Motivational interviewing for contact tracing: developing co-produced training to improve practice

Lead Research Organisation: University of Manchester
Department Name: Environment, Education and Development

Abstract

The research would develop training for contact tracers, to aim to help them to improve their communication with members of the public, feel more confident in the job they do and improve their wellbeing and job satisfaction. This would involve training them in a communication approach called motivational interviewing (MI) which would help members of the public identify their own reasons for complying with track and trace guidance relating to self-isolation and providing information about people whom they have recently been in contact with. In phase 1, the research team would work with contact tracers in one local authority to find out more about their role, and what they would like from the MI training. This would enable the project team and contact tracers to work together on the development of a training package.
In phase 2, contact tracers from local authorities or employed through private agencies would be invited to attend one of four one-day online training days. The training programme will be offered free to contact tracers via online portals. Participants will be asked to sign up via Eventbrite for one of four sessions. It is intended to have no more than 25 participants at each training session to improve the training experience. After each training session, all attendees will complete an online survey. This will be used to develop and improve the training for future sessions. Some contract tracers who volunteer will be asked to take part in a short telephone interview to find out to what extent the training has helped their practice. Their feedback will be analysed and this will used to develop a final training package, which could mean that more contact tracers could be trained in the future.

Publications

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Atkinson C (2023) The role of motivational interviewing training in supporting the practice of COVID-19 contact tracers in International Journal of Health Governance

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Atkinson C (2023) The role of motivational interviewing training in supporting the practice of COVID-19 contact tracers in International Journal of Health Governance

 
Description The key findings from this piece of work are summarised as follows:
The process of co-developing a training programme for contact tracers was highly successful. Collaboration with local authority partners was essential in discovering the specific training needs for contact tracers and in testing out the newly designed training programme. It was evident that this local authority was already heavily invested in embedding motivational interviewing throughout their organisation. Collaborative work with these partners is ongoing.
It was evident that contact tracers working in local authorities were already highly skilled for contact tracing, and despite a lack of training for this work in the context of the COVID-19 pandemic, they possessed skills that aligned with motivational interviewing, such as good communication and the ability to express empathy. This suggests that the need for this training programme may lie elsewhere, for example, in the national test and trace context. It was concluded that the training could also be usefully applied in other contexts.
This work also confirmed the feasibility of collecting data on contact tracing experience and skills, occupational self-efficacy and workplace wellbeing, which whilst it was not possible to analyse within the scope of this small-scale exploratory study, would be feasible in a future larger-scale study.
The model of on-line training delivery used in this study was a new development, necessary due to COVID-19 restrictions - usually this type of MI training would be delivered in a face-to-face context. Some modifications to the delivery format were made as the sessions progressed but overall the on-line training proved successful. The advantage of this model is that the training could be more easily delivered to a broad audience nationwide, compared to the in-person version, and would be more cost-effective. The use of technology in delivering the training has also inspired plans to convert the training into an on-line training package, which would have the potential to reach an even broader audience.
Exploitation Route It is likely that the local authority representatives who participated in this work have taken key messages from the training back to their organisations. It was evident that participants recognised the benefits of the motivational interviewing approach, many were eager to apply their newly learned skills not only in their own practice, but to incorporate elements into their own training programmes.
It is possible for the training programme to be developed as an on-line training course which would have the potential to be accessed by a broad audience nationally (even internationally). The training can also be usefully applied in a range of contexts (not solely in contact training for COVID-19) with far reaching benefits.
Sectors Healthcare
 
