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date: 24 May 2018

(p. 495) Index

(p. 495) Index

A
AACORN (African American Collaborative Obesity Research Network), 271
AAPP three-function model, 66
ABA (applied-behavior-analytic) model, 394
abandoning adherence, 9
absolute risk, 193–194
abstinence, strongly related to receipt of a high-depth success story, 262
abstinence programs, adolescent sexual activity and, 417–418
accessibility of information, adherence models and, 331–332
accurate recall, aiding, 112
ACE inhibitors, adherence in older people, 436–437
acting upon another person, in communication, 69
action items, focusing on, 29
action outcome expectancies, 182
action stage, 215
acute illness, varying grades of severity, 177
acuteness (acute vs. chronic), 57
adaptive coping behaviors, 186
adaptive gestures, 39
addictive disorders
notion of wider, 243
readiness to change and the transtheoretical model as applied to, 214–246
TTM a new paradigm for understanding, 243
TTM giving poor explanation of development and change in, 240–241
ADEs (adverse drug events), 326, 352–353
adherence, 2. See also adolescent adherence; compliance
assessment of, 370–382
classes of, 387–388
classifying factors into groups, 2
in clinical practice, assessment of, 373–374
communication and assessment of, 372–373
cost issues, 326–327
data-analytic assessment techniques, 390, 392–393
defined, 454
definitions and scope, 387–388
described, 9
determinant of objective health outcomes, 2
diabetes care communications, 357–360
as dichotomous or continuous, 94
disease management behaviors, 307
dramatic variations in estimates of, 10
factors influencing, 10
gender and race factors, 312–313
in general population, medication adherence, 434–435
health-care system dynamics, 324–325
historic models, 323–324
implicit critique of suboptimal, 64
inconsistencies in, 372
influences in pediatric patients on, 393–397
information-motivation-strategy model, 330–334
interacting dimensions affecting, 271
magnitude and determinates of, 10–11
measurement of in older people, 438–439
mediating mechanisms, 313
in mental health care, 454–465
monitoring systems, 329–330, 390–391
multifaceted assessment of, 374–375
non-traditional improvement of, 323–335
not utilizing communication approaches to improve, 111
in older people, factors in, 435–438
one-dose-per-day improving, 17
patient-centered consultation and, 93–94
patient’s willingness to show, 42
in pediatric patients, 387–403
physicians’ negative attitudes toward ethnic minority patients, 268
to prescribed medication regime, 187
to prescriptions, 164
prompts, reinforcers, and punishments for, 346–347
psychological factors in, 396
rates of, 10, 164
reminder systems, 327–328
social and environmental facilitators, 345–347
social networks and support, 311–312
systematic dosing regimens, 328–329
technology-based improvement of, 324–330
theoretical perspectives on, 2–3
adherence-enhancing interventions, effectiveness of, 11
adherence-promotion intervention models, pediatric adherence, 397–398
adherence rates
enhanced when the patients feel well-supported by their physicians, 164
expected to be lower in the developing world, 10
ad hoc interpreters, 143
adolescent adherence
chronic illness and, 410–411
developmental factors, 408–410
diabetes management and, 422–424, 480
future research issues in, 424–425
health-behavior promotion and change, 412–424
health status-related behaviors, 411–412
obesity issues and, 418–422
adolescent development
early adolescence, 409
late adolescence, 410
middle adolescence, 409–410
stages of, 408–410
adult learning, general theories of, 114
advanced learners, overestimating skills, 117
(p. 496) adverse drug events (ADEs), 326, 352–353
advocacy groups, lobbying for involvement of patients, 102
advocate, for the patient, 137
affect
defined, 197
role in conceptualization of perceived risk, 206
role in making decisions, 196
role in medical decision making and behavior, 198
targeting in studies and interventions, 198
affect-as-information hypothesis, 197
affect heuristic, 197
affective outcomes, 94
affective reactions, to risk, 198
affiliation, dimension of, 39
affiliative behaviors, 39, 41
affiliative communication style, 48
affiliativeness, 41, 50
affordability, as a barrier to health behaviors, 17
African American breast cancer survivors, stories from, 261
African American church, 275
African American Collaborative Obesity Research Network (AACORN), 271
African Americans
beliefs about antidepressant medication, 273
culturally tailored weight loss program for women, 281
females, body image accepted by, 270
lower levels of patient engagement in the dialogue, 269
males, selecting larger figures as attractive, 270
perceptions of hypertension, 272
rating intrinsic spirituality as important in depression care, 273
age
adherence assessment and, 376
adherence in older people and, 432, 435–436
barriers to health care and, 343
Agency for Healthcare Research and Quality (AHRQ) educational web site, 30
agreeableness, personality trait of, 41–42
AIDS, adherence rates, 11
alcohol consumption, accounted for by social and cultural factors, 241
Alcohol Problems Questionnaire, 227
alcohol use
as adolescent health-risk behavior, 412–416
prevention approaches for adolescents, 412–414
treatment programs for adolescents, 414–416
alert fatigue, caused by poor signal-to-noise ratio, 169
algorithm method, working in practice, 218
Alzheimer’s disease, 147, 149
American Nurses Association, Standards of Nursing Practice, 85
analogue patients, testing, 48
anchoring and adjustment heuristic, 196
anger, 186
antagonist, third person as, 137
anticipated regret, gaining attention as an important factor related to perceived risk and behavior, 206
anticipatory guidance, pediatric adherence promotion, 397–398
antidepressants, nonadherence with, 456
antihypertensive medications, adherence to, 10
antiretrovial therapy, adherence rates, 11
anxiety disorders, 455–456
applied-behavior-analytic (ABA) model, 394
approach motivation, 258
appropriate times, giving explanations at, 112
aptitude, in health-care communication, 355
argumentation, 71, 73
arguments
co-construction process of, 78
constructing in a dialogue, 71
defining, 70
ARIMA (autoregressive integrated moving average), 390, 392–393
artful creation of dialogue, 71–78
art of information exchange, 56–59
Ask Me 3 campaign, 29–30
aspirational models, developed for medical consultation, 85–86
assignment optimization, team communication and, 365–366
assimilation. See also correspondence
comparison leading to, 255
with a less fortunate patient was resisted, 260
psychological closeness with, 256
asymmetric relationships, 65
asymmetry, in the physician-patient relationship, 68
asynchronous channels, 156
attention, in health-care communication, 355
attentional or recall bias, in patients’ answers, 46
attenuation, 73
attitudes
in health-care communication, 355
influencing actions, 15
attitudes and behavior, relationship between, 254
attribution theory, 179, 180
attrition rates, adolescent obesity intervention and, 420–421
audio recordings, as less intrusive than video, 117
audiotape, of the patient’s own consultation, 61
authenticity, required for good communication, 54
automated data collection, pediatric diabetes adherence, 473
automated telephony, 31
automatic sensing systems, 46
autonomy, promoting patient, 104
autonomy enhancing behaviors, 147
autoregressive integrated moving average (ARIMA), 390, 392–393
availability heuristic, 196–197
avoidance motivation, 258
B
Banishing Obesity and Diabetes in Youth (BODY), 420
barriers in health care
adherence assessment barriers, 375–376
to adolescents, 409–410
age and, 343
communication barriers, 354–355
perceived barriers, pediatric adherence and, 393
perceptions of, 2
race, ethnicity and culture and, 342–343
sex and, 343–344
sexual orientation and, 344
social and environmental barriers, 341–344
socioeconomic status and, 339–342
baseline understanding, assessing, 29
bedside manner, 54–55
behavior, 254
behavioral composites, 39, 51
behavioral contracting, pediatric diabetes adherence and, 478
behavioral factors. See also health-related behavior
adherence assessment and, 376–382
adherence interventions in older people and, 442, 445–446
adolescent diabetes management and, 424
adolescent health status and, 411–412
adolescent sexual activity, intervention strategies and, 416–418
chronic illness and mental health issues, 456–458
contextual influence on pediatric adherence, 395–396
healthy weight in adolescents, 419
pediatric adherence, 393–395, 398
pediatric diabetes management, 474–475, 478
promotion strategies for pediatric adherence, 398
social support and, 309
(p. 497) behavioral family systems therapy for diabetes (BFST-D) intervention
adolescent diabetes management and, 424
pediatric diabetes adherence, 478
behavioral intentions, predictors of actual behaviors, 15
behavioral interventions, more effective than educational interventions, 12
behavioral processes, in TTM, 215
behavior change, viewed as a process rather than an event, 242
behaviors, 187–188
changing, 11
dependent on intentions, 3
never initiated or abandoned, 9
beliefs
as core of health behavior, 2
role in influencing actions, 15
best practices, in clear and effective communication, 25, 26
