Healthy Choices is an evidence-informed intervention (see references below). Adapted from Motivational Enhancement Therapy (MET), Healthy Choices is comprised of four 30-45 minute sessions that can be led by paraprofessional staff or other provider types to encourage antiretroviral treatment adherence and reductions in alcohol use and other substance use for youth living with HIV. Healthy Choices has also been shown to improve sexual risk behaviors and depression. The sessions are delivered over 3 months, typically week 1, week 2, week 8 and week 12. Other target behaviors relevant to self-management may also be addressed. The intervention is based on Tailored Motivational Interviewing (TMI). Motivational Interviewing (MI) is “a collaborative conversation style for strengthening a person’s own motivation and commitment to change”. Motivational Interviewing conversational style may also be thought of as guiding a person to change, rather than directing them to follow change. TMI is MI tailored with communication science studies of HIV clinic interactions to address target behaviors for persons with HIV and for young people. Read Dr. Naar's book, "Motivational Interviewing with Adolescents and Young Adults (Applications of Motivational Interviewing)".
Goals of Healthy Choices-HIV
- To improve adherence to antiretroviral treatment and alcohol use
- To address other health behaviors in persons living with HIV for which self-management is relevant, such as, retention in care, substance use and sexual activity
- To provide developmentally tailored strategies to engage young people
Target Population
The intervention has been particularly successful with young people living with HIV (ages 16- 24) but may be delivered to older adults.
Download the Healthy Choices - HIV Toolkit
For more information, contact Dr. Sylvie Naar at Sylvie.Naar@med.fsu.edu
References:
- Naar, S., Robles, G., MacDonell, K. K., et al. (2020). Comparative effectiveness of community-based vs clinic-based healthy choices motivational intervention to improve health behaviors among youth living with HIV, a randomized clinical trial. JAMA, 3(8):e2014650. doi:10.1001/jamanetworkopen.2020.14650
- Naar-King, S., Parsons, J. T., Murphy, D., Kolmodin, K., Harris, D. R., & ATN 004 Protocol Team (2010). A multisite randomized trial of a motivational intervention targeting multiple risks in youth living with HIV: initial effects on motivation, self-efficacy, and depression. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 46(5), 422–428. https://doi.org/10.1016/j.jadohealth.2009.11.198
- Chen, X., Murphy, D. A., Naar-King, S., Parsons, J. T., & for the Adolescent Medicine Trials Network for HIV/AIDSInterventions (2011). A clinic-based motivational intervention improves condom use among subgroups of youth living with HIV. Journal of Adolescent Health, 49(2), 193-198. doi:10.1016/j.jadohealth.2010.11.252
- Murphy, D. A., Chen, X., Naar-King, S., Parsons, J. T., & Adolescent Trials Network. (2012). Alcohol and marijuana use outcomes in the Healthy Choices Motivational Interviewing intervention for HIV-positive youth. AIDS Patient Care and STDs, 26(2), 95-100. doi:10.1089/apc.2011.0157
- Naar-King, S., Parsons, J. T., Murphy, D. A., Chen, X., Harris, D. R., & Belzer, M. E. (2009). Improving health outcomes for youth living with the human immunodeficiency virus: A multisite randomized trial of a motivational intervention targeting multiple risk behaviors. Archives of Pediatrics & Adolescent Medicine, 163(12), 1092-1098. doi:10.1001/archpediatrics.2009.212