269505 Incorporating motivational interviewing into virtual contraceptive counseling

Monday, October 29, 2012

Cathryn Imperato, RN, DNP, NP-C , Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, MA
Megan Hempstead, MPH, CHES , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Daniel Schulman, MS , College of Computer and Information Science, Northeastern University, Boston, MA
Meryl Kopy, MA , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Huong Tran, MD , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Leanne S. Yinusa-Nyahkoon, ScD, OTR/L , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Suzanne Mitchell, MD, MS , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Michael Paasche-Orlow, MD, MA, MPH , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Timothy Bickmore, PhD , College of Computer and Information Science, Northeastern University, Boston, MA
Karla Damus, PhD, MSPH, RN, FAAN , Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, MA
Brian Jack, MD , Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA
Background: Innovative methods for overcoming ambivalence about contraceptive use to prevent unintended pregnancies in vulnerable populations are needed. Motivational interviewing (MI) has been found to be effective for resolving ambivalence about health behavior change, but implementation has been limited by the time, training and funding required for widespread use. “Virtual patient advocates” (VPAs) are computerized, animated characters that emulate the conversational behavior of an empathic clinician and are an ideal means of increasing access to culturally appropriate/individualized family planning counseling. Purpose: Incorporating the elements of MI into a computer-based intervention to resolve patients' ambivalence about using contraception has the potential to decrease the rate of unintended pregnancy within vulnerable populations, particularly young African American women. Methods: We designed a motivational interviewing-based pregnancy planning dialogue script for a VPA, as part of a larger effort to create a computer-based preconception care program to reduce disparities in adverse perinatal/reproductive health outcomes. The script was developed with input from experts in preconception care, motivational interviewing and health literacy, and presented to a small focus group of young African American women for additional feedback on its design. Results: The dialogue script was found to be an acceptable method of obtaining information about pregnancy planning and contraception; it can be utilized across multiple platforms and incorporated into a culturally sensitive virtual family planning counselor. Conclusion: The implementation of a VPA providing individualized contraceptive counseling based on MI has the potential to overcome ambivalence about contraceptive use and decrease rates of unintended pregnancy within vulnerable populations.

Learning Areas:
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related nursing

Learning Objectives:
To design a dialogue script which incorporates the elements of motivational interviewing into a computer-based intervention to resolve patients' ambivalence about using contraception.

Keywords: Family Planning, Computer-Assisted

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctorally-trained nurse practitioner with extensive experience in the delivery of women's health care and family planning counseling, and my research interests have been focused on increasing access to and utilization of reproductive health services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.