better patient-centered care, related to survival, 94
biases, 158, 196–197
bidirectional communication
within the clinical encounter, 25–26
skills, 23
biochemical measurement, older people’s adherence and, 439
biologic indices of nonadherence, pediatric patients, 388–389
biomedical era, of medicine, 84
biopsychosocial perspective, adoption of, 43
Blacks Receiving Interventions for Depression and Gaining Empowerment (BRIDGE), 277–278, 279
blood glucose monitoring
automated data collection, 473
pediatric diabetes management and, 470
telecommunications technology for, 480–481
BMI (body mass index), obesity measurements and, 418–419
BO condition, information on both outcomes and self-efficacy, 239
BODY (Banishing Obesity and Diabetes in Youth), 420
body image, 270
body language, inviting questions, 29
body mass index (BMI), obesity measurements and, 418–419
body sizes, scales depicting pictures of various, 270
breast cancer, estimate of developing, 194–195
breast cancer risk perceptions, among African American women, 199
BRIDGE (Blacks Receiving Interventions for Depression and Gaining Empowerment), 277–278, 279
brief advice condition, effective among patients relatively low on readiness to change, 235
brief interventions, 235
brief motivational interviewing, 235
British Medical Association, encouraging a child patient to express views and participate, 140
Brown Bag Medication Exercise, 33
building a relationship, 57
C
CAHPS (Consumer Assessment of Healthcare Providers and Systems), 102–103
calcium channel blockers (CCBs), adherence in older people, 436–437
Calgary-Cambridge approach, 66
Calgary-Cambridge guides, 56
defined seven communication tasks, 59
dividing explanation and planning into key objectives, 112
highlighting importance of assessing patients’ information needs, 61
to the medical interview, 111
campaigns, communicating health risks, 259
cancer patients
scoring high in neuroticism, 260
unrealistically optimistic, 207
with worsened condition preferring less involvement, 90
cancer treatment options, uncertainty surrounding, 202
cardiovascular disease, adherence rates, 10–11
care ambassador approach, clinic-integrated pediatric diabetes management, 478–479
caregivers
neglecting their own health care, 148
physician as, 72
supporting health status of older people, 149
care outcomes, 60
Care Quality Commission website, 102
care regimens, technology management of, 327–328
care transitions, between specialties, 162
catastrophe theory, using the model to phase transitions occurring at different levels of readiness to change, 244
categorization or signposting, using explicit, 112
causal arguments, 70
causal beliefs, focusing on cause of past events, 180
causation, opposed to diagnosis and treatment, 110
cause of an illness, 183
CBT (cognitive-behavioral therapy), 235
CCBs (calcium channel blockers), adherence in older people, 436–437
CDSS (clinical decision support systems), reducing human errors, 168
cell phones, systematic dosing using, 328
Centers for Medicare and Medicaid Services (CMS), providing with data on quality measures, 102
central route, of persuasion, 253
CER (comparative effectiveness research), pediatric adherence evaluation, 401–402
challenges, 70
change
implying phenomena occurring over time, 242
processes of, 215
change interventions
enhancement of health behaviors, 314–316
in health behavior, 313–314
Charles et al. framework, 87–88, 89
checklists
low adherence rate, 169
team-based communication and, 359–360
chemotherapy
care of patients requiring, 165
patient needing an additional cycle of, 72
child cognitive development, theory of, 229
children
competence to interact in pediatric encounters, 138
involvement in pediatric visits, 140
preferred being active participants in care, 140
children-initiated actions, in pediatric visits, 140
child self-efficacy, pediatric adherence and, 393
chronic conditions, regimens for requiring long-term behavior changes, 12
chronic illness
adherence assessment and, 379–380, 388
in adolescence, 410–411
mental health care adherence and, 456–458
in older people, nonadherence and, 434–435
self-management, 307
chunking and checking, 112
chunks, splitting information into smaller, 29
CHWs (community health workers), 276, 280
cigarettes, reducing the number of smoked in the home, 206
classical and operant conditioning principles, emphasizing, 2
(p. 498) clinical care, impact of culture on, 267–269
clinical common ground, development of, 63
clinical communication
common problems in, 110–111
improving, 165–170
inherently creative, 55
clinical consequences of nonadherence, in general population, 438
clinical conversation, 55
clinical data, poor presentation, 158
clinical decision support systems (CDSS), reducing human errors, 168
clinical depression, common in chronic disease, 188
clinical improvements, associated with better adherence, 12
clinical learning, elements required, 114
clinical model, vs. communication model, 58
clinical practice
adherence assessment in, 373–374
conditions required for SDM (shared decision making) to become a reality in, 103
implementation of SDM (shared decision making) in, 91
pediatric adherence in, 402–403
pediatric diabetes management, 471–472, 478–479
SDM (shared decision making) in, 89
spectrum of, 57, 58
clinical rotations, lack of explicit and formal CST (communication skills training) during, 126
clinical setting, considerations for, 206–207
clinical situations, requiring communication flexibility by physicians, 58
clinical trials
adherence assessment in, 372
impact of nonadherence in, 389
clinical vignette, 72–78
clinic attendance, failure to attend for professional supervision of diabetes, 188
clinicians. See also health-care professionals; physician(s)
checking patients’ recall, 14
clinical communication skills, 114
encouraging and facilitating question asking, 29
engaging, 170
overestimating literacy levels of their patients, 26
overestimating patients’ understanding, 23
statements for communication domains, 26
underestimating nonadherence of their own patients, 11
closed-loop insulin regulation, pediatric diabetes management and, 470
Cloze-style, dropped-word reading comprehension test, 27
CMS (Centers for Medicare and Medicaid Services), providing with data on quality measures, 102
coaching patients, on how to raise issues and express preferences, 98
coalitions
changing during an interaction, 137
formation of, 144, 148
in triadic groups, 136–137
co-construction, producing dynamic interpersonal reasoning, 71
co-construction process, 78
co-diagnostician, interpreter as, 144
coding schemes
standardized, 46–47
study-specific, 45–46
coercion, cannot be exercised by the physician, 70
cognition, stages of, 181
cognition distribution, team-based communication and, 361–362
cognitive/affective components, 45
cognitive/affective factors
in adolescence, 409–410
education interventions for adherence in older people and, 443
memory and recall factors in older people’s nonadherence and, 437–438
mental health care adherence and, 459–460
pediatric adherence, 393
pediatric diabetes management and, 474–475
pessimistic thinking and poor coping in depression and, 461–462
prescription protocols for older people and, 433
cognitive artifacts
education interventions for adherence in older people and, 443
improvements in, 367
team communication and, 361–366
cognitive-behavioral therapy (CBT), 235
pediatric diabetes management, 479–480
cognitive biases, 158
cognitive capacity, 161
cognitive care, 59
cognitive decline, related to nonadherence, 17
cognitive deficits, representing barriers, 17
cognitive dissonance theory, 200
cognitive-experiential processes, in TTM (transtheoretical model), 215
cognitive functioning, in elderly patients, 42
cognitively impaired patients, as gatekeepers for participation, 149
cognitive outcomes, 93
cognitive performance, predicting adherence in the elderly, 17
cognitive reactions, to risk, 198
cognitive state, of the individual receiving the message, 158
cognitive systems engineering, 366
coherence of sequencing, establishing in a conversation, 70
collaboration, significantly associated with better adherence, 14
collaborative care (CC) intervention, 279
collaborative learning, with peers, 114
collective cultures, prevention and sensitivity to negative outcomes, 258
collectivist culture in Japan, establishing different social norms, 147
colorectal cancer
comparative risk of, 259
not knowing risk, 200
combinatorial formula, determining number of possible conversations, 160
commitment, patients lacking, 13
Committee on Bioethics of the American Academy of Pediatrics, 140
common ground
defined, 157
establishing, 157
finding with the patient, 43
in a human-computer interaction, 169
laying out, 76
Common-Sense Model (CSM), 2, 197
communication
across transitions of care, 163–165
adherence assessment, 370–382
adherence intervention in older people, 443
between adults and children as asymmetric, 139
alcohol use in adolescents and role of, 412–414
building blocks of effective, 156–160
clearly and simply, 27
cognitive systems engineering, 366
as context-dependent, 62
contextual, 68–69
defining, 156
effective clinical, 111–113
effective relevant to health outcomes, 14–15
factors impacting successful, 26
first domains of, 25–26
health-care information, 351–353
