Date of Completion


Embargo Period



Help Seeking; Emerging Adulthood; Motivational Interviewing; Engagement in Care; Self-Determination Theory; Health Behavior Change; Blood-Injection-Injury Phobia

Major Advisor

Dean G. Cruess

Associate Advisor

Seth C. Kalichman

Associate Advisor

Amy A. Gorin

Field of Study



Doctor of Philosophy

Open Access

Open Access


For those who experience symptoms of Blood, Injection, Injury (BII) phobia, situations involving blood and needles elicit clinical levels of anxiety and subsequent avoidance. This avoidance increases their risk for suboptimal health outcomes. Current interventions take the form of general information campaigns; a tailored, one-on-one approach targeting individuals in distress may demonstrate greater efficacy. Motivational Interviewing (MI) has demonstrated effectiveness across multiple behavior change domains. The current project first conducted formative elicitation research to help develop a single session, peer-delivered, motivational interview; we then used a randomized, controlled trial to test whether the newly developed intervention would evince changes in attitude, motivation, and behavior related to mental health help-seeking. Sixty-one participants were randomized to receive either the newly developed intervention or an information only control condition. Both groups exhibited similar changes in attitude and motivation, however, a 2 (groups) by 3 (time points) ANCOVA test revealed an overall effect of time on average motivation scores (F=4.910, p=.01) and a time by group interaction effect (F=3.881, p=.03) indicating that the two groups exhibited different patterns of change. Secondary effect size analysis provided evidence for a more sustained effect in the intervention condition relative to control in both motivation and attitude measures. At one month follow up, participants in the intervention condition reported greater numbers of help seeking behavior (IR=2.46; 95%CI=1.40, 4.35; p=.002). The intervention was considered acceptable by the participants and feasible to conduct using peer-facilitators. This preliminary pilot provides support for the use of MI in this context.