Computer-Assisted Motivational Intervention (CAMI)

2

Manuscripts

Released in 1979 through 2011

1

Manuscript

Impact studies rated high or moderate quality

Services intended at ages
0-6 months
7-11 months
12-23 months
Favorable results from well-defined research
No favorable effects found

Skip to:  

The Computer-Assisted Motivational Intervention (CAMI) was designed to delay repeat childbearing among adolescent girls by motivating them to change their contraceptive behaviors. During home visits, adolescents completed a computer-based survey assessing their sexual relationships, contraceptive intentions and plans, and current pregnancy prevention practices. An algorithm assessed the participant’s risk for repeat pregnancy, sexually transmitted infections, and readiness to use contraception and/or condoms. Following the survey, CAMI counselors conducted a 20- to 30-minute motivational interview in which they discussed how the teen’s goals and actions aligned, and encouraged the adolescent to change her behavior. Home visits lasted about one hour and were conducted once per quarter over a two-year period.

This report also includes a review of an enhancement to CAMI, called CAMI+. In addition to the standard program, CAMI+ provided participants with biweekly or monthly home-based parent training and case management services. The 16-module curriculum, designed specifically for African American adolescent mothers, covered topics such as child development and discipline. The home visits were initiated prenatally at about 32 weeks gestation.

Related Models:

Effectiveness

Does not meet criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.

Does not meet criteria for an evidence-based home visiting model for Indigenous peoples and communities.

Extent of Evidence

For more information about manuscripts, search the research database.

For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.

2

Manuscripts

Released in 1979 through 2011

2

Manuscripts

Eligible for review

1

Manuscript

Impact studies rated high or moderate quality

Note: When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

Summary of Findings

To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.

Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.

No effect:
Findings are not statistically significant.

Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.

Outcomes Manuscripts Favorable Findings No Effects Findings Unfavorable Findings
Child development and school readiness Not measured - - -
Child health Not measured - - -
Family economic self-sufficiency Not measured - - -
Linkages and referrals Not measured - - -
Maternal health View 1 Manuscript 0 1 0
Positive parenting practices Not measured - - -
Reductions in child maltreatment Not measured - - -
Reductions in juvenile delinquency, family violence, and crime Not measured - - -

Research Characteristics

Well-designed impact studies about this model included participants with the following characteristics. The evidence for effectiveness for the model may include additional studies that did not report this participant information.

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American
97.00%
Unknown
3.00%

Maternal Education

Less than a high school diploma
42.00%
Unknown
58.00%

Other Characteristics

This data is only reported if known for at least 50 percent of participants in well-designed impact studies of the model.

Enrollment in means-tested programs
86.00%

Well-designed impact studies about this model were conducted in the following locations:

  • Maryland

Implementation

In this section:

Overview

Theoretical approach, intended population, and targeted outcomes.

Skip to section

Support Availability

Skip to section

Service Delivery

Model services, adaptions and enhancements, model intensity and length.

Skip to section

Requirements

Staffing and organizational requirements.

Skip to section

Overview

Theoretical approach

A variety of strategies have been explored to reduce repeat childbearing among adolescent girls, but the results have been modest. The Computer-Assisted Motivational Intervention (CAMI) was based on the premise that the limited success of previous programs might have been due to the lack of attention paid to teens’ level of motivation and ambivalence towards changing their contraceptive behaviors. CAMI was designed to delay repeat childbearing among adolescent girls by increasing the use of contraceptives.

Intended population

CAMI enrolled pregnant and parenting African American adolescents between ages 12 and 18.

Targeted outcomes

CAMI aimed to reduce the percentage of adolescents who had another child within two years.

Highlights

Services intended at ages
0-6 months
7-11 months
12-23 months

Support Availability

Implementation support availability

CAMI was developed by faculty and staff of the University of Maryland Schools of Medicine and Social Work, the Johns Hopkins University School of Medicine, and the University of Pittsburgh School of Medicine.

Technical assistance is not available.

Service Delivery

Model services

CAMI provided quarterly home visits during which the participants completed a computer-based survey about their sexual relationships, contraceptive intentions and plans, and current pregnancy prevention practices such as condom use. An algorithm assessed the participant’s risk for repeat pregnancy and sexually transmitted infections and readiness to use contraception and/or condoms. A CAMI counselor used these algorithm results to conduct a 20 to 30 minute tailored, motivational interview with the participant. During the interview, the teen participant and her counselor discussed how the teen’s goals and actions aligned and the counselor encouraged the participant to change her behavior.

No information was available about the curriculum used.

Model intensity and length

Every quarter, the adolescents completed the computer-based survey assessing their sexual relationships, contraceptive intentions and plans, and current pregnancy prevention practices and participated in a motivational interview with the CAMI counselor. Each CAMI session lasted about 1 hour and included the computer-based survey and the 20 to 30 minute motivational interview.

The intervention began within six weeks postpartum (range 1-6 weeks postpartum) and continued for two years.

Adaptations and enhancements

The model developers enhanced the program by pairing CAMI with home-visiting services called CAMI+. In addition to the standard program, CAMI+ provided participants with biweekly or monthly home-based parent training and case management services to help the participants address issues related to housing or child care, for example. The 16-module curriculum, designed specifically for African American adolescent mothers, drew on social cognitive theory and covered topics such as child development and discipline. The home visits were initiated prenatally at about 32 weeks gestation. 

Related Models:

Requirements

Staffing requirements

CAMI was administered by a program director and coordinator. The counselors, who conducted the motivational interviews, were paraprofessionals from the participants’ communities. A motivational interviewing consultant provided training and supervision to the CAMI counselors.

There were no education requirements for staff; however, the CAMI counselors had experience working with adolescents and were knowledgeable about the participants’ communities. In addition, the counselors were required to achieve a level of motivational interviewing proficiency as measured by videotaped standardized patient interviews.

A motivational interviewing consultant held biweekly group training and supervision meetings during the first four months of the project during which recorded CAMI sessions were reviewed. A program coordinator supervised the five counselors to ensure that activities were being conducted per protocol.

The CAMI counselors received 2.5 days of pre-service training. Each counselor was videoed delivering a session, and the interview was assessed using the Motivational Interviewing Process Code, a measure used to evaluate an interviewer’s proficiency with the technique.

Organizational requirements

No specific requirements exist for eligible implementing agencies, although agencies best suited to implement the model have staff with knowledge and training in motivational interviewing and knowledge of adolescent health issues, contraceptive methods, and condom use.

No information was available about the fidelity guidelines that implementing programs or CAMI counselors were required to meet.

Highlights

Professional certification required for home visitors
No

HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer as of the above date. HomVEE reserves the right to edit the profile for clarity and consistency. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.