AI-Augmented Motivational Interviewing Training for Primary Care (AIM-PC)

September 12, 2024 updated by: Paul J Hershberger, PhD, Wright State University
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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

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' 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.

Study Type

Interventional

Enrollment (Estimated)

150

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: 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.
Active Comparator: 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.
Behavioral: 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.
Active Comparator: 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.
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
MI Communication Metrics
Time Frame: Months 4-7, Months 16-20, Months 30-33
Motivational interviewing skills/metrics (percentage of time the clinician speaks, number of open-ended questions, number of close-ended questions, number of reflective statements, number of 0-10 scales). Each of the metrics is the total number of occurrences.
Months 4-7, Months 16-20, Months 30-33
MI Spirit
Time Frame: Months 4-7, Months 16-20, Months 30-33
Using a 0-10 scale, the spirit of motivational interviewing (MI) in a role play with a standardized patient will be measured by two artificial intelligence (AI) tools respectively: ReadMI and Dougall GPT.
Months 4-7, Months 16-20, Months 30-33

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bias Manifestation
Time Frame: Months 4-7, Months 16-20, Months 30-33
Dougall GPT will be used to identify the number of biases evident in a role play with a standardized patient.
Months 4-7, Months 16-20, Months 30-33
Mini Z (Zero) Burnout Scale 2.0
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
Ten survey questions (5 pt Likert scale) assessing perceived burnout and factors contributing to burnout. Scores range from 10-50, with 10 indicating the least amount of burnout.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
Aggregated Patient Data for Each Participating PCP
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
Data routinely collected by the Premier Physician Network for participating primary care providers (PCPs). All measures are percentages of patients 0% - 100%) indicating that their PCP listened, explained things clearly, and would recommend the PCP). Also, percentages of patients (0%-100%) of patients with poor hemoglobin A1c control, with hypertension control, and completing recommended screenings for each participating PCP are provided.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
Perceived Stress Scale (PSS)
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
Scale with 10 items (4 pt Likert scale) measuring perceived experience of stress. Scores range from 0-40 with 0 being the least amount of stress.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
Brief Resilience Scale (BRS)
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
Six-item scale (5 pt Likert scale) assessing responses to stressful periods. Scores range from 6-30 with higher scores indicating more resilience.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
Clinician Support for Patient Activation Measure (CS-PAM)
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
This 13-item scale (response options range from 1 = not important to 4 = extremely important) assesses PCP (primary care provider) attitudes and self-reported behaviors related the patient engagement in the management of their health conditions. Scores are translated into a 1-100 scale (Rasch methods) with higher scores indicating more positive beliefs about patients' invovlement in their care.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
Stress Mindset Measure (SMM)
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
This 8-item (5 pt Likert scale ranging from 0=strongly disagree to 4=strongly agree) measures perspectives on stress as debilitating versus enhancing. Scores range from 0 to 32 with higher scores indicating a mindset that stress is enhancing.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
MI Survey Measure
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
Three items (5 pt Likert scale) assess PCP (primary care provider) attitudes regarding the impact of motivational interviewing (MI) training on confidence, intent to use/incorporation of the MI approach, and importance of MI training for other PCPs. Scores range from 3 to 15 with higher scores indicating more positive regard for MI.
Months 4-5, Months 16-17, Months 25-26, Months 32-33
Diversity Awareness Self-Reflection Tool (DASRT)
Time Frame: Months 4-5, Months 16-17, Months 25-26, Months 32-33
SeventeenValues and Attitudes items (three response alternatives for each item ranging from 1=things I do often to 3=things I do rarely) from the Diversity Awareness Self-Reflection Tool will be used to assess PCP (primary care provider) self-awareness of their attitudes and behavior toward patient of diverse backgrounds. Scores range from 17 to 51 with lower scores indicating a higher degree of diversity competency.
Months 4-5, Months 16-17, Months 25-26, Months 32-33

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Wright State University

Collaborators

Premier Health

Investigators

  • Principal Investigator: Paul J Hershberger, PhD, Wright State University Boonshoft School of Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2025

Primary Completion (Estimated)

June 30, 2028

Study Completion (Estimated)

June 30, 2028

Study Registration Dates

First Submitted

September 5, 2024

First Submitted That Met QC Criteria

September 12, 2024

First Posted (Estimated)

September 19, 2024

Study Record Updates

Last Update Posted (Estimated)

September 19, 2024

Last Update Submitted That Met QC Criteria

September 12, 2024

Last Verified

September 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 25-0047-P0001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Only aggregate participant data will be made available to other researchers.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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