Title Motivational interviewing for contact tracing: developing co-produced training to improve practice - Survey Data and Interview Transcripts 
Description During the COVID-19 pandemic of 2020-2022, contact tracing became a national priority due to its centrality to infection control; low rates of self-isolation compliance and regional and centralised initiatives. Contact tracing is a vital component of infection control. Testing and isolating people who have tested positive for COVID-19, then tracking and quarantining their contacts is key to reducing transmission. Historically, contact tracing has been a local activity, although the government's response to COVID-19 has included centralised call centres. A UK study found low adherence to self-isolation (18.2% N=31,787), particularly amongst the least affluent. The authors identified a potential tension that existed between the government strategy to promote adherence to self-isolation guidance through fines, and the widely accepted position that it is individual's intrinsic motivation that promotes behavioural change. Therefore, the government approach could result in fewer people initially presenting for tests, for fear of the financial repercussions. Motivational interviewing (MI) is a collaborative conversational style for promoting motivation and commitment to behavioural change. MI is effective for working with clients who feel ambivalent about change, making it potentially ideal as a way of talking to individuals testing positive with the COVID-19 virus, who may have conflicting feelings about self-isolation. Its potential role in improving social distancing and other COVID-19 related safety precautions has already been highlighted; as have its benefits for contact tracing within sexual health. The United States Center for Disease Control and Prevention (CDC) (2020) describe MI amongst the skills and qualities necessary for contact tracers. When used in contact tracing within sexual health Op de Coul et al. (2013) found that training in MI led to positive changes in professionals' attitudes and contact tracing skills. This exploratory study sought to consider the feasibility of developing and delivering brief, accessible MI training for contact tracers. The project would involve the co-production, delivery and evaluation of the training. It is anticipated that, in line with previous research, the training would improve the skills and self-efficacy of contact tracers, with this also impacting wellbeing. Future research could then seek to assess its potential impact on public engagement with self-isolation, following contact tracing. Survey data were collected from participants who attended one of four one-day on-line training sessions. There was a pre-training survey which captured information including; contact tracing experience and skills, occupational self-efficacy, and wellbeing at work. A post-training survey gather participants' feedback on the session. Volunteers were also recruited to take part in a short telephone interview. Anonymised transcripts are provided. 
Type Of Material Database/Collection of data 
Year Produced 2022 
Provided To Others? Yes  
Impact This dataset highlights that contact tracers working within local authorities, tend to have a level of expertise that enables them to conduct their contact tracing work successfully. These individuals feel well equipped to do the work and consequently have a high level of wellbeing and self-efficacy in the workplace. This is an exploratory study, so the data were collected to explore the feasibility of doing so in a future larger-scale study. The targets of this training in the future are likely to be a different cohort ie potentially individuals with a lower level of competence and in greater need of this type of support. 
 
Description Presentation to UKSHA 
Organisation UK Health Security Agency
Country United Kingdom 
Sector Public 
PI Contribution On 19 November 2021, we presented the finding of our ESRC-funded MI for contact tracing research to the UK Health Security Agency's (UKHSA - formerly NHS Test and Trace) COVID Evaluations and Studies Group (see A2). This has led to the Head of Social Interventions and Behaviour Evaluation at UKSHA requesting our further involvement in a coordinated response to the COVID tracking.
Collaborator Contribution It was hoped that our study could inform a wider UKSHA RCT looking into whether using MI improving the efficacy of contact tracing in infection control. Unfortunately this has not been feasible because contact tracing has broadly been ceased, in lien with the wider COVID-19 strategy. It was envisaged that our of the research team would train participants in the RCT. However, this did not happen because of the scaling down of contact tracing.
Impact Unfortunately the collaboration was not continued because of the wind down of contact tracing
Start Year 2021
 
Description 6th International Conference on Motivational Interviewing, to be held virtually from 13-16 June, 2022 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was an online/virtual conference hosted by the Motivational Interviewing Network of Trainers (international organisation ensuring quality delivery of motivational interviewing). This international conference would have been attended by hundreds of people from around the world. We do not know exactly how many people attended our presentation - potentially 50 to 100. There were questions and discussions afterwards. It is difficult to predict the impact, however, the majority of participants are interested in motivational interviewing (the conference focus) and it is likely that some will work in areas involving contact tracing, for example infectious disease control.
Year(s) Of Engagement Activity 2022
 
Description Manchester Motivational Interviewing Network Event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was an event to relaunch the Manchester Motivational Interviewing Network (MMIN) following a period of disruption due to the pandemic, to re-engage with members and to report on MMIN activities over the past 2-3 years. We delivered a presentation on our research study to develop motivational interviewing training to support contact tracers. 47 people signed up to attend, this was a hybrid event - 8 attended in person and 23 online. It is difficult to predict the impact, however, participants were present due to their interest in motivational interviewing and it is likely that some are involved in some form of contact tracing, for example infectious disease control.
Year(s) Of Engagement Activity 2023