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Health Behavior Change in the Dental Practice


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Table of Contents

Foreword Preface List of Contributors 1. Introduction to Health Behavior Change for the Dental Practice Health Care in the Twenty-first Century The Opportunity in the Dental Setting Adop tion and Integration of Health Behavior Change The Role and Responsibility of the Dental Professional Collaborative Care Toward Whole Health References 2. The Challenge of Behavior Change Introduction Behavior Change: Some Key Concepts The Patient?s Perspective The Clinician?s Perspective Understanding Health Behavior Change Social Cognitive Theory and Self-Efficacy Theory The Health Belief Model Theory of Planned Behavior The Transtheoretical Model of Behavior Change Self-Determination Theory Summary References 3. Communication and Health Behavior Change Counselling Introduction The Relationship between the Clinician and the Patient Styles of Communication Directing Following Guiding Key Skills for Communicating about Health Behavior Change Question 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? Summary Acknowledgments References 4. Motivational Interviewing (MI) and Its Basic Tools Introduction What Is Motivational Interviewing? Research Evidence for MI What Triggers Behavior Change? Motivation and the Clinician-Patient Relationship Definition of MI ?Spirit? of MI Major Principles Express Empathy Develop Discrepancy Roll with Resistance Support Self-Efficacy OARS: Basic Tools for Building Motivation to Change Use Open-Ended Questions Affirm Patients Use Reflective Listening Use Summaries Elicit Change Talk Evocative Questions Decisional Balance or Pros and Cons Matrix The Importance Ruler Elaborating, Querying Extremes, and Looking Back and Forward Exploring Goals and Values Responding to Change Talk Responding to Resistance Enhancing Confidence Strengthening Commitment Negotiating a Plan for Change Summary References 5. Brief Interventions in Promoting Health Behavior Change Introduction Using a Patient-Centered Approach Righting Reflex Goals of Brief Interventions Assessing Motives Health History Form Open-Ended Questions Readiness Scales Raising Awareness Giving Information versus Raising Awareness Conveying Understanding Supporting Change Encouraging Patient Problem Solving Offering a Set of Strategies Planning for the Change Use of the Telephone for Brief Interventions Use of Computers for Brief Interventions Giving Brief Advice When Brief Interventions Are Not Appropriate Bringing It All Together Summary References 6. Implementation of Health Behavior Change Principles in Dental Practice Introduction Content of Change (the Objectives) Context of Change (the Environment) Process of Change (the Implementation Plan) Micro-Environment: The Dental Visit Easier than You Think Patient Activation Fabric for the Dental Visit (Implementation Model) ?Your Patient Is Here,? Single Behavior Patient Scenario Multiple Behavior Patient Scenario Macro-Environment: The Practice Setting Importance of Support Overcoming Potential Obstacles to Practice Implementation Practical Guidance for Beginners (or Non-Beginners) Summary References 7. Health Behavior Change Education Introduction History of Medical and Dental Education In Medicine In Dentistry In Dental Hygiene Currents Trends in Dental Care and Education The Need for Change in Dental Education Public Health Goals and Responsibilities New Educational Initiatives and Methods Theoretical Education Pathology and Epidemiology of Diseases Behavior as a Determinant of Health and Disease Practical Education Students Continuing Education Clinicians Assessment of Health Behavior Change Education Faculty Students Clinicians Summary References Index

About 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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