Understanding the potential of teachable moments: the case of smoking cessation

Abstract

The label 'teachable moment' (TM) has been used to describe naturally occurring health events thought to motivate individuals to spontaneously adopt risk-reducing health behaviors. This manuscript summarizes the evidence of TMs for smoking cessation, and makes recommendations for conceptual and methodological refinements to improve the next generation of related research. TM studies were identified for the following event categories: office visits, notification of abnormal test results, pregnancy, hospitalization and disease diagnosis. Cessation rates associated with pregnancy, hospitalization and disease diagnosis were high (10-60 and 15-78%, respectively), whereas rates for clinic visits and abnormal test results were consistently lower (2-10 and 7-21%, respectively). Drawing from accepted conceptual models, a TM heuristic is outlined that suggests three domains underlie whether a cueing event is significant enough to be a TM for smoking cessation: the extent to which the event (1) increases perceptions of personal risk and outcome expectancies, (2) prompts strong affective or emotional responses, and (3) redefines self-concept or social role. Research in TMs could be improved by giving greater attention to assessment of conceptually grounded cognitive and emotional variables, appropriately timed assessment and intervention, and inclusion of appropriate target and comparison samples.

The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends

“…Because cancer survivors seem amenable to making positive changes in their lifestyles to improve their health, it has been suggested that the diagnosis of cancer could serve as a 'teachable moment' for making health behavior changes [25]. In terms of cancer, a 'teachable moment' would provide an opportunity for targeted health programs to take advantage of these moments to improve the health and well-being of cancer survivors [8,18,29,34]. More research is needed, however, examining variables that may be associated with changing health behavior so that more targeted and effective health programs can be developed.…”

Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses

“…The medical encounter provides a window of opportunity to access smokers who otherwise may not seek assistance with quitting, and provides a teachable moment whereby smokers may be more receptive to messages about health risks (McBride, Emmons, & Lipkus, 2003). Metaanalyses have shown that patients who receive counseling by physicians or nurses are 1.5 to 2 times more likely to quit than those who receive usual care (Fiore, 2000;Rice & Stead, 2004).…”

Diabetes diagnosis and nutrition facts label use among US adults, 2005–2010

“…Drawing from the health belief model, a teachable moment is a cueing event that increases perceptions of risk and outcome expectancies, prompts strong emotional responses and causes a redefinition of an individual's self-concept or social role (10,11) . According to McBride et al (11) , a disease diagnosis is considered a teachable moment because it may NHANES, National Health and Nutrition Examination Survey; IPR, income to poverty ratio; ref., reference category.…”

“…According to McBride et al (11) , a disease diagnosis is considered a teachable moment because it may NHANES, National Health and Nutrition Examination Survey; IPR, income to poverty ratio; ref., reference category. Individual-level data (n 5110) from NHANES 2005-2010 waves.…”

“…Behavioural theories and interventions emphasize the importance of cues in prompting motivation for behaviour change (10) . A specific type of cue, labelled a 'teachable moment', describes a naturally occurring health or life event that motivates individuals to spontaneously engage in risk-reducing health-promoting behaviour (11) . While chronic illnesses like diabetes are a major threat to health and quality of life, disease diagnosis itself could serve as a critical teachable moment for patients to initiate behaviour change (12)(13)(14)(15) .…”