Examining the Impact of Race on Motivational Interviewing Implementation and Outcomes with HIV+ Heavy Drinking Men Who Have Sex with Men

Anthony Surace, David G. Zelaya, Arryn A. Guy, Nadine R. Mastroleo, Ayla Durst, David W. Pantalone, Peter M. Monti, Kenneth H. Mayer and Christopher W. Kahler
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Anthony Surace: Center of Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA
David G. Zelaya: Center of Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA
Arryn A. Guy: Center of Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA
Nadine R. Mastroleo: Department of Psychology, Binghamton University, Binghamton, NY 13902, USA
Ayla Durst: Center of Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA
David W. Pantalone: The Fenway Institute, Fenway Health Boston, Boston, MA 02215, USA
Peter M. Monti: Center of Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA
Kenneth H. Mayer: Department of Global Health and Population, Harvard Medical School, Boston, MA 02115, USA
Christopher W. Kahler: Center of Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA

IJERPH, 2022, vol. 19, issue 7, 1-14

Abstract: Motivational interviewing (MI)-based interventions focus on changing behavior through building client motivation. It is unknown how racial mismatch between clients and providers may impact MI implementation and subsequent behavior. We used a mixed methods approach to examine differences in Motivational Interviewing Skill Code (MISC) coded sessions and post-session outcomes between a sample of HIV-positive cisgender men who have sex with men (MSM) participants of an MI-based intervention to reduce heavy drinking who identified as persons of color (POC; n = 19) and a matched sample of White participants ( n = 19). We used quantitative methods to analyze how providers implemented the intervention (i.e., MISC codes) and post-session drinking. We used qualitative analyses of session transcripts to examine content not captured by MISC coding. Quantitative analyses showed that providers asked fewer open-ended questions and had a lower ratio of complex reflections to simple reflections when working with POC participants, but no significant differences were observed in drinking post-intervention between participants. Qualitative analyses revealed that participants discussed how racial and sexual orientation discrimination impacted their drinking. Allowing clients to share their experiences and to explore individually meaningful reasons for behavioral change may be more important than strict adherence to MI techniques.

Keywords: motivational interviewing for alcohol use; men who have sex with men with HIV; racial discrimination; mixed methods; qualitative analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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