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This study included African Americans with asthma in emerging adulthood, a developmental period largely neglected in the research literature but known to be a time of great risk asthma morbidity and mortality. We conducted thematic analysis of semi-structured interviews ( N = 19) to explore barriers to adherence in the context of the transition into adulthood. Key themes for non-adherence emerged after careful follow-up prompting by the interviewer: forgetting to take medications, deciding not to take medications as prescribed, and systemic barriers. Clinicians and researchers interested in improving adherence should carefully assess barriers to adherence when working with this population. Effective adherence interventions should target both intentional and unintentional reasons for non-adherence behavior and take into account the unique developmental needs of emerging adults.

The provision of culturally relevant yet evidence-based interventions has become crucial to global HIV prevention and treatment efforts. In Thailand, where treatment for HIV has become widely available, medication adherence and risk behaviors remain an issue for Thai youth living with HIV. Previous research on motivational interviewing (MI) has proven effective in promoting medication adherence and HIV risk reduction in the United States. However, to test the efficacy of MI in the Thai context a feasible method for monitoring treatment fidelity must be implemented. This article describes a collaborative three-step process model for implementing the MI Treatment Integrity (MITI) across cultures while identifying linguistic issues that the English-originated MITI was not designed to detect as part of a larger intervention for Thai youth living with HIV. Step 1 describes the training of the Thai MITI coder, Step 2 describes identifying cultural and linguistic issues unique to the Thai context, and Step 3 describes an MITI booster training and incorporation of the MITI feedback into supervision and team discussion. Throughout the process the research team collaborated to implement the MITI while creating additional ways to evaluate in-session processes that the MITI is not designed to detect. The feasibility of using the MITI as a measure of treatment fidelity for MI delivered in the Thai linguistic and cultural context is discussed.

This paper briefly reviews the research literature on motivational interviewing (MI) and behaviour change in adolescents and then discusses the implications of adolescent cognitive and social–emotional developmental processes for the relational and technical components of MI. Research suggests that MI is efficacious in improving substance use in adolescents. Research has been slower to emerge in other behaviours, but available randomized controlled trials suggest that MI has great promise for improving mental and physical health outcomes in this developmental period. The relational and technical components of MI are highly relevant for the adolescent developmental period, and studies have shown that these components are related to outcomes in this population. There are several ways to include MI in clinical interventions for adolescents, ranging from MI in brief settings to using MI as a platform from which all other treatments are offered. Future research is necessary to test the effects of MI in adolescent group settings and the full integration of MI into other adolescent treatment approaches.

Purpose: To examine health risk behaviors in distressed youth living with HIV (YLH) with problem substance use. Methods: Assessed distress, antiretroviral (ARV) adherence, and unprotected sex in a racially and geographically diverse sample of 122 YLH. Results: A total of 87% of distressed YLH reported significantly more past-month ARV nonadherence (odds ratio [OR] = 7.15) and were more likely to have unprotected sex under the influence (OR = 5.14) than nondistressed youth. Conclusions: Distressed YLH with problem substance use may benefit from interventions to improve adherence and to decrease sexual risk, especially while under the influence of drugs.