The Experts below are selected from a list of 4767 Experts worldwide ranked by ideXlab platform
Josie M M Evans - One of the best experts on this subject based on the ideXlab platform.
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Is diagnosis of type 2 diabetes a “Teachable Moment”? A qualitative study
Diabetes research and clinical practice, 2020Co-Authors: Elena Dimova, Vivien Swanson, Josie M M EvansAbstract:Abstract Aims To explore the potential of type 2 diabetes diagnosis to be a “Teachable Moment”. Methods Semi-structured interviews were conducted with 23 participants (10 people with type 2 diabetes, 13 relatives of people with type 2 diabetes) in Scotland, UK. They explored cognitive, emotional and behavioural changes following diagnosis of type 2 diabetes in oneself or in a relative. Data were analysed using Framework approach. Results Strong emotional responses are not always related to the occurrence of a Teachable Moment. Risk perception and outcome expectancy were found to be Teachable Moment factors for patients with type 2 diabetes and their offspring, but not their partners. Change in self-concept increases the likelihood of type 2 diabetes diagnosis to be a Teachable Moment for patients but not for relatives. In some cases, type 2 diabetes is perceived as incompatible with current roles thus hindering diabetes self-management. Relatives often engage in caring for patients and “policing” their behaviour but did not report perceived changes in social roles. Conclusions The study suggests that diagnosis of type 2 diabetes is a Teachable Moment for some patients and their relatives. These findings have implications for interventions to address diabetes self-management in patients and primary prevention in their relatives.
Susan A. Flocke - One of the best experts on this subject based on the ideXlab platform.
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A randomized trial to evaluate primary care clinician training to use the Teachable Moment Communication Process for smoking cessation counseling
Preventive medicine, 2014Co-Authors: Susan A. Flocke, Peter J Lawson, Elizabeth Antognoli, Mary M. Step, Theodore V. Parran, Stevens S. Smith, Brigid Jackson, Susan A. Krejci, Sybil MarshAbstract:Abstract Objective To implement and evaluate the impact of a Teachable Moment Communication Process (TMCP) training intervention on clinicians' smoking cessation counseling behaviors in practice. Method Using a group randomized trial, 31 community-based, primary care clinicians in Northeast Ohio received either TMCP training or an attention control (2010–2012). TMCP training consisted of two, three-hour sessions involving didactic instruction, skill practice with standardized patients, and coaching. Clinician performance of TMCP elements was assessed by coding audio-recordings of routine visits with smokers at baseline and post-intervention (n = 806). Results Baseline performance of all TMCP elements was similar in the two groups. After the intervention, TMCP-trained clinicians were more often observed advising patients to quit while linking smoking to the patient's concern (58% vs. 44%, p = 0.01), expressing optimism (36% vs. 3%, p Conclusion The intervention significantly changed the content of clinicians' smoking cessation communication in ways consistent with the TMCP model for health behavior change.
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A Teachable Moment communication process for smoking cessation talk: description of a group randomized clinician-focused intervention
BMC health services research, 2012Co-Authors: Susan A. Flocke, Elizabeth Antognoli, Mary M. Step, Sybil Marsh, Theodore V. Parran, Mary Jane MasonAbstract:Background Effective clinician-patient communication about health behavior change is one of the most important and most overlooked strategies to promote health and prevent disease. Existing guidelines for specific health behavior counseling have been created and promulgated, but not successfully adopted in primary care practice. Building on work focused on creating effective clinician strategies for prompting health behavior change in the primary care setting, we developed an intervention intended to enhance clinician communication skills to create and act on Teachable Moments for smoking cessation. In this manuscript, we describe the development and implementation of the Teachable Moment Communication Process (TMCP) intervention and the baseline characteristics of a group randomized trial designed to evaluate its effectiveness.
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Identifying Teachable Moments for health behavior counseling in primary care.
