Does the Use of Motivational Interviewing Skills Promote Change Talk Among Young People Living With HIV in a Digital HIV Care Navigation Text Messaging Intervention?

Motivational interviewing (MI) is a counseling approach to facilitate behavior change. MI has been widely applied to in-person-delivered, health behavior change interventions; however, mobile health (mHealth) interventions are beginning to adopt and expand the reach of MI in health promotion practice with the use of mobile phones and digital platforms. This study examines whether the use of MI skills (e.g., OARS [open-ended questions, affirmations, reflective listening, and summaries]) promotes change talk in an SMS text messaging intervention for young people living with HIV in San Francisco. We undertake a novel method of analyzing text message intervention data in order to characterize the microprocesses of change talk. Data were collected via computer-assisted self-interviewing surveys of self-reported sociodemographic information, and two-way text messages facilitated by a digital HIV care navigator during the 6-month intervention. We qualitatively assessed all text messages exchanged for the utilization of four basic MI skills on the part of the interventionist (OARS) and participant change talk. This study found that high levels of all four MI skills-and moderate levels of open-ended questions only-were associated with more change talk compared to low levels. Additionally, using three or more MI skills was associated with change talk. Future research is needed to inform how to analyze large amounts of data passively collected as a native part of implementing mHealth and text messaging applications of MI interventions.