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OLIVIA JOY KILLEEN, Sarah Miller, Chamisa MacKenzie, Michele Heisler, Ken Resnicow, Paula Anne Newman-Casey; Paraprofessionals’ perceptions of a brief, glaucoma-specific motivational interviewing training program. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3729.
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© ARVO (1962-2015); The Authors (2016-present)
Motivational interviewing (MI) counseling improves patient self-management in chronic diseases. We hypothesized that trained paraprofessionals could provide glaucoma education consistent with principles of MI. We trained paraprofessionals in brief, MI-based glaucoma education to explore the efficacy of and identify barriers to paraprofessional-led MI.
6 glaucoma technicians and 2 medical assistants received a 16-hour glaucoma-specific MI training over 3 didactic sessions, followed by 3 individualized MI coaching sessions. Following the training we assessed participants’ confidence to implement their newly acquired MI skills via a validated survey instrument. We conducted in-person, semi-structured exit interviews with all 8 participants. These sessions were audio recorded and transcribed verbatim. Using grounded theory, 2 researchers identified themes in the transcripts, developed a codebook and coded the transcripts. A MI trainer reviewed all transcripts to determine if participants demonstrated understanding of MI principles.
After completing the training, participants scored their satisfaction with the training and their ability to implement MI into clinical practice at a mean of 72% (range 65% - 87%). All participants felt MI training was valuable, improved communication with patients, and increased their job satisfaction. However, the MI trainer only rated paraprofessionals’ descriptions of their patient interactions as consistent with MI principles 63% of the time (27/43 interactions). Participants identified barriers to implementing patient education, including perceptions that providing patient education exceeds the scope of paraprofessionals’ knowledge (8/8 participants, 36 comments), lack of time (8/8 participants, 31 comments), the need for standardized educational content approved by physicians (6/8 participants, 10 comments), poor communication within the medical team (5/8 participants, 14 comments), and paraprofessionals’ limited continuity with patients (5/8 participants, 12 comments).
Though trained paraprofessionals can expand the reach of physicians by providing glaucoma education to improve patient self-management, significant barriers to implementing education in the clinical setting included perceptions that providing patient education exceeds the scope of paraprofessionals’ knowledge and lack of time for paraprofessional-led education.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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