Teachable moments for health behavior change and intermediate patient outcomes

PATIENT EDUCATION AND COUNSELING

卷:96

Article

Flocke, Susan A.^1,2,3  Clark, Elizabeth⁴  Antognoli, Elizabeth¹  Mason, Mary Jane¹  Lawson, Peter J.¹  Smith, Samantha¹  Cohen, Deborah J.⁵ 

[1] Case Western Reserve Univ, Sch Med, Dept Family Med & Community Hlth, Cleveland, OH 44106 USA

[2] Case Western Reserve Univ, Sch Med, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA

[3] Case Comprehens Canc Ctr, Cleveland, OH USA

[4] Univ Med & Dent New Jersey, Dept Family Med, New Brunswick, NJ USA

[5] Oregon Hlth & Sci Univ, Dept Family Med, Portland, OR 97201 USA

关键词: Health promotion;    Health behavior change;    Communication;    Primary care;    Teachable moment;   

DOI  :  10.1016/j.pec.2014.03.014

来源: Elsevier

【 摘 要 】

Objective: Teachable moments (TM) are opportunities created through physician-patient interaction and used to encourage patients to change unhealthy behaviors. We examine the effectiveness of TMs to increase patients' recall of advice, motivation to modify behavior, and behavior change. Methods: A mixed-method observational study of 811 patient visits to 28 primary care clinicians used audio-recordings of visits to identify TMs and other types of advice in health behavior change talk. Patient surveys assessed smoking, exercise, fruit/vegetable consumption, height, weight, and readiness for change prior to the observed visit and 6-weeks post-visit. Results: Compared to other identified categories of advice (i.e. missed opportunities of teachable moment attempts), recall was greatest after TMs occurred (83% vs. 49-74%). TMs had the greatest proportion of patients change in importance and confidence and increase readiness to change; however differences were small. TMs had greater positive behavior change scores than other categories of advice; however, this pattern was statistically non-significant and was not observed for BMI change. Conclusion: TMs have a greater positive influence on several intermediate markers of patient behavior change compared to other categories of advice. (C) 2014 Published by Elsevier Ireland Ltd.

【 授权许可】

Free