants (n = 23) who had completed all scheduled visits and received three bMI sessions. The findings indicated that the most recalled conversation was related to multiple sexual partners, having sex under the influence of alcohol, and MSM learned more about sexually transmitted diseases. Many expressed being comfortable with the sessions because the counselor was respectful and non-judgmental. Most found the bMI sessions to have a positive impact on changing and reducing risky sexual behaviors, particularly it reportedly increased their use of condoms and reduced the number of multiple partners. MSM found the bMI to be useful and acceptable in reducing sexual risk behaviors among MSM.
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Affiliation(s)
- Matshidiso A. Malefo
- School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
| | - Olalekan A. Ayo-Yusuf
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa;
| | - Mathildah Mpata Mokgatle
- School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
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Kottke MJ, Sales JM, Goedken P, Brown JL, Hatfield-Timajchy K, Koumans EH, Hardin JW, Kraft JM, Kourtis AP. 2gether: A Clinic-Based Intervention to Increase Dual Protection from Sexually Transmitted Infections and Pregnancy in Young African American Females. J Womens Health (Larchmt) 2023; 32:29-38. [PMID: 36413049 DOI: 10.1089/jwh.2022.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: To determine whether the 2gether intervention increases use of a dual protection (DP; concurrent prevention of pregnancy and sexually transmitted infections [STIs]) strategy and decreases pregnancy and STIs among young African American females, who disproportionately experience these outcomes. Materials and Methods: We conducted a randomized clinical trial comparing the 2gether intervention to standard of care (SOC). Participants were self-identified African American females aged 14-19 years who were sexually active with a male partner in the past 6 months. Participants were followed for 12 months; 685 were included in the analytic sample. The primary biologic outcome was time to any incident biologic event (chlamydia, gonorrhea, trichomonas infections, or pregnancy). The primary behavioral outcomes were use of and adherence to a DP strategy. Results: 2gether intervention participants had a decreased hazard of chlamydia, gonorrhea, trichomonas infections, or pregnancy during follow-up, hazard ratio = 0.73 (95% confidence interval [CI] 0.58-0.92), and were more likely to report use of condoms plus contraception, generally, adjusted risk ratio (aRR) = 1.61 (95% CI 1.15-2.26) and condoms plus an implant or intrauterine device (IUD), specifically, aRR = 2.11 (95% CI 1.35-3.29) in the prior 3 months compared with those receiving SOC. 2gether participants were also more likely to report use of condoms plus an implant or IUD at last sex and consistently over the prior 3 months. Conclusions: 2gether was efficacious in increasing use of condoms with contraception and decreasing pregnancy or selected STIs in our participants. Implementation of this intervention in clinical settings serving young people with high rates of pregnancy and STIs may be beneficial. ClinicalTrials.gov, No. NCT02291224 (https://clinicaltrials.gov/ct2/show/NCT02291224?term=2gether&draw=2&rank=5).
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Affiliation(s)
- Melissa J Kottke
- Department of Gynecology and Obstetrics, Jane Fonda Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jessica M Sales
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Peggy Goedken
- Department of Gynecology and Obstetrics, Jane Fonda Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jennifer L Brown
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kendra Hatfield-Timajchy
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emilia H Koumans
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James W Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Joan Marie Kraft
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Athena P Kourtis
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Computer- vs. nurse practitioner-delivered brief intervention for adolescent marijuana, alcohol, and sex risk behaviors in school-based health centers. Drug Alcohol Depend 2021; 218:108423. [PMID: 33307377 DOI: 10.1016/j.drugalcdep.2020.108423] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study examined approaches to delivering brief interventions (BI) for risky substance use and sexual behaviors in school-based health centers (SBHCs). METHODS 300 Adolescents (ages 14-18; 54 % female) with risky marijuana and/or alcohol use identified via CRAFFT screening (scores >1) were recruited from two SBHCs and randomized to computer-delivered BI (CBI) or nurse practitioner-delivered BI (NBI). Both BIs included motivational and didactic content targeting marijuana, alcohol, and risky sexual behaviors. Assessments at baseline, 3-month, and 6-month follow-up included past 30-day frequency of marijuana use, alcohol use, binge drinking, unprotected sex, and sex while intoxicated; marijuana and alcohol problems; and health-related quality-of-life (HRQoL). A focused cost-effectiveness analysis was conducted. An historical 'assessment-only' cohort (N=50) formed a supplementary quasi-experimental comparison group. RESULTS There were no significant differences between NBI and CBI on any outcomes considered (e.g., days of marijuana use; p=.26). From a cost-effectiveness perspective, CBI was 'dominant' for HRQoL and marijuana use. Participants' satisfaction with BI was significantly higher for NBI than CBI. Compared to the assessment-only cohort, participants who received a BI had lower frequency of marijuana (3-months: Incidence Rate Ratio [IRR] = .74 [.57, .97], p=.03), alcohol (3-months: IRR = .43 [.29, .64], p<.001; 6-months: IRR = .58 [.34, .98], p = .04), alcohol-specific problems (3-months: IRR = .63 [.45, .89], p=.008; 6-months: IRR = .63 [.41, .97], p = .04), and sex while intoxicated (6-months: IRR = .42 [.21, .83], p = .013). CONCLUSIONS CBI and NBI did not yield different risk behavior outcomes in this randomized trial. Supplementary quasi-experimental comparisons suggested potential superiority over assessment-only. Both NBI and CBI could be useful in SBHCs.
