Change Package Your Team Name: Newport News Social Services Topic Area: MD Name of the Intervention: Motivational Interviewing to increase HV KSA and comfort level discussing MD with families. Primary Driver: Capacity and Support of HV to address MD

Definition of the Intervention Each HV went to MI training and then implemented a MI strategy each week with three families to increase the KSA of MI and comfort level using the techniques. Initially the workers were hesitant and did not know how it would work using the MI in HVs. However, by the end, the HVs found that using the technques help them be reflective with their families and learn more information about them just by using the strategies.

Description of the Intervention Date of HV Child Name Mom Name MI Technique(s) Used How do you feel the MI techniques assisted you in gathering information? What new information have you learned about the family since using a MI technique?   We used a local LIA members tool and just added an extra column to collect additional data.

How is the intervention carried out? Each HV completed one of the tracking tool each week that went to 3 home visits. Each week a MI strategy was implemented. The HV was allowed to use the MI technique anytime during that HV that felt it was needed. Then the HV had to write down what happened and what new information they learned from the family using the MI technique.

Evidence that the intervention is effective The results were positive. Initially workers relayed that they were not sure of how to implement the techniques and how the parents would relate. We met weekly for 5 weeks and each week, the HV came back with more confidence in relaying information to supervisor about the home visit. The MI techniques helped the workers think more reflectively in the situations of the home visits. For instance, a home visit occurred where the worker was discussing with MOB her guardianship. The MGM has guardianship over the MOB due to some cognitive issues. MGM has custody of MOB's child and MOB wants her back. MOB was abused by boyfriend and in 2013 he has a serious DV incident and was reflecting on all this during a visit with the worker. Worker used the summaries technique and encourage MOB to look her strengths and how far she has come. Home visitor felt using this technique at that time helped MOB see the bigger picture and how everything that happened in life can be used for a positive. She felt that this technique helped MOB put things into perspective. All the home visitors felt that this PDSA encouraged them to apply the techniques in the home visits and they use them from now on without thinking! This training is a mandatory training for all new home visitors on my team and I will use this PDSA as a way to encourage the home visitor to apply these techniques after the training. This will now be a standard procedure.

Pre-requisites for the intervention What is needed in order to have success with this intervention? Motiviational Interviewing Training. The training is not offered regularly so it may cause an issue in the future. The tracking tool helped because it was an opportunity for the worker to use critical thinking and reflect on the family. Supervision helped give the worker a chance to discuss in detail what they learned from the family. This also helped the supervsior to get a more detailed idea of what the worker was working on with the family and build our reflective supervision.

Advice Barriers / Challenges Key advice to overcome barriers Free Training offered MGMT willingness to pay for trainings

Adaptations (if applicable) Are there adaptations of this information? For example, have other LIAs taken the Marion half-sheet and made changes? If yes, include that information here.

References/ Inspiration (if applicable) Where did this intervention come from? Include citations or links to information about the intervetnion, or more evidence that it works