importance of in healthcare environment, 109–111
improving through technology, 166–168
key to achieving health behavior change and treatment adherence, 3
on medications, 32
mental health care adherence and role of, 464–465
(p. 499) patient communications, adherence assessment and, 375
pediatric adherence promotion and, 399
pediatric diabetes, interventions targeting family communications, 478
as peripheral reaction, 113
public policy initiatives in, 490–494
reform proposals for, 490–494
research literature, 57
strategies for effective, 26
between teams during care transitions, 162
between three individuals, 157
in triadic (and more) medical encounters, 136–152
between two individuals, 157
in visits with an interpreter present, 142–145
communication-adherence link, stronger when the physician was a resident, 13
communication aids, using, 27, 30–31
communication behaviors, already happening reaction, 113
communication breakdown
causing unintentional discontinuity of treatment, 164–165
impact on patient adherence to care, 163–164
communication challenges, faced by patients, 33
communication channel, 156–157
communication choices, to convey risk, 202
communication devices, 156
communication dynamics
instances of multiparty communication, 152
structuring clinical encounters, 25–26
communication factors, impacting patients’ health, 61
communication failures
contributor to adverse clinical events and outcomes, 155
at handover, 163
leading to nonadherence, 164
communication patterns
in a healthcare system, 160
when interpreters are present, 143
communication policies, 156
communication services, 156
communication skills
assumed to be generic in educational/training settings, 57
better teaching in geriatric dyadic encounters, 150
as essentially behavioral, 116
not necessarily improving with time, 113
used in information-gathering/-sharing tasks and in relationship-building tasks, 57
communication skills training (CST)
across the medical education curriculum, 125–129
in the clinical workplace, 129
feedback from teachers and facilitators, 123–124
formal CST, integration into individual clerkship experiences, 127
formats, 95–97
for health professionals, 113–129
integrating across a 4-year curriculum, 126
issues related to who, what, where, when, and how, 130–132
location of programs, 129
methods continuum, 118
outside of the workplace, 129
physicians receiving, 13
principles guiding, 115–118, 124–125
programs, 95, 102
repeated practice and rehearsal in, 118
rigorous assessment of, 114
when and for how long, 124
communication space, 160, 161
communication strategy, providing information designed to enhance comprehension of links, 203
communication style, assessing a physician’s, 47
communication system, elements of, 156
communication tasks, 44, 56
community health workers (CHWs), 276, 280
comorbidity. See multimorbidity
companions
active participants in medical visits, 147
active participants in oncologic medical visits, 142
facilitating patient-physician discussions, 146
as perpetrator of abuse, 146
raising significantly more questions than patients, 142
roles of, 149
comparative effectiveness research (CER), pediatric adherence evaluation, 401–402
Comparative Fit Indices (CFIs), 228
comparative risk, 194
comparative risk perceptions, 195
comparison, integrally connected to persuasion, 252
comparison process, 252
comparisons, most patients trying to make the best of, 260
comparison scenario, judgment of similarity or dissimilarity, 256
comparison theory, effect of, 263
competence, conveying impressions of, 41
complexity, clearly linked to poorer follow-through, 17
complex regimens
adherence in older people and, 444–445
pediatric diabetes management and, 469–482
compliance, 2, 42. See also adherence
defined, 454
described, 9
medication adherence in older people and, 433–434
complications, information engendering fear, 178
composite addiction variable, more powerful predictor of future cessation than was stage of change, 242
composure, 47
comprehension, more comprehensive conceptualization of, 195
computer aided instruction (CAI), 119
computer algorithms, coding and analyzing recodings, 46
computer-generated messages, including alerts and reminders, 168
computerized alerts, 168, 169
computerized physician order entry (CPOE), 168, 354
computer-tailored letter, to daily smokers, 238
computing technology, advances in leading to increased experimentation in risk communication strategies, 204
conceptual framework, of perceived risk, health decisions, and behavior, 194
concordance, not utilizing communication approaches to improve, 111
conduit role, of an interpreter, 144
confidence, necessary for a commitment to adherence, 16
confidence interval information, increasing absolute risk perceptions, 202
confounders, controlling for potential, 93
confusion of responsibility, in health-care communication, 355
congestive health failure, addressing poorly controlled, 26
congruence. See correspondence
conscientiousness, leading to better health, 184
consequences
of an illness, 184
of nonadherence, 438
unanticipated of use of technology, 168–169
Consumer Assessment of Healthcare Providers and Systems (CAHPS), 102–103
consumerism, 43
consumerist physician-patient relationship, 43–44
consumers, advocating for, 102
Consumers Health Forum of Australia, 102
(p. 500) contemplation ladder, 223
contemplation stage, 215
contemplation stage of change, most innovative aspect of TTM, 243
contemplators
benefiting most from both kinds of information (BO condition), 239
gathering information and evaluation, 230
content
of exchanges between interlocutors, 70
influencing interaction, 67
of information gathering and explanation, 109
contextual features, 200–201
contextual influence
communication reforms and, 493–494
on pediatric adherence, 395–396
continuing medical education (CME)
communication skills taught to students, 127–129
communication-skills training program, 276
systematic reviews of literature, 114
continuous threads, throughout encounter, 59
continuous variable, readiness to change as, 223–224
contraceptive information, adolescent sexual activity and risk reduction using, 417–418
contract, between patients and health-care providers, 16
contrast, more likely if the standard is extreme or unattainable, 256
contrast effect, 255
control
dimension of, 39
over the medical interaction, 43
versus sharing, 43
controlability, 180
control condition, no information, 239
controlling condition, 48
convergence, importance of in pediatric encounters, 140
convergence model, examining triadic encounters in cancer care, 142
conversation
art of, 54
practical means of establishing a relationship with another person, 67
psychological aspects of, 54
conversational maxims, Grice’s, 160
cooperative principle, 160
of conversation, 64
COPE, 186
coping appraisal, 181
coping behaviors, 186
coping competency
mental health care adherence and, 461–462
pediatric diabetes adherence and, 479
co-production, of arguments and actions, 70–71
core communication skills content, presentation of, 118–119
core conceptual knowledge, incorporating in CST (communication skills training), 115–116
correlations, between communication and adherence, 13
correspondence, achieving, 42
cost-benefit ratio, changing, 77
cost issues
economic consequences of nonadherence, 438
equitable access to eHealth, 334–335
of nonadherence, 2, 324, 326–327, 370–371
technology and management of, 326–327
costs of nonadherence, 389
counselors, participants wanting increased identification with, 280
counterarguments, predominance of supporting thoughts over, 253
CPOE (computerized physician order entry), 168, 354
critical correlations, between scales, 224–226
cross-checking strategies, team-based communication and, 359–360
CSM (Common-Sense Model), 2
cues, picking up and responding to verbal and nonverbal, 113
cues to action
pediatric adherence and, 393
repeated, 179
significance of, 180
cultural appropriateness, 274–275
cultural beliefs, 184, 271
cultural broker, interpreter acting as, 144
cultural competency, focusing on reducing disparities, 269
cultural differences
between clinicians and patients, 268
influencing a patient’s preference for involvement, 90
cultural groups, differences within, 275
cultural issues
adherence assessment and, 376–378
adherence in older people and, 443
communication reforms and, 493–494
equitable access to eHealth, 334–335
pediatric adherence, 396–397
socioeconomic status and, 342–343
culturally and linguistically diverse (CALD) backgrounds, patients from, 99
culturally sensitive health interventions, examples of, 276–281
culturally sensitive interventions, developing, 275–276
culture
definitions of, 267
health behavior change and, 269–271
impact on clinical care, 267–269
influence on communication in triadic geriatric encounters, 147
intervention development and, 274–275
of an organization, 170
role of, 267–281
treatment adherence and, 271–274
culture change, toward a patient-focused organization, 101
culture of safety, requiring change, 169
curability or controllability, of an illness, 184
cure, introducing a doubt about, 73
cusp catastrophe model, 229
cycle of change, 215, 216
D
dairy products, African Americans and, 269
danger control, 182, 253
DANVA (diagnostic analysis of nonverbal accuracy), 49
