Health Behavior Change in the Dental Practice / Edition 1

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Health Behavior Change in the Dental Practice presents an overview of strategies for health behavior change for oral health, focusing on motivational interviewing. Targeting the clinical application of the principles, the book applies lessons learned from the field of general medicine to the dental practice. By presenting a series of clinical cases and accompanying dialogue, the book guides the reader in using motivational interviewing as a tool for oral hygiene education, tobacco use cessation, and dietary counseling. Health Behavior Change in the Dental Practice supports the trend toward host modulation therapy in oral health research, offering practical techniques to promote health behavior change in patients.

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Product Details

  • ISBN-13: 9780813821061
  • Publisher: Wiley
  • Publication date: 10/19/2010
  • Series: Wiley Desktop Editions Series
  • Edition number: 1
  • Pages: 196
  • Sales rank: 834,757
  • Product dimensions: 5.90 (w) x 8.90 (h) x 0.40 (d)

Meet the Author

Christoph A. Ramseier, Dr. med. dent., MAS is AssistantProfessor of Periodontology at the School of Dental Medicine,University of Berne, Switzerland.

Jean E. Suvan, DipDH, MSc, CRA, FHEA is Clinical ResearchCoordinator of the Periodontology Unit at UCL Eastman DentalInstitute, UK.

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Table of Contents



List of Contributors

1 Introduction to Health Behavior Change for the Dental Practice 3

Health Care in the Twenty-first Century 5

The Opportunity in the Dental Setting 6

Adoption and Integration of Health Behavior Change 8

The Role and Responsibility of the Dental Professional 10

Collaborative Care Toward Whole Health 11

References 12

2 The Challenge of Behavior Change 13

Introduction 15

Behavior Change: Some Key Concepts 15

The Patient's Perspective 16

The Clinician's Perspective 19

Understanding Health Behavior Change 24

Social Cognitive Theory and Self-Efficacy Theory 24

The Health Belief Model 25

Theory of Planned Behavior 27

The Transtheoretical Model of Behavior Change 28

Self-Determination Theory 30

Summary 32

References 32

3 Communication and Health Behavior Change Counselling 35

Introduction 37

The Relationship between the Clinician and the Patient 38

Styles of Communication 40

Directing 40

Following 40

Guiding 40

Key Skills for Communicating about Health Behavior Change 42

Question 1: Is the patient happy to talk with you about behavior change? 43

Question 2: How are you asking questions? 45

Question 3: How do you provide support? 46

Question 4: How do you convey understanding? 48

Question 5: How do you get information across? 52

Question 6: How do you bring it all together? 55

Summary 57

Acknowledgments 58

References 58

4 Motivational Interviewing (MI) and Its Basic Tools 59

Introduction 61

What Is Motivational Interviewing? 61

Research Evidence for MI 62

What Triggers Behavior Change? 63

Motivation and the Clinician-Patient Relationship 64

Definition of MI 67

"Spirit" of MI 67

Major Principles 70

Express Empathy 70

Develop Discrepancy 71

Roll with Resistance 71

Support Self-Efficacy 71

OARS: Basic Tools for Building Motivation to Change 71

Use Open-Ended Questions 72

Affirm Patients 72

Use Reflective Listening 73

Use Summaries 75

Elicit Change Talk 75

Evocative Questions 76

Decisional Balance or Pros and Cons Matrix 76

The Importance Ruler 78

Elaborating, Querying Extremes, and Looking Back and Forward 78

Exploring Goals and Values 79

Responding to Change Talk 79

Responding to Resistance 80

Enhancing Confidence 83

Strengthening Commitment 87

Negotiating a Plan for Change 87

Summary 90

References 90

5 Brief Interventions in Promoting Health Behavior Change 93

Introduction 95

Using a Patient-Centered Approach 95

Righting Reflex 96

Goals of Brief Interventions 96

Assessing Motives 97

Health History Form 97

Open-Ended Questions 98

Readiness Scales 99

Raising Awareness 100

Giving Information versus Raising Awareness 101

Conveying Understanding 103

Supporting Change 104

Encouraging Patient Problem Solving 105

Offering a Set of Strategies 105

Planning for the Change 106

Use of the Telephone for Brief Interventions 107

Use of Computers for Brief Interventions 108

Giving Brief Advice 108

When Brief Interventions Are Not Appropriate 109

Bringing It All Together 109

Summary 110

References 111

6 Implementation of Health Behavior Change Principles in Dental Practice 113

Introduction 115

Content of Change (the Objectives) 116

Context of Change (the Environment) 117

Process of Change (the Implementation Plan) 118

Micro-Environment: The Dental Visit 119

Easier than You Think 119

Patient Activation Fabric for the Dental Visit (Implementation Model) 119

"Your Patient Is Here" 124

Single Behavior Patient Scenario 125

Multiple Behavior Patient Scenario 136

Macro-Environment: The Practice Setting 138

Importance of Support 138

Overcoming Potential Obstacles to Practice Implementation 139

Practical Guidance for Beginners (or Non-Beginners) 141

Summary 143

References 143

7 Health Behavior Change Education 145

Introduction 147

History of Medical and Dental Education 147

In Medicine 147

In Dentistry 148

In Dental Hygiene 149

Current's Trends in Dental Care and Education 150

The Need for Change in Dental Education 152

Public Health Goals and Responsibilities 152

New Educational Initiatives and Methods 152

Theoretical Education 153

Pathology and Epidemiology of Diseases 153

Behavior as a Determinant of Health and Disease 154

Practical Education 155

Students 155

Continuing Education 158

Clinicians 158

Assessment of Health Behavior Change Education 163

Faculty 163

Students 163

Clinicians 164

Summary 165

References 165

Index 169

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Customer Reviews

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Sort by: Showing all of 2 Customer Reviews
  • Posted February 14, 2014

    Effective Teaching System

    This text focuses on motivational interviewing as the system of teaching patients. The description of educational methods is sound and easy to follow. A dental hygienist or dentist learning this system can pick one or two techniques and use them in practice, them develop a few more as concepts are mastered. This is a system that can be put into practice by a typical clinician whose aims include helping patients develop self-efficacy and responsibility for their health. The text could be improved by including additional teaching methods and identifying when different methods should be considered.

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  • Anonymous

    Posted February 14, 2014

    No text was provided for this review.

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