Barriers and Facilitators to Implementing a Motivational Interviewing-based Intervention: A Multi-Site Study of Organizations Caring for Youth Living With HIV

Understanding possible barriers and facilitators to effective implementation of evidence-based interventions to help high-risk adolescents and youth prevent and manage HIV is crucial for their scale-up. This manuscript reports on qualitative interview data collected during the early phase implementation of a motivational interviewing (MI) based intervention, at 10 HIV care clinics in the United States, providing care services to youth. Relying on the Exploration-Preparation-Implementation-Sustainment (EPIS) framework to understand implementation and the dynamic adaptation process (DAP) model, to balance notions of intervention fidelity and flexibility, providers and stakeholders at each site (N=97) were interviewed prior to implementation to gather their perspectives on, organizational readiness for the intervention as well as provider and client characteristics. The interviewers then summarized their experience with rapid feedback forms (RFFs). Data extracted from the RFFs highlighted the anticipated barriers to and facilitators of the proposed MI-based intervention, with the EPIS framework used to organize these findings. Study findings illustrate the inner and outer contextual factors that can affect implementation and denote the points at which the MI-based intervention may be tailored to fit the unique context of a clinic, while remaining faithful to the intervention’s original design.