Table 1.

Minority-Youth Sequential Coding for Observing Process Exchanges Codes.

Patient (Target) behaviors
Change Talk	Statement conveying underlying motivation, including desire, ability, reason, or need for behavior change. I take my medication because I could give my partner HIV.
Commitment Language	Statement about taking action, including current or future agreement, intention, or obligation related to behavior change I’ll take my medication tomorrow.
Sustain Talk	Statement describing current or future intention to avoid or take action against target behavior change, or statement describing underlying motivation to not change. I didn’t tell my partner about my HIV status.
HIV-Related	Statement about a target behavior that does not meet the definition for change talk, commitment language, or sustain talk. What are the side effects of this medication?
Other Statements	All other patient statements including those that end topic development or develop the topic of the conversation but are about non-target behaviors. When I was a kid, people used to tease me a lot and it really made me mad.
Provider (Given) behaviors
Affirmation	Positive or complimentary statement that expresses appreciation, confidence, or reinforces the patient’s strengths or efforts. So, you did that. I don’t know if you get how huge this is for you, like, and how much we see that. This is a huge step. This is fantastic, and it doesn’t mean that it’s easy.
Emphasize Autonomy	Statement directly acknowledging, honoring, or emphasizing the patient’s freedom of choice, autonomy, or personal responsibility. I really respect the fact that you are not ready to share your diagnosis with your mother.
General Information Positive	Offering educational information, advice, suggestions, or potential solutions/actions using patient-centered communication strategies such as asking for permission, using the third person, giving the option to reject information before providing it, and offering a menu of options. I have some information about drugs, would you like to hear it?
General Information Negative	Offering educational information, advice, suggestions, or potential solutions/actions, or expressing concern in a non-productive way such as not asking for permission, using imperative language (e.g., “I want you to...”), re-emphasizing negative consequences, and disagreeing/arguing with the patient. You will never have an undetectable viral load if you continue to miss doses.
Reflection of Change Talk	An active listening statement that restates a patient’s own statement or behavior regarding his/her underlying motivation for behavior change. You are worried that HIV is going to affect your health.
Reflection of Commitment Language	An active listening statement that restates a patient’s own statement or behavior regarding his/her current or future intention, plan, or action related to behavior change. So, you feel confident that you can take your medication every day.
Reflection of Sustain Talk	An active listening statement that restates a patient’s own statement or behavior regarding his/her current or future intention to avoid or take action against target behavior change, or a statement describing underlying motivation to not change. In the past, side effects were one reason you didn’t take your medication.
Other Reflections	An active listening statement that restates a patient’s own statement or behavior on a topic unrelated to the target behavior. You’re not liking this weather either.
Open Question to Elicit Change Talk	A question designed to allow a wide range of possible answers and phrased to elicit the patient’s underlying motivation for behavior change. Why might you want to talk to your partner about your HIV status?
Open Question to Elicit Commitment Language	A question designed to allow a wide range of possible answers and phrased to elicit the patient’s current or future intention or action related to behavior change. What ideas do you have about talking to your partner?
Open Question to Target Behavior Neutral	A question designed to allow a wide range of possible answers related to the target behavior without having a specific slant towards eliciting change talk and commitment language, or sustained talk. How have you been feeling on this new medication?
Open Question to Elicit Sustain Talk	A question designed to allow a wide range of possible answers and phrased to elicit a patient’s current or future intention to avoid or take action against target behavior change, or a statement describing underlying motivation to not change. Why do you prefer not to wear a condom?
Other Open Questions	A question designed to allow a wide range of possible answers unrelated to the target behavior. So, what do you do in your free time?
Closed Question to Elicit Change Talk	A question that implies a short answer or specifies a restricted range of responses phrased to elicit the patient’s underlying motivation for behavior change. Will you talk to your partner about your HIV status?
Closed Question to Elicit Commitment Language	A question that implies a short answer or specifies a restricted range of responses phrased to elicit the patient’s current or future intention or action related to behavior change. When will you talk to your partner?
Closed Question to Target Behavior Neutral	A question that implies a short answer or specifies a restricted range of responses regarding the target behavior that does not have a specific slant towards eliciting change talk and commitment language, or sustained talk. Do you have any problems with taking your medication?
Closed Question to Elicit Sustain Talk	A question that implies a short answer or specifies a restricted range of responses phrased to elicit a patient’s current or future intention to avoid or take action against target behavior change, or a statement describing underlying motivation to not change. You don’t like coming to clinic?
Other Closed Questions	A question that implies a short answer or specifies a restricted range of responses unrelated to the target behavior. You need some water?
MI Inconsistent Strategies	Counselor strategies that use a negative tone while directly engaging the patient (e.g., shaming, blaming, ridiculing, etc.), warn/threaten of negative consequences of the patients’ behavior, or offers advice, suggestions, or actions in a direct and imperative way (e.g., “You should...”, “Why don’t you...”, etc.,). “I just don’t understand how you continue to forget to take your medication!”
Other Statements	Statements that are not counselor strategies/reflections or are unrelated to target behavior. Okay, Cool.