Review
Teachable moments for health behavior change: A concept analysis

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Abstract

Objective

“Teachable moments” have been proposed as events or circumstances which can lead individuals to positive behavior change. However, the essential elements of teachable moments have not been elucidated. Therefore, we undertook a comprehensive review of the literature to uncover common definitions and key elements of this phenomenon.

Methods

Using databases spanning social science and medical disciplines, all records containing the search term “teachable moment*” were collected. Identified literature was then systematically reviewed and patterns were derived.

Results

Across disciplines, ‘teachable moment’ has been poorly developed both conceptually and operationally. Usage of the term falls into three categories: (1) “teachable moment” is synonymous with “opportunity” (81%); (2) a context that leads to a higher than expected behavior change is retrospectively labeled a ‘teachable moment’ (17%); (3) a phenomenon that involves a cueing event that prompts specific cognitive and emotional responses (2%).

Conclusion

The findings suggest that the teachable moment is not necessarily unpredictable or simply a convergence of situational factors that prompt behavior change but suggest the possible creation of a teachable moment through clinician–patient interaction.

Practice implications

Clinician–patient interaction may be central to the creation of teachable moments for health behavior change.

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.

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