data-analytic approaches
adherence assessment, 390, 392–393
evaluation of pediatric adherence, 400–401
data source, 226–227
DCM (depression case manager), 279
decision aids, 97–98
decisional balance
pediatric adherence, 394–395
in the TTM (transtheoretical model), 246
decisional balance measures, 215, 231
decision making
decision aids affecting, 97–98
distinguishing different stages of, 90
errors, technology management of, 326
mental health care adherence and, 460
nonadherence in pediatric patients and, 389
shared, 14
decision stage, in SDM (shared decision making), 87
decoder
in PPNC (parallel-process model of nonverbal communication), 45
processing of nonverbal cues, 45
deep structures, 275
default, 43
default physician-patient relationship, 44
defensive information processing, 200–201
defensive strategies, 200, 201
deliberation stage, in SDM (shared decision making), 87, 88
dementia diagnosis disclosure, expressions of power during, 147
Democracy in Healthcare movement, 101
(p. 501) demographic characteristics, influencing patient preferences, 90
demographics, associated with risk perceptions, 199
demonstrate empathy (Habit 3), 47
denial
difficult to recognize, 186
as method of fear control, 182
Department of Health and Ageing website, MyHospitals, 102
depressed patients, three times more likely to be nonadherent, 17
depression, 188–189, 272–274
adherence in patients with, 455
adherence mechanisms in, 459
associated with altered health beliefs, 185
chronic illness and nonadherence in, 456–458
common in medical patients, 17
in diabetes, 188
health-related behaviors and adherence in, 458–459
individual components of, 185
nonadherence in patients with, 456
pessimistic thinking and poor coping with, 461–462
prevalence/severity of, 455–456
depression case manager (DCM), 279
desired self, versus the feared self, 258
DESMOND program, 178, 179
detection behavior, choosing to perform, 257
determinants, 45
determination or decision-making stage, 215
developmental age, child’s, 140
diabetes. See also type 1 diabetes; type 2 diabetes
adherence rates, 11
in adolescents, management of, 422–424
adolescent type 1 diabetics, adherence in, 475–476
automated data collection, pediatric adherence assessment, 473
complex pediatric diabetes management regimens, strategies for, 469–482
education alone inferior, 179
education interventions for adherence in older people with, 443
family influences, pediatric diabetic management, 476
future trends in pediatric adherence, 482
global clinical ratings, pediatric diabetes management, 471–472
intervention-based management, pediatric diabetes adherence, 477–482
pediatric adherence assessment and self-management, 470–473
pediatric type 2 diabetes, adherence in, 475–476
physicians’ use of jargon with patients, 110
poor control of, 177
self-management of, social support and, 311–312
self-report questionnaires, pediatric diabetes adherence and self-management, 472
single-parent families, pediatric diabetic management in, 476
social factors in pediatric diabetes management, 476–477
structured interviews, pediatric diabetes management, 472–473
suboptimal pediatric diabetes adherence, 473–474
team-based communication concerning, 356–360
Diabetes Control and Complications Trial, 179
diabetes-management intervention studies, systematic review of, 12
diabetes-management regime, costs or barriers of, 181
Diabetes Prevention Program, 179
diabetes scales, perceived control of, 180
Diabetes Self-Management Profile (DSMP), 473
diabetic control, of urban African Americans, 280
diagnostic analysis of nonverbal accuracy (DANVA), 49
diagnostic issues, mental health adherence and, 463–464
diagnostic tests, adhering to after discharge, 165
dialogic approach, 67
dialogic point of view, of the medical encounter, 66–67
dialogism, concept of, 66–67
dialogue
co-constructed by interlocutors’ arguments and interactions, 78
emphasis on co-construction aspect of, 71
expressing multiple realities, 67
involving a patient and a physician, 67
suggesting a process to reach mutual understanding, 67
dichotomous, adherence, 94
dichotomous conceptualization, of understanding or accepting risk, 195
didactic presentations
efficacy of, 114
of evidence and rationale, 119
dietary changes
mental health care and role of, 458–459
social support and, 309–310
dietary self-management, 187–188
direct effect, from precontemplation on action, 226
direct pathway, from doctor-patient communication involvement to health outcomes, 92
discontinuation, nonadherence and, 387–388
discontinuity patterns, demonstration of, 231
discourse frame, 69
disease, attending to, 267
disease-centered medicine
focus on, 84
increased emphasis on, 126
disease management behaviors
adherence and illness management, 311–312
adherence in older people, 437
chronic illness and mental health issues in, 456–458
clinical consequences of nonadherence and, 438
mental health care adherence and, 460, 463–465
social networks and support, 307
Disease Management Programs (DMPs), mental health care adherence and, 463–465
disease severity, pediatric nonadherence and, 396
disease states, variations in adherence across, 11
disempowered individuals, not engaging with their physician, 99
dispersed pictographs, 202
dissimilarity information, searching for, 256
distress, 17
distributed opinions, team-based communication on diabetes and, 356–360
DMPs (Disease Management Programs), mental health care adherence and, 463–465
doctor-patient communication, 55
doctor-patient-family-caregiver relationship, fostering, 146
doctor-patient relationships, 55
becoming increasingly collaborative, 65
preferred styles of, 56–57
doctors’ recommendations, patients not following, 111
dominance, 47
dominance behavior, predicting patient satisfaction, 41
dosage errors, in mental health treatment, 456
dosage regimens, older people using, 440–441
dosette packages, adherence improvements, 328
dosing complexity, affects medication adherence in general, 17
dosing instructions, inconsistency, 32
dosing regimens, 12, 328–329, 440–441
(p. 502) downward assimilation
no evidence of true, 256
outcomes of social comparison, 255
rarely seen, 260
downward comparison theory, 255
downward contrast, outcomes of social comparison, 255
drinking, social support and networks and, 310
drinks per drinking day (DDD), 233, 234
drug characteristics, adherence in older people linked to, 436–437
DSMP (Diabetes Self-Management Profile), 473
dual-role staff interpreters, linguistic competency of, 143
ductal carcinoma in situ, diagnosis of, 195
dyadic interaction, 137
E
E4 model, for physician-patient communication, 44
eating behaviors, culturally learned, 269
Ebbinghaus illusion, 159
ECM (Electronic Compliance Monitoring), adherence improvements and, 333–334
economic consequences of nonadherence, in general population, 438
ED (emergency department) providers, viewing their role as stabilization and disposition, 162
educating, 44
educating and motivating patients, 56
education
defined, 177–178
determinant of patient preferences, 90
educational attainment, perceived risk and, 199
educational content, organizing and prioritizing, 27
educational diagnosis of health behavior (P-predisposing, E-enabling, N-nurturing), 274–275
educational factors
adherence intervention in older people and, 442–443, 445–446
adolescent sexual risk behaviors and, 416
healthy weight in adolescents, 419
pediatric adherence promotion, 398
educational interventions
comparing behavioral versus multicomponent, 179
development of, 147
impact on actual clinician behavior, 114
educational offerings, components more likely to lead to behavior change, 114
educational settings, 118–120
educational supports, using, 30
education programs, needed after the shock of original diagnosis, 178
effect sizes, standardized across study types, 10
efficacy beliefs, higher resulting in less need for fear control, 182
efficacy expectancies, in the TTM, 246
eHealth, equitable access issues, 334–335
elaborate processing, of nonverbal cues, 45
elaboration-likelihood model of persuasion (ELM), 253, 261
e-learning, in CST, 119
electronic asynchronous communication, 167
Electronic Compliance Monitoring (ECM), adherence improvements and, 333–334
electronic health records (EHR)
adherence improvements and, 325
educational benefits of for populations with LHL, 33
facilitating access to patient information, 166–167
electronic medical record (EMR)
adherence improvements and, 325, 333–334
patient motivation and, 333
provider-patient relationships, 329
elicitation-type communication, 25
elicit the patient’s perspective (Habit 2), 47
ELM (elaboration-likelihood model of persuasion), 253, 261
e-mail, 167, 168
emblematic gestures, 39
emergency department (ED)
interactions with specialty wards, 162
team-based communication in, 356–357
emotional care, 59
emotional equilibrium, essential for the development of adaptive coping behavior, 186
emotional health challenges, reducing adherence, 16–17
emotional representations, 184
emotional response, to a diagnosis, 186
emotions, gestures expressing, 39
empathizing, 44
empathy, statement of, 75
empathy, friendliness, and courtesy, significantly associated with patient satisfaction, 60
enabling factors, pediatric adherence, 393
encoders, 45
engaging, 44
enlisting, 44
ensemble, forming, 78