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Marrazzo J, Park I. Behavioral Counseling for Sexually Transmitted Infection Risk Reduction. JAMA 2020; 324:640-641. [PMID: 32808989 DOI: 10.1001/jama.2020.12324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Ina Park
- University of California, San Francisco
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Cordova D, Munoz-Velazquez J, Mendoza Lua F, Fessler K, Warner S, Delva J, Adelman N, Fernandez A, Bauermeister J. Pilot Study of a Multilevel Mobile Health App for Substance Use, Sexual Risk Behaviors, and Testing for Sexually Transmitted Infections and HIV Among Youth: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16251. [PMID: 32181747 PMCID: PMC7109616 DOI: 10.2196/16251] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/04/2019] [Accepted: 02/10/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Preventing and reducing substance use disorders, sexually transmitted infections (STIs)/HIV, and teen pregnancy, and the associated risk behaviors (ie, substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among the youth. Mobile health (mHealth) apps may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated efficacy in reducing substance use or sexual risk behaviors or improving the uptake of STI/HIV testing among the youth, particularly in clinic settings. OBJECTIVE This small-scale study aimed to examine the feasibility of conducting a pilot randomized controlled trial (RCT). We evaluated the effects of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, on the potential mechanisms by which behavior change occurs, namely clinician-youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy. We also assessed the ability to measure targeted outcomes of past 30-day substance use (ie, alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use before sex, as well as the uptake of STI/HIV testing. METHODS Employing community-based participatory research principles, 50 youths aged 13 to 21 years were recruited from a youth-centered community health clinic in Southeast Michigan, randomized sequentially to either S4E or enhanced usual practice, and assessed at baseline, immediately postintervention, and 30 days postintervention. S4E consists of 3 modules, including alcohol and drug use, tobacco, and STI/HIV. RESULTS Relative to youth in the enhanced usual practice group, S4E participants demonstrated higher youth-clinician risk communication (mean 3.22, SD 1.67) and increases in prevention knowledge (∆ score mean 0.36, SD 0.51) and self-efficacy (∆ score mean 0.16, SD 0.47). In addition, youth in the S4E group showed reductions in the proportions of past 30-day overall substance use (Cohen h=0.71, 95% CI 0.15 to 1.27), as well as past 30-day alcohol (Cohen h=0.71, 95% CI 0.15 to 1.27), tobacco (Cohen h=0.17, 95% CI -0.39 to 0.73), and drug use (Cohen h=1.28, 95% CI 0.72 to 1.84). The results also suggest a reduction in the proportion of youths who reported past 30-day condomless sex (Cohen h=0.18, 95% CI -0.38 to 0.74) and alcohol use before sex (Cohen h=0.44, 95% CI -0.12 to 1.00). Finally, the findings also demonstrated an increase in the proportion of youths who reported STI/HIV testing over time (Cohen h=0.16, 95% CI -0.39 to 0.72). CONCLUSIONS The findings suggest the feasibility of a small-scale pilot RCT. S4E demonstrated shifts in the hypothesized direction, reducing substance use, sexual risk behaviors, and improving the uptake of STI/HIV testing among youth in a clinic setting. The findings suggest that a larger RCT may be warranted. TRIAL REGISTRATION ClinicalTrails.gov NCT03855410, https://clinicaltrials.gov/ct2/show/NCT03855410.
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Affiliation(s)
- David Cordova
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | | | - Frania Mendoza Lua
- School of Social Service Administration, University of Chicago, Chicago, IL, United States
| | | | - Sydni Warner
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Jorge Delva
- School of Social Work, Boston University, Boston, MA, United States
| | | | - Angela Fernandez
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Jose Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
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