ReviewTeachable moments for health behavior change: A concept analysis
Introduction
A large body of health care research and practice has been focused on the various strategies and contexts by which healthy behaviors can be promoted and unhealthy behaviors can be discouraged. One such strategy is the “teachable moment.” Teachable moments have been advocated for promoting health behavior change in a variety of settings [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]. Often described as a particular event or set of circumstances which leads individuals to alter their health behavior positively, the teachable moment has been intuitively accepted as an important focus for both clinicians and researchers interested in promoting health and wellness [7], [10], [13], [14]. However, empirical support for the effectiveness of health interventions based on the teachable moment is noticeably absent [3]. Moreover, the teachable moment for health behavior change is inadequately developed as a concept and is therefore unlikely to form a solid foundation for either research or practice [15]. Given the limitations of current health science research on the teachable moment concept, we cast a very broad net to examine potential insights from a range of disciplines. We systematically investigated the uses, descriptions and theoretical underpinnings of the teachable moment across a range of scholarly disciplines in order to explore the essential elements and evidence-base for this phenomenon.
Section snippets
Methods
Using databases covering a variety of scholarly fields, records containing the search term “teachable moment*” in any of the records’ fields were collected. All years contained in the following databases were searched: AltHealth Watch, AltaReligion, Business Premier, CINAHL, Communication and Mass Media Complete, ERIC, Professional Development Collection, PsychInfo, PubMed, Social Sciences Index, Social Work Abstracts, SocIndex, and Sociological Abstracts. Articles from non-English journals
Results
While the use of the teachable moment concept is widespread across a variety of scholarly disciplines and can be found frequently in popular media, its usage is far from standardized. Our extensive review of the literature revealed three categories into which the majority of usages fell. Table 1 provides a description of each category, the frequency of use and examples of each category type. In the first category, the term teachable moment is used more or less synonymously with the term
Discussion
Theorizing those aspects of the teachable moment that may cause behavior change is an important step in developing the utility of the teachable moment for research and intervention. Yet more is required. Barnett et al. [3] argue that there is insufficient evidence to determine whether or not particular events promote greater change among patients, whether interventions undertaken at those times produce greater change, or whether interventions implemented at such times would be as effective if
Role of funding
This study was funded by a research grant to Susan Flocke by the National Cancer Institute (#R01 CA 105292). The funding source had no involvement in the study design, or the collection, analysis or interpretation of data; nor did it affect the writing of the report or the decision to submit the paper for publication.
Conflict of interest
Neither author has any actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, this work.
Acknowledgements
The authors would like to acknowledge the members of the Case Department of Family Medicine writing workgroup and particularly Mary Step, PhD and David Litaker, MD, PhD for the valuable feedback at various stages of writing this manuscript.
References (91)
- et al.
Psychological treatments for noncardiac chest pain: recommendations for a new approach
J Psychosom Res
(2004) - et al.
Direct observation and patient recall of health behavior advice
Prev Med
(2004) - et al.
Medical triggers are associated with better short- and long-term weight loss outcomes
Prev Med.
(2004) Teachable moments: a paradigm shift
J Emerg Nurs
(2001)Health promotion in primary medical care: problems and potential
Prev Med
(1986)Teaching in crisis. Patient and family education in critical care
Crit Care Nurs Clin North Am
(2001)- et al.
Behavioral associations between prostate and colon cancer screening
J Am Coll Surg
(2005) Information-giving in medical consultations: the influence of patients’ communicative styles and personal characteristics
Soc Sci Med
(1991)- Health observances create ‘teachable moment’: take advantage of heightened public awareness. Patient Educ Manag. 2000;...
From early pregnancy through the postpartum year. Extending the teachable moment
Stanford Nurse
(1994)