environmental factors
adolescent obesity intervention and, 421–422
alcohol use in adolescents and, 412–414
health care access and, 345–347
pediatric adherence, 393
pediatric diabetes management, 477
environments, facilitating walking and other forms of physical activity, 270
ethical implications, of increasing patients’ responsibility, 207
ethnicity
adolescent sexual risk behaviors and, 416
influence on preferences for depression treatment, 273
socioeconomic status and, 342–343
ethnic minorities, less likely to believe that medicines were effective, 273
Europe, patient experience surveys, 102
EUT (expected-utility theory), 196
evaluative mechanisms, operating relatively independently, 254
everyday learning and practice, integration of CST (communication skills training) into, 125
evidence-based heuristic model, of adherence, 10
evidence-based principles, for providing effective feedback, 122
excessive appetites, 243
exchanges, on treatments between physicians and patients, 62
exercise
benefits in diabetes, 188
mental health care and, 458–459
older people’s adherence and, 435–438, 440–446
social support and, 309–310
exotic behaviors, 275
expectancy, determining behavior, 182
expectations, self-fulfilling prophecy and, 340–341
expected-utility theory (EUT), 196
expected value, 196
experiences, feedback of, 102
experiential learning, 114, 116
experiential material, in CST, 122
experiential practice, 120–124
expert opinions, conflicting, 202
expert system intervention, 237–238
explaining and planning task, 59, 61
explanation and planning, 109, 112–113, 130
explanations
organizing, 112
relating to the patient’s perspective, 112
explanatory-type communication, 25
explicit discussions, occurring infrequently in medical encounters, 64
expository communications, appropriate model for, 261
exposure, to the importance and methods for effective communication, 114
expressivity, 44
extended parallel-process model, 196
(p. 503) extended-release medications, adherence improvement in older people using, 442
external factors (barriers), 181
F
face, with nonverbal behaviors, 39
facilitator, physician’s role as, 65
faculty development
for CST (communication skills training), 130
in medical education, 114
family-based interventions, pediatric adherence, 398–399
family conflict, adherence rates lower, 16
family influences
adolescent diabetes management and, 423–424
adolescent obesity intervention and, 421–422
adolescent sexual risk behaviors and, 416
alcohol use in adolescents and, 412–414
greater perceived susceptibility to cancers, 199
healthy weight in adolescents, 419
intervention-based pediatric diabetes adherence strategies, 478–482
in middle adolescence, 410
pediatric adherence, 396–397
pediatric diabetic management and, 476
positively influencing adherence, 16
family-member interpreter, advantages and disadvantages of, 145
family members
influences on patient commitment to healthy behaviors, 16
roles during medical visits, 146
family-oriented therapy, alcohol/substance abuse in adolescents, 414–415
Family Smoking Prevention and Tobacco Control Act of 2009, 258
family support networks
facilitation of health goals, 345–347
screening behaviors, 311
sources of, 314
fear
conceptualized as a drive state motivating trial-and-error behavior, 252
instigating defensive processes, 252
motivating or inhibiting behavior, 198
triggering two qualitatively different motivational processes, 253
fear and threat, at the diagnosis of diabetes, 178
fear appeals
people responding to, 198
theoretical frameworks of, 182
fear arousal
enhancing the impact of loss-framed messages but detracting from gain-framed messages, 259
presumed to enhance message acceptance, 252
fear control, 182, 253
feedback
balancing between effective and ineffective behaviors, 123
on communication, 117
defining, 122
difficult to give and receive, 122
in experiential CST (communication skills training) sessions, 122–124
receiving external, 117
on teaching skills, 114
feelings, necessary to making good decisions, 198
feelings of risk
more predictive of behavior and intentions, 198
strongly correlated with being vaccinated against influenza, 206
female clinicians, better at acquiring communication skills in training, 92
female patients, more likely to prefer an active role in decision making, 90
female physicians, 41
female providers, engaging patients more in partnership building, 91
field-based health-care communication, team-based approach to, 355–360
final decision, making about care, 90
financial barriers, to patient involvement, 101
financial incentives, offering health-care providers, 101–102
finding a solution to a problem, as a shared conversational frame, 64
fixed dose combinations, adherence improvement in older people using, 440–442
flexibility
clinical situations requiring, 58
communication increasing, 115
medical problem requiring, 57
paramount in clinical communication, 55
in use of proven communication skills, 66
food preferences, culturally learned, 269
foot care, for diabetic patients, 188
forcing functions, implementing, 168
forethought, leading on to motivation and action, 182
forgiving drugs, adherence improvement in older people using, 442
formality, 47
forward stage transitions, 233–235, 239
four habits coding scheme (FHCS), 47
fragmented care, minimizing the effects of, 164
framework
of an asymmetrical relationship, 79
of teaching skills or competencies, 116
framing effect, 111, 158, 159, 197
friends support networks
facilitation of health goals, 345–347
influences on patient commitment to healthy behaviors, 16
pediatric diabetes management, 476–477
screening behaviors, 311
sources of, 314
functional diversity, between teams, 162
functional social support, mental health care adherence and, 462
G
gain-and-loss-framed messages, effects of, 258
gain-framed health communications, 257
gain-framed message, 257
gathering information task, 59
gender issues
adolescent sexual risk behaviors and, 416
medication adherence in general population, 434–435
older people’s adherence and, 435–436
social networks and support, 312–313
general factor, identified by Budd and Rollnick, 226
general-health control group, 281
general health motivation, measures of, 180
General Medical Council in the United Kingdom, 101–103, 125
general practitioners’ (GP) in Sweden, preferring interpreters who were neutral, 144
generic prescriptions, cost issues, 327
genetic testing, for disease risk, 203
genuine stage theory, assumptions of, 229–231
geriatric team, 148–149
geriatric visits, triadic communication in, 145–150
geropsychiatrist participants, intervention by, 147
gestures, nonverbal behavior expressed through, 39
“gist” interpretation, of a hazard as risky or not risky, 195
global clinician ratings, pediatric diabetes management, 471–472
global health ratings, better in patients reporting better patient-centered care, 94–95
globality, 180
global ratings, 46, 47
glycemic control
better with greater personal control, 188
pediatric diabetes management and, 470
glycemic control (HbA1c), 188
goals
related to behaviors and outcomes, 3
structured, 166
(p. 504) GP (general practitioner) consultations, context factors affecting communication process, 58
graduate students, communication skills taught to, 127–129
graphic warning labels
on cigarette packs, 252
on cigarette-pack warning labels, 258
having an advantage, 258
group-based analysis, adherence assessment, 390, 392–393
group work, reinforcing catalog of skills, 120
growth-curve modeling, adherence assessment, 393
growth mixture modeling, 236
H
handoff practices, current are deficient, 163
handoff system, implementation of a computerized, 168
handover support, via information technology, 167–168
harm, 195
HbA1c (glycosylated hemoglobin), indicating the degree of control of diabetes, 188
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), 344
Health-Action-Process Approach (HAPA), 2
health actions, failure of, 1
health behavior interventions, developed based on pilot data, 200
health behavior practices, social norms about, 259
health behaviors, 1–2
barriers and keys to changing, 9
carrying out incorrectly, 10
consequences framed as gains or losses, 197
importance of adherence to, 2
potentially yielding a pleasant or an unpleasant outcome, 257
theoretical perspectives on, 2–3
Health-Belief Model (HBM), 2, 15, 180, 196
adherence, 323–324
influences on pediatric adherence, 393
limitations of, 181
medication adherence in general population, 434–435
mental health care adherence and, 461
modifying factors, including age and ethnicity influencing beliefs, 274
health beliefs
affecting treatment adherence, 271
in diabetes based on HBM (Health Belief Model), 185
health outcomes and, 177–189
health-related behavior dependent on, 178
measurement of, 185–186
varying across social groups, 268
healthcare, communication of, 160–165
Health Care and Education Reconciliation Act, 101
health care delivery systems, health literacy at the level of, 33
health-care professionals, 62, 138, 144, 145. See also clinicians; physician(s)
health-care providers
assessing practical supports available to a patient, 16
attitudes acting as a barrier to patient partnerships, 100
communication training, 102
impact of provider communication-skills training on, 96
