Health Behavior Change in the Dental Practice

Christoph A. Ramseier, Dr. med. dent., MAS is Assistant Professor of Periodontology at the School of Dental Medicine, University of Berne, Switzerland. Jean E. Suvan, DipDH, MSc, CRA, FHEA is Clinical Research Coordinator of the Periodontology Unit at UCL Eastman Dental Institute, UK.

• Foreword PrefaceList of Contributors1. Introduction to Health Behavior Change for the Dental PracticeHealth Care in the Twenty-first CenturyThe Opportunity in the Dental SettingAdop tion and Integration of Health Behavior ChangeThe Role and Responsibility of the Dental ProfessionalCollaborative Care Toward Whole HealthReferences2. The Challenge of Behavior ChangeIntroductionBehavior Change: Some Key ConceptsThe Patient’s PerspectiveThe Clinician’s PerspectiveUnderstanding Health Behavior ChangeSocial Cognitive Theory and Self-Efficacy TheoryThe Health Belief ModelTheory of Planned BehaviorThe Transtheoretical Model of Behavior ChangeSelf-Determination TheorySummaryReferences3. Communication and Health Behavior Change CounsellingIntroductionThe Relationship between the Clinician and the PatientStyles of CommunicationDirectingFollowingGuidingKey Skills for Communicating about Health Behavior ChangeQuestion 1: Is the patient happy to talk with you about behavior change?Question 2: How are you asking questions?Question 3: How do you provide support?Question 4: How do you convey understanding?Question 5: How do you get information across?Question 6: How do you bring it all together?SummaryAcknowledgmentsReferences4. Motivational Interviewing (MI) and Its Basic ToolsIntroductionWhat Is Motivational Interviewing?Research Evidence for MIWhat Triggers Behavior Change?Motivation and the Clinician-Patient RelationshipDefinition of MI“Spirit” of MIMajor PrinciplesExpress EmpathyDevelop DiscrepancyRoll with ResistanceSupport Self-EfficacyOARS: Basic Tools for Building Motivation to ChangeUse Open-Ended QuestionsAffirm PatientsUse Reflective ListeningUse SummariesElicit Change TalkEvocative QuestionsDecisional Balance or Pros and Cons MatrixThe Importance RulerElaborating, Querying Extremes, and Looking Back and ForwardExploring Goals and ValuesResponding to Change TalkResponding to ResistanceEnhancing ConfidenceStrengthening CommitmentNegotiating a Plan for ChangeSummaryReferences5. Brief Interventions in Promoting Health Behavior ChangeIntroductionUsing a Patient-Centered ApproachRighting ReflexGoals of Brief InterventionsAssessing MotivesHealth History FormOpen-Ended QuestionsReadiness ScalesRaising AwarenessGiving Information versus Raising AwarenessConveying UnderstandingSupporting ChangeEncouraging Patient Problem SolvingOffering a Set of StrategiesPlanning for the ChangeUse of the Telephone for Brief InterventionsUse of Computers for Brief InterventionsGiving Brief AdviceWhen Brief Interventions Are Not AppropriateBringing It All TogetherSummaryReferences6. Implementation of Health Behavior Change Principles in Dental PracticeIntroductionContent of Change (the Objectives)Context of Change (the Environment)Process of Change (the Implementation Plan)Micro-Environment: The Dental VisitEasier than You ThinkPatient Activation Fabric for the Dental Visit (Implementation Model)“Your Patient Is Here,”Single Behavior Patient ScenarioMultiple Behavior Patient ScenarioMacro-Environment: The Practice SettingImportance of SupportOvercoming Potential Obstacles to Practice ImplementationPractical Guidance for Beginners (or Non-Beginners)SummaryReferences7. Health Behavior Change EducationIntroductionHistory of Medical and Dental EducationIn MedicineIn DentistryIn Dental HygieneCurrents Trends in Dental Care and EducationThe Need for Change in Dental EducationPublic Health Goals and ResponsibilitiesNew Educational Initiatives and MethodsTheoretical EducationPathology and Epidemiology of DiseasesBehavior as a Determinant of Health and DiseasePractical EducationStudentsContinuing EducationCliniciansAssessment of Health Behavior Change EducationFacultyStudentsCliniciansSummaryReferencesIndex