Identifying teachable moments for health behavior counseling in primary care

Patient Educ Couns. 2011 Nov;85(2):e8-15. doi: 10.1016/j.pec.2010.11.009. Epub 2010 Dec 22.


Objective: Situations with potential to motivate positive change in unhealthy behavior have been called 'teachable moments'. Little is known about how they occur in the primary care setting.

Methods: Cross-sectional observational design. Audio-recordings collected during 811 physician-patient interactions for 28 physicians and their adult patients were analyzed using conversation analysis.

Results: Teachable moments were observed in 9.8% of the cases, and share three features: (1) the presence of a concern that is salient to the patient that is either obviously relevant to an unhealthy behavior, or through conversation comes to be seen as relevant; (2) a link that is made between the patient's salient concern and a health behavior that attempts to motivate the patient toward change; and (3) a patient response indicating a willingness to discuss and commit to behavior change. Additionally, we describe phenomena related to, but not teachable moments, including teachable moment attempts, missed opportunities, and health behavior advice.

Conclusions: Success of the teachable moment rests on the physician's ability to identify and explore the salience of patient concerns and recognize opportunities to link them with unhealthy behaviors.

Practice implications: The skills necessary for accomplishing teachable moments are well within the grasp of primary care physicians.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Counseling / methods*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diet
  • Female
  • Health Promotion / methods*
  • Humans
  • Male
  • Middle Aged
  • Obesity / prevention & control
  • Patient Education as Topic*
  • Physician-Patient Relations*
  • Primary Health Care*
  • Smoking Prevention
  • Teaching / methods*