health care providers, not immune to biases and pitfalls understanding numeric information, 206–207
health-care providers, pressure to respond to increasing demand with limited resources, 163
health-care system dynamics
adherence and, 324–325
pediatric adherence, 397, 399
health-care utilization, decision aids affecting, 98
health communications
applications of self-affirmation to, 256
based on persuasion principles, 256–259
based on social comparison, 259–260
combining persuasion and comparison in, 261–262
designing and disseminating to inform and persuade the public, 251
using comparisons with patients, 259–260
health communication studies, 63
health dialogue, 55–56
health-education dimension (P-person, E-extended family, N-neighborhood), 274
health information
communication of, 351–353
patients unable to understand, 13
health information exchange, outside the medical encounter, 55–56
health information technology (HIT)
adherence and, 330–332
decision-making error management, 326
health literacy
adherence assessment and, 375–376
communication reform and, 492–494
described, 23, 24, 99
individuals with adequate having limited health numeracy, 31
instruments used to assess, 26–27
interventions, 25
in medical settings, 23–33
skills, 24–25, 28
socioeconomic status and, 342–344
Health Literacy Skills Instrument, 28
health locus of control (HLC), 180
health outcomes, 11, 60, 92
health record, mixed, 1
health-related behavior
adolescent development and, 408–410
adolescent diabetes management and, 422–424
adolescent health status and, 411–412
adolescent sexual activity, intervention strategies for, 416–418
aging and adherence issues, 432–448
change regimens in mental health care and, 454–455
change vs. maintenance, 313–314
conceptual definitions, 306
disease management behaviors, 307
enhanced support for, 314–316
future research issues, 316–317
healthy weight in adolescents, 419
illness and management behavior, support and adherence, 311–312
lifestyle behaviors, 308–310
mechanisms for mental health care adherence, 459
mediating mechanisms, 313
medication adherence in general population, 434–435
mental health care adherence and, 454, 458–459
pediatric adherence, 393–398
in pediatric patients, 387–403
physical activity and diet, 309–310
preventive behavior, 306–307
risky behaviors, 310
screening behaviors, 310–311
social and environmental facilitators of, 345–347
social networks and support, 305–317
team-based improvement techniques, 351–367
theoretical mechanisms, 307–308
health-related outcomes, 94–95
health-related tasks, real-world, 28
health-risk behaviors
adolescent health status and, 412
sexual activity in adolescents and, 416–418
health risk messages, referred to as fear appeals, 198
health risks
understanding, 194–195
understanding perceptions of, 198
health status, measuring, 95
Healthy People 2010, defining health literacy, 24
healthy weight, in adolescents, 419
heart and coronary arteries, realistic images, 204
(p. 505) heart disease management, social support and, 311–312
heavy-drinking inpatients, noncontemplative change among, 230
helical approach to learning, 125, 127
heterogeneity
associations between demographic characteristics and perceived risk, 199
prescription protocols for older people and, 433
heuristics, 183, 196–197, 200
hidden curriculum, influence of, 126
hidden patients, caregivers as, 146
hierarchical model, with a higher order factor, 226
hierarchical model of intelligence, 229
hierarchical structure, characterizing much of the culture of medicine, 159
high affiliative conditions, 41, 48
high blood pressure adherence, improving, 276, 279
high-depth outcome expectation participants, 262
high dominant nonverbal behaviors, 41
high elaboration, 253
higher order factor, introducing into model, 226
high-fat foods, consumption of by African Americans, 270
high-risk women, overestimating risk of breast cancer, 205
high-tailored proxy health intervention, 262
Hispanics, more likely to have negative beliefs about antidepressant medication, 273
HIV management
adherence rates, 11
adolescent sexual activity and, 416–418
nonadherence in, psychological factors, 457–458
social support and, 311–312
home remedies, for hypertension, 271
homosexuality, barriers to health care and, 343
Hospital Compare website, 102
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), 344
hospital environment, high level of ambient noise, 157
hospitalized patients, experiencing medication continuity error, 165
human attention limitations, 158
human-computer communication, 168
human limitations, understanding, 158
human perceptual system, distorting sense data, 158
hypertension, 271–272
adherence rates, 10–11
multifaceted approach to adherence shown to be essential, 12
I
iceberg model of culture, applied to race, 267–268
icon arrays, 31, 32
ICT (information-communication technologies), adherence models and role of, 332–333
ICU (intensive care unit), discharge to specialty ward, 162
IF-THEN contingency rules or links, 197
IF-THEN linkages, between health risk and protective action, 203
illness beliefs, distinguishing from treatment beliefs, 184
illness coherence, 183
illness experience, of patients, 267
illness management
adherence in older people, 437
clinical consequences of nonadherence and, 438
social networks and support, 311–312
Illness Perception Questionnaire (IPQ), 184, 185
illness-related characteristics, pediatric adherence and, 396
illness representations (IRs), 182, 183–184
central determinant of coping behaviors, 185
coherence with treatment representations, 187
determinants of, 184–185
related to coping behaviors, 187
relation to behavior and outcomes in diabetes, 187–189
illustrative gestures, 39
immediacy, 40
immotives, 239
impact
of interventions, 243
produced by expert system intervention, 238
implicit elements, 72
incentives, adherence intervention in older people and, 442
independent study, in e-learning, 119
indicators of health, on the decline, 1
indirect pathways, 92
individual differences, associated with risk perceptions, 199–200
individual factors, 62
individualistic cultures, promotion and sensitivity to positive outcomes, 258
individualized approaches, 493–494
individualized manuals (TTT), 237
individual relationship-building skills, 57
individuals
determining success of a communication act, 156
interacting through speech, 69
individuals with LHL (limited health literacy), 26, 29
inducing fear producing more responsiveness, 259
influenza vaccination, higher perceived risk, 205
information
adherence and, 330–332
adherence in older people and complexity of, 437–438
cognitive artifacts and synthesis of, 361–366
distributed access to, 166–167
ecology, 353–354
as first component of the IMS model, 13–15
mental health care adherence and, 459–460
not enough provided, 110
presenting as a frequency, 31
presenting both gains and losses, 197
provided in a medical encounter, 79
providing current amount and type of, 112
sources of, in health-care communication, 355
informational requirements, receiver’s, 157
information-communication technologies (ICT), adherence models and role of, 332–333
information exchange, 57
art of, 78
examples of regarding medications, 64–65
present in all the sequential tasks, 59
information exchange stage, in SDM (shared decision making), 87–88
information gathering/sharing communication skills, patient outcomes and, 61–62
information giving, central to patients being able to make informed choices, 110
Information-Motivation-Behavioral-Skills Model, 3
information-motivation-strategy (IMS) model
adherence framework, 330–334
communication reform and, 491–494
elements of introduced by DiMatteo and DiNicola, 13
health-related behavior change and treatment adherence, 3
mental health care adherence and, 459
pediatric adherence, 394
reflecting nonadherence for three reasons, 13
self-fulfilling prophecy and, 340–341
(p. 506) information-related content, discussion of insufficient, 62
information-sharing methods, team-based communication, 367
information systems
adherence intervention in older people and, 442
cognitive artifacts in, 365–366
poorly designed, 169
information technology, 166, 168, 169
informed approach, 86
informed collaborative choice, 15
informed consent, 30, 85
informed decision-making model, 87
initiation of adherence, 387–388
instructional methods, use of multiple, 114
instruments, measuring coping behavior, 186
insulin, failure to take, 177
insulin administration systems, automated data collection, 473
integrated formal CST (communication skills training) across the curriculum, examples of, 127
integrated model, 196
integrative models, recent, 89
intensive care unit (ICU), discharge to specialty ward, 162
intensive intervention, 276, 279, 280
intentional adherence, in older people, 434
intentional behavior change
TTM (transtheoretical model) as limited, 241
TTM (transtheoretical model) focused on, 245
intentional nonadherence, 9
intentions
derived from consideration of attitudes, subjective norms, and perceived behavioral control, 254
importance of, 181
influenced by attitudes, 3
interactional strategies, improving triadic communication, 142
interaction mode, 156
interactions, 71
analysis between the two participants, 71
complexity of, 160–163
serving relationship building, 57
between two participants, 73
