Teachable moments for health behavior change and intermediate patient outcomes

Abstract 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. Meth...

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Bibliographic Details
Published in:Patient education and counseling 2014-07, Vol.96 (1), p.43-49
Main Authors: Flocke, Susan A, Clark, Elizabeth, Antognoli, Elizabeth, Mason, Mary Jane, Lawson, Peter J, Smith, Samantha, Cohen, Deborah J
Format: Article
Language:English
Subjects:
Adult
Behavioural changes
Clinical outcomes
Communication
Exercise
Female
Follow-Up Studies
Health Behavior
Health behavior change
Health behaviour
Health promotion
Health Promotion - methods
Healthy food
Humans
Internal Medicine
Male
Middle Aged
Motivation
Nursing
Physician-Patient Relations
Primary care
Primary health care
Primary Health Care - methods
Surveys and Questionnaires
Tape Recording
Teachable moment
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Summary:Abstract 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 or 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. Practice implications TMs show promise as an approach for clinicians to discuss behavior change with patients efficiently and effectively.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2014.03.014