Patient education and counseling, 2010Co-Authors: Deborah J. Cohen, Peter J Lawson, Elizabeth C. Clark, Brad A. Casucci, Susan A. FlockeAbstract:Abstract Objective Situations with potential to motivate positive change in unhealthy behavior have been called ‘Teachable Moments’. Little is known about how they occur in the primary care setting. Methods Cross-sectional observational design. Audio-recordings collected during 811 physician–patient interactions for 28 physicians and their adult patients were analyzed using conversation analysis. Results Teachable Moments were observed in 9.8% of the cases, and share three features: (1) the presence of a concern that is salient to the patient that is either obviously relevant to an unhealthy behavior, or through conversation comes to be seen as relevant; (2) a link that is made between the patient's salient concern and a health behavior that attempts to motivate the patient toward change; and (3) a patient response indicating a willingness to discuss and commit to behavior change. Additionally, we describe phenomena related to, but not Teachable Moments, including Teachable Moment attempts, missed opportunities, and health behavior advice. Conclusions Success of the Teachable Moment rests on the physician's ability to identify and explore the salience of patient concerns and recognize opportunities to link them with unhealthy behaviors. Practice implications The skills necessary for accomplishing Teachable Moments are well within the grasp of primary care physicians.
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Teachable Moments for health behavior change a concept analysis
Patient Education and Counseling, 2009Co-Authors: Peter J Lawson, Susan A. FlockeAbstract:Abstract Objective “Teachable Moments” have been proposed as events or circumstances which can lead individuals to positive behavior change. However, the essential elements of Teachable Moments have not been elucidated. Therefore, we undertook a comprehensive review of the literature to uncover common definitions and key elements of this phenomenon. Methods Using databases spanning social science and medical disciplines, all records containing the search term “Teachable Moment * ” were collected. Identified literature was then systematically reviewed and patterns were derived. Results Across disciplines, ‘Teachable Moment’ has been poorly developed both conceptually and operationally. Usage of the term falls into three categories: (1) “Teachable Moment” is synonymous with “opportunity” (81%); (2) a context that leads to a higher than expected behavior change is retrospectively labeled a ‘Teachable Moment’ (17%); (3) a phenomenon that involves a cueing event that prompts specific cognitive and emotional responses (2%). Conclusion The findings suggest that the Teachable Moment is not necessarily unpredictable or simply a convergence of situational factors that prompt behavior change but suggest the possible creation of a Teachable Moment through clinician–patient interaction. Practice implications Clinician–patient interaction may be central to the creation of Teachable Moments for health behavior change.
Elena Dimova - One of the best experts on this subject based on the ideXlab platform.
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Is diagnosis of type 2 diabetes a “Teachable Moment”? A qualitative study
Diabetes research and clinical practice, 2020Co-Authors: Elena Dimova, Vivien Swanson, Josie M M EvansAbstract:Abstract Aims To explore the potential of type 2 diabetes diagnosis to be a “Teachable Moment”. Methods Semi-structured interviews were conducted with 23 participants (10 people with type 2 diabetes, 13 relatives of people with type 2 diabetes) in Scotland, UK. They explored cognitive, emotional and behavioural changes following diagnosis of type 2 diabetes in oneself or in a relative. Data were analysed using Framework approach. Results Strong emotional responses are not always related to the occurrence of a Teachable Moment. Risk perception and outcome expectancy were found to be Teachable Moment factors for patients with type 2 diabetes and their offspring, but not their partners. Change in self-concept increases the likelihood of type 2 diabetes diagnosis to be a Teachable Moment for patients but not for relatives. In some cases, type 2 diabetes is perceived as incompatible with current roles thus hindering diabetes self-management. Relatives often engage in caring for patients and “policing” their behaviour but did not report perceived changes in social roles. Conclusions The study suggests that diagnosis of type 2 diabetes is a Teachable Moment for some patients and their relatives. These findings have implications for interventions to address diabetes self-management in patients and primary prevention in their relatives.