interactive computer programs, 31
interactive computer reports (ITT), 237
interactive exchange, between clinician and patient, 109–110
interactive syncretism, 78
interdepartmental transition, 163
interhospital transition, 163
interlocutors in the medical encounter, 64
intermediate outcomes, 92
intermediate/outcome variables, in TTM, 215
internal factors (skills, knowledge), 181
internal locus of control, 180
International Medical Interpreters Association, 143
International Tobacco Control Four Country Survey Study, 258
Internet
educating and alerting people to health hazards, 198
providing ideal medium decision-support tools, 103
internet access
equitable access to eHealth, 334–335
pediatric adherence promotion and, 395–400
internet-based cancer risk calculators, 204
interpersonal behavior, mapping onto two main dimensions, 39
interpersonal communication, main functions of, 57
interpersonal health care, culture impacting quality of, 269
interpersonal theories approach, 43
interpreter
roles of, 143–144
in triadic encounters, 142–143
interrupt-driven, multitasking setting, consequences of, 161
interrupted task, time to restart, 162
interrupted time series, adherence assessment, 390, 392–393
interruptions, of tasks, 161–162
interruptive channels, 156
intershift transition, 163
intervention, implications for, 189
intervention components, examples of culturally tailored, 277–278
intervention group, 281
interventions
adherence in older people and, 440–446
in adolescent sexual activity, delaying tactics, 416–417
alcohol/substance abuse in adolescents, 414–416
assessing effectiveness of, 95–99
behavioral interventions, adherence in older people and, 442
behavior contracting and modification, pediatric diabetes management, 478
clinic-integrated pediatric diabetes management, 478–479
cognitive-behavioral therapy and self-monitoring, pediatric diabetes management, 479–480
complex/multifaceted interventions, older people’s adherence, 444–445
costs of nonadherence, 324
diabetes in adolescents and, 422–424
enhancement of health behaviors, 314–316
enhancing cultural sensitivity in, 275–276
expanded to the entire population, 243
improving patient medical knowledge, 99
improving recall of medical information by cancer patients, 61
limitations of, in older people’s adherence, 445–446
matched to stage more effective at producing forward stage movement, 239
motivational interviewing, pediatric diabetes management, 480
obesity in adolescents and, 420–422
patient involvement, 98–99
pediatric diabetes management, 477–482
risk reduction programs for adolescent sexual activity, 417–418
showing promise, 60
social and environmental facilitators, 345–347
social support interventions, pediatric diabetes, 480
stage-based, 245
stress management/coping skills, pediatric diabetes management, 479
targeting African Americans incorporating spiritual values, 275
targeting at the appropriate stage, 3
telecommunications technology, pediatric diabetes intervention, 480–481
TTM (transtheoretical model) increasing impact of intervention, 243
type 2 diabetes in children, 481–482
intra-individual change, pediatric adherence, 394–395
invariant sequence of stages, 230
invest in the beginning (Habit 1), 47
invest in the end (Habit 4), 47
in vivo measurement, of interpersonal sensitivity, 49
involvement, level of, 257
IPQ (Illness Perception Questionnaire), 185
irreversibility, 229–230
It’s Your Game: Keep It Real (IYG), 417
ITT condition, superior or equal effectiveness to the other three conditions for smokers, 238
J
jargon, use of, 110, 157
JNC-VII hypertension treatment guidelines, 276
K
key skills, in effective healthcare communication, 112
L
laboratory-based research, testing manipulations for information processing stages, 252
(p. 507) laboratory-information-management (LIM) system, 325
Labov and Fanshell (LF), codes developed by, 71
lack of time, to adequately explore the patient as a person, 100
lactose intolerance, among African Americans, 269
language, using concise, easily understood, 112
language and terms, without shared understanding of, 28
language issues
adherence assessment, 378
equitable access to eHealth, 334–335
team-based communication, 353
latent growth-curve modeling, adherence assessment, 393
lay and expert, views of and responses to risk, 201
laypeople, perceiving as alarming information intended to be reassuring, 201
LCME (Liaison Committee on Medical Education), 125
learner-centered approach, 115
learner-centered courses, most effective, 95
learner-centered CST (communication skills training), 115
learner-centered education, contrasted with teacher-centered education, 115
learner-generated cases, interventions using, 122
learner’s communication skills, key elements required to ensure sustained change, 115
learner self-assessment, before eliciting feedback from others, 122
learning, by reflecting, 116
learning communication, not achieved after a single exposure, 125
learning goals, organizing and prioritizing, 29
lectures, in CST (communication skills training), 118–119
Leeds Dependence Questionnaire, 227
legal issues, team-based communication, 352–353
legislation, developing to advocate for patient involvement in health care, 101
length of the visit, related to patients’ trust, 41
level of addition, predicting behavior change better than the stages of change, 241–242
level of involvement, ascertaining patient wishes, 113
level of motivation, 236
levels of change, 216
in TTM (transtheoretical model), 215
LHL (limited health literacy), 23, 24–25
Liaison Committee on Medical Education (LCME), 125
lifelong learning, applying to clinical communication skills, 131
lifestyle intervention, compared with standard management, 179
lifestyle practices, preventive health behaviors, 306–310
Likert scale, self-report questionnaires, pediatric diabetes adherence and self-management, 472
LIM (laboratory-information-management) system, 325
limitations, perceptual, 158
limited health literacy (LHL), 23, 24–25
limited numeracy skills, linked with negative health outcomes, 31
line graph, ease of understanding, 158
listener, relying on a set of tacit assumptions, 64
literacy challenges, not typically obvious, 24
literacy level, impacting patients’ ability to correctly identify medications, 32
literacy testing, administering, 28
living room language. See plain language
locus-of-control beliefs, 180
longitudinal approach, to CST (communication skills training), 125
longitudinal curriculum, within residency training programs, 127
longitudinal helical manner, CST (communication skills training) provided in, 129
long-term complications, nonadherence in pediatric patients, 388–389
long-term management, central importance of, 12
loss framed, 257
loss-framed messages, 257, 259
low affiliative conditions (distance), 41
low-depth participants, 262
low dominant nonverbal behaviors. See high dominant nonverbal behaviors
low elaboration, 253
low health literacy, as barrier to patient participation, 99
low-participation companion, cutting off older patient, 147
low perceived risk, reconceptualized as a type of optimism, 206
low-tailored story, versus a high-tailored, 262
M
main concerns, inquiring about patients’, 29
maintenance
adolescent obesity intervention and role of, 420–421
in health behavior, 313–314
maintenance stage, 215
Making Health Care Decisions, 87
maladaptive coping, 181
maladaptive coping behaviors, 186
maladaptive responses, identifying as a means of fear control, 182
male physicians, satisfaction with, 41
mammography health messages, effect of gain/loss framing of, 205
management options, exploring with the patient, 113
mandatory training programs, for CST (communication skills training), 130
manner, maxim of, 160
mathematical tasks, decreasing the number of patients having to do, 31
maxims
applying within professional contexts, 64
defining the principle of cooperation, 160
meaning, emerging from multiple sources, 63
measured or observed effect, specific cues bringing about, 40
measurement constructs, different kinds of, 217
mechanisms, predictors of behavior, 207
mediating mechanisms, health-related behavior, 313
mediator, 136
medical appointments, wasted as a result of nonadherence, 2
medical consultations, 55, 85
medical decision making
illness-based determinants of involvement in, 90–91
patient preference for involvement in, 89–90
medical decision-making models, 86–87
medical dialogue, within the larger context of the lifelong health dialogue, 56
medical discussions, 63
medical education students, communication skills taught to, 127–129
medical encounter, effective information exchange is paramount, 57
medical encounters
adapting communication research findings to specific individual, 65–66
conditions affecting exchange of information, 62
constituting a particular type of conversation, 68
as a particular type of asymmetrical interpersonal communication or social conversation, 67
reframing art as dialogue in, 66–71
socially accepted behaviors, 63
medical information exchange, art of, 54–79
medical interviews, evolution of the approach to the conduct of, 54–55
(p. 508) medical jargon
clinicians regularly using, 28–29
included in medication dosing instructions, 32–33
Medical Outcomes Study (MOS), 14
medical problem, requiring flexibility on the physicians’ part, 57
medical teams
having different agendas and expectations, 162
minimizing conflicts and misunderstanding between, 165–166
medical visit, manipulating physician nonverbal communication during, 48
medication, vulnerable to unintentional discontinuation during care transitions, 164
medication adherence, 187
in general population, 434–435
in older people, 433–434
medication communication, 32–33
medication errors, team-based communication and, 359–360
medication event monitoring systems (MEMS)
adherence monitoring, 330
clinical practice adherence, 373–374
older people’s adherence measurements, 439
pediatric adherence, 402–403
medication label, prototype for a standardized, 32
medication reconciliation, 33, 166
medications
active and re-prescribed providing more clinical common ground, 65
ensuring safety, 27
errors in self-management at home, 32
information exchange about, 62–65
prescription of new, 110
simplifying regimes and instructions, 32
social and dialogical perspectives on communication about, 63–65
medi-sets, simplifying process of taking multiple medications, 33
memory
in adherence assessment, 379
adherence in older people, 437–438
mental health care adherence and, 460
mental health care
adherence issues in, 454–465
barriers for African American and Hispanic patients, 272
chronic illness and adherence in, 456–458
decision making participation and involvement and, 460
disease and treatment information and adherence in, 460
health-behavior change regimens in, 454–455, 458–459
informational/cognitive factors in, 459–460
major disorders, influence on adherence of, 455
mechanisms for adherence in, 459
motivational factors in adherence, 461
nonadherence in, 456
patient health beliefs and, 461
prevalence/severity of mental health disorders, 455–456
provider-based adherence strategies, 462–464
resource/strategy-related factors in, 462
self-efficacy limitations in, 461
mental illness, beliefs about religious or supernatural causes of, 273
mental model consistency, 203
mental models, of risk, 197
messages
structuring, 158, 165
types of, 156
messaging, 167
MET (motivational enhancement theory), 226, 235
microcone, 46
middle schools, sexual activity interventions in, 417
minimal intervention, 276
minorities, having less trust in physicians, 271
miscommunication, low mutual understanding associated with, 144
misrepresentation, in health-care communication, 354–355
models
delineating components of effective clinician-patient communication, 111
of the functions and communication tasks of the clinical encounter, 57–59
using factor groupings for explaining health behavior, 2
moderate risk, 194
modifying factors, pediatric adherence, 393
monitoring, evaluation, and patient-tracking systems
adherence assessment in pediatric patients, 390–391
adherence improvements and, 325
mortality statistics, chronic illness in adolescence and, 411
MOS (Medical Outcomes Study), 14
motivated forgetting, adherence assessment, 371
motivation
adherence assessment, 378–379
adherence models and role of, 332–333
measured by RCQ[TV] (Readiness to Change Questionnaire [Treatment Version]), 236
mental health care adherence and, 461
reported to be one of the most consistent predictors overall, 232
as second component of IMS (information-motivation-strategy) model, 15–16
motivational enhancement theory (MET), 226, 235
motivational interviewing (MI), 215
alcohol/substance abuse in adolescents, 415
helping people to resolve ambivalence and change behavior, 243
as the intervention of choice, 235
pediatric diabetes management, 480
motivation matching hypothesis, reexamination of, 236
multidimensional health locus of control (MHLC) scale, 180
multifaceted adherence assessment, 374–375, 444–446
multifaceted approach, best for improving health behaviors, 12
multifaceted self-management training, effectiveness of for asthma patients, 12
multilevel approach, to conceptualizing perceived risk, 198–199
multimedia approaches, 31
multimodal approach, effective CST (communication skills training) courses using, 124
multimorbidity
chronic illness and mental health issues in, 456–458
depression and, 455
older people’s adherence and, 436
multiparty medical encounters, difficult for certain patients, 138
multiple-dyadic relationships, in an emergency-department visit, 139
multitasking, 161–162
mutual beliefs, interplay of, 69
mutuality, 43
mutually acceptable plan, negotiating, 113
mutual physician-patient relationship, 44
mutual understanding, between physician and the patient, 144
N
NAAS (Nonverbal Accommodation Analysis System), 47
narrative communication, persuasive power of, 261–262
narratives, 203–204
National Health Service (NHS)
Patient Partnership Strategy, 85
in the United Kingdom, 101
National Safety Foundation, 29–30
National Voices, umbrella advocacy group in United Kingdom, 102
natural conversations, normal imprecision and indirectness of, 64
(p. 509) naturalistic decision making (NDM), team-based communication and, 352–353
NCM (nurse case manager), 280
NDM (naturalistic decision making), team-based communication and, 352–353
need of cognition, being high in, 253
negative behaviors, harmful to the patient’s health, 275
negative correlations, between stage measures, 225
negative frame, 159
negative outcomes, costs of nonadherence, 324
neuroticism/anxiety, consistent predictor of morbidity and mortality, 184
neurotics, tending to have a negative outlook, 260
new behavioral self-control skills, training of, 235
Newest Vital Sign (NVS), 28
NHS Choices website, 102
NNT (number needed to treat), 31
no-information group, absence of, 239–240
noise, 157
nonadherence
adolescent obesity intervention and, 420–421
clinical consequences of, 438
combating, 11–12
communication of, 372–373
consequences of, 438
cost of, 2, 324, 326–327, 370–371
economic consequences of, 438
illness-related characteristics, 396
impact in pediatric patients, 388–389
intentional or unintentional, 9, 434
mental health care and prevalence of, 456
motivated forgetting, 371
multimorbidity and polypharmacy in older people and, 436
non-traditional improvement of, 323–335
in older people, 433–434
in pediatric patients, 387–403
placing a burden on patients, providers, and the health-care system, 11
prevalence, pediatric patients, 388
primary nonadherence, 372
provider-patient relationship and assessment of, 379–380
related to depression in diabetic patients, 17
research methodology concerning, 389–395
to treatment recommendations, 2
to treatments for depression as common, 272
unintentional, 460
nonaffiliative behaviors, patient mirroring, 42
noncollectivist culture, in the United States, 147
non-English speakers, limited health literacy more common among, 28
noninterruptions, 44
noninterruptive channels, 156
nonmedication therapies, adherence to, 388
nonpersistence, 9
Nonverbal Accommodation Analysis System (NAAS), 47
nonverbal behaviors
associated with patient trust, 41–42
interacting with verbal behavior, 39
intrinsically related to verbal behavior, 51
manipulation of, 47–48
meaning of, 39
varying from one condition to the other, 48
nonverbal communication
assessing in the medical encounter, 45–48
defined, 38–40
importance of, 15
level of detail or abstraction, 45
in medical interactions, 38–51
purposes of, 39
nonverbal cues
broad definition in PPNC (parallel-process model of nonverbal communication), 45
decoding, 48
specific coding, 46
nonverbal dominance, negative impact on satisfaction, 50
nonverbal expression of concern, 48
nonverbal expressions, examples of, 49
nonverbal gesture, with a defined linguistic content, 39
nonverbal sensitivity, self-perceived by physicians, 49
normalization of deviance, 170
norms, providing in community campaigns, 259
norms of behavior, social networks, 308
number needed to treat (NNT), 31
numbers alone, lacking context, 200–201
numeracy, 24, 31–32, 199–200
numeracy-related tasks, minimizing, 27
numeric concepts, improving patients’ understanding of, 31
numeric format, to convey risk, 202
nurse case manager (NCM), 280
NVS (Newest Vital Sign), 28
O
obesity
adherence rates, 11
in adolescents, 418–422
intervention programs for adolescents, 420–422
stage model of management of, 418–420
statistics on, 418–419
Obesity Reduction Black Intervention Trial (ORBIT), 277–278, 281
obesity research paradigm, 271
objective measures, of patient centeredness, 95
objective structured clinical examinations (OSCEs), 121, 127
observation, opportunities for, 117
OC condition, information on outcomes of quitting only, 239
office design, effect of, 149–150
off-site training, necessitating clinicians taking time off from work, 131
older patient-caregiver relationship, 148
older patients
level of participation reduced in triadic encounters, 146
needing help from family members to accomplish daily activities, 148
permission from, 149
raising fewer topics in all content areas in triads, 146
well-educated showing involvement preferences similar to younger patients, 90
older people
age as adherence factor in, 435–436
drug characteristics and adherence in, 436–437
factors in adherence in, 435–438
fragmentation of care for, 150
future research issues on adherence in, 447–448
improvement of adherence in, 439–440
interventions for adherence in, 440–446
limitations of adherence studies in, 446–447
limitations of intervention in