Shirley M Bluethmann - One of the best experts on this subject based on the ideXlab platform.
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grasping the Teachable Moment time since diagnosis symptom burden and health behaviors in breast colorectal and prostate cancer survivors
Psycho-oncology, 2015Co-Authors: Shirley M Bluethmann, Karen Basenengquist, Sally W Vernon, Matthew G Cox, Kelley Pettee Gabriel, Sandra A Stansberry, Cindy L Carmack, Janice A Blalock, Wendy DemarkwahnefriedAbstract:Background A cancer diagnosis may provide a ‘Teachable Moment’ in cancer recovery. To better understand factors influencing lifestyle choices following diagnosis, we examined associations between time since diagnosis and symptom burden with recommended dietary (e.g., five or more fruit/vegetable servings/day), physical activity (e.g., >150 active min, 3–5 times/week), and smoking behaviors (i.e., eliminate tobacco use) in cancer survivors. Methods We analyzed cross-sectional survey data collected from breast (n = 528), colorectal (n = 106), and prostate (n = 419) cancer survivors following active treatment at The University of Texas MD Anderson Cancer Center. Four regression models were tested for behaviors of interest. Additionally, we assessed symptom burden as a potential moderator and/or mediator between time since diagnosis and behaviors. Results Respondents were mostly female (55%) and non-Hispanic White (68%) with a mean age of 62.8 ± 11.4 years and mean time since diagnosis of 4.6 ± 3.1 years. In regression models, greater time since diagnosis predicted lower fruit and vegetable consumption (B = −0.05, p = 0.02) and more cigarette smoking (B = 0.06, p = 0.105). Greater symptom burden was a significant negative predictor for physical activity (B = −0.08, p < .001). We did not find evidence that symptom burden moderated or mediated the association between time since diagnosis and health behaviors. Conclusion We assessed the prevalence of recommended behaviors in the context of other challenges that survivors face, including time since diagnosis and symptom burden. Our results provide indirect evidence that proximity to a cancer diagnosis may provide a Teachable Moment to improve dietary and smoking behaviors and that symptom burden may impede physical activity following diagnosis. Copyright © 2015 John Wiley & Sons, Ltd.
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Grasping the 'Teachable Moment': time since diagnosis, symptom burden and health behaviors in breast, colorectal and prostate cancer survivors.
Psycho-oncology, 2015Co-Authors: Shirley M Bluethmann, Sally W Vernon, Matthew G Cox, Kelley Pettee Gabriel, Sandra A Stansberry, Cindy L Carmack, Janice A Blalock, Karen Basen-engquist, Wendy Demark-wahnefriedAbstract:Background A cancer diagnosis may provide a ‘Teachable Moment’ in cancer recovery. To better understand factors influencing lifestyle choices following diagnosis, we examined associations between time since diagnosis and symptom burden with recommended dietary (e.g., five or more fruit/vegetable servings/day), physical activity (e.g., >150 active min, 3–5 times/week), and smoking behaviors (i.e., eliminate tobacco use) in cancer survivors. Methods We analyzed cross-sectional survey data collected from breast (n = 528), colorectal (n = 106), and prostate (n = 419) cancer survivors following active treatment at The University of Texas MD Anderson Cancer Center. Four regression models were tested for behaviors of interest. Additionally, we assessed symptom burden as a potential moderator and/or mediator between time since diagnosis and behaviors. Results Respondents were mostly female (55%) and non-Hispanic White (68%) with a mean age of 62.8 ± 11.4 years and mean time since diagnosis of 4.6 ± 3.1 years. In regression models, greater time since diagnosis predicted lower fruit and vegetable consumption (B = −0.05, p = 0.02) and more cigarette smoking (B = 0.06, p = 0.105). Greater symptom burden was a significant negative predictor for physical activity (B = −0.08, p
Peter J Lawson - One of the best experts on this subject based on the ideXlab platform.
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A randomized trial to evaluate primary care clinician training to use the Teachable Moment Communication Process for smoking cessation counseling
Preventive medicine, 2014Co-Authors: Susan A. Flocke, Peter J Lawson, Elizabeth Antognoli, Mary M. Step, Theodore V. Parran, Stevens S. Smith, Brigid Jackson, Susan A. Krejci, Sybil MarshAbstract:Abstract Objective To implement and evaluate the impact of a Teachable Moment Communication Process (TMCP) training intervention on clinicians' smoking cessation counseling behaviors in practice. Method Using a group randomized trial, 31 community-based, primary care clinicians in Northeast Ohio received either TMCP training or an attention control (2010–2012). TMCP training consisted of two, three-hour sessions involving didactic instruction, skill practice with standardized patients, and coaching. Clinician performance of TMCP elements was assessed by coding audio-recordings of routine visits with smokers at baseline and post-intervention (n = 806). Results Baseline performance of all TMCP elements was similar in the two groups. After the intervention, TMCP-trained clinicians were more often observed advising patients to quit while linking smoking to the patient's concern (58% vs. 44%, p = 0.01), expressing optimism (36% vs. 3%, p Conclusion The intervention significantly changed the content of clinicians' smoking cessation communication in ways consistent with the TMCP model for health behavior change.
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Identifying Teachable Moments for health behavior counseling in primary care.
Patient education and counseling, 2010Co-Authors: Deborah J. Cohen, Peter J Lawson, Elizabeth C. Clark, Brad A. Casucci, Susan A. FlockeAbstract:Abstract Objective Situations with potential to motivate positive change in unhealthy behavior have been called ‘Teachable Moments’. Little is known about how they occur in the primary care setting. Methods Cross-sectional observational design. Audio-recordings collected during 811 physician–patient interactions for 28 physicians and their adult patients were analyzed using conversation analysis. Results Teachable Moments were observed in 9.8% of the cases, and share three features: (1) the presence of a concern that is salient to the patient that is either obviously relevant to an unhealthy behavior, or through conversation comes to be seen as relevant; (2) a link that is made between the patient's salient concern and a health behavior that attempts to motivate the patient toward change; and (3) a patient response indicating a willingness to discuss and commit to behavior change. Additionally, we describe phenomena related to, but not Teachable Moments, including Teachable Moment attempts, missed opportunities, and health behavior advice. Conclusions Success of the Teachable Moment rests on the physician's ability to identify and explore the salience of patient concerns and recognize opportunities to link them with unhealthy behaviors. Practice implications The skills necessary for accomplishing Teachable Moments are well within the grasp of primary care physicians.
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Teachable Moments for health behavior change a concept analysis
Patient Education and Counseling, 2009Co-Authors: Peter J Lawson, Susan A. FlockeAbstract:Abstract Objective “Teachable Moments” have been proposed as events or circumstances which can lead individuals to positive behavior change. However, the essential elements of Teachable Moments have not been elucidated. Therefore, we undertook a comprehensive review of the literature to uncover common definitions and key elements of this phenomenon. Methods Using databases spanning social science and medical disciplines, all records containing the search term “Teachable Moment * ” were collected. Identified literature was then systematically reviewed and patterns were derived. Results Across disciplines, ‘Teachable Moment’ has been poorly developed both conceptually and operationally. Usage of the term falls into three categories: (1) “Teachable Moment” is synonymous with “opportunity” (81%); (2) a context that leads to a higher than expected behavior change is retrospectively labeled a ‘Teachable Moment’ (17%); (3) a phenomenon that involves a cueing event that prompts specific cognitive and emotional responses (2%). Conclusion The findings suggest that the Teachable Moment is not necessarily unpredictable or simply a convergence of situational factors that prompt behavior change but suggest the possible creation of a Teachable Moment through clinician–patient interaction. Practice implications Clinician–patient interaction may be central to the creation of Teachable Moments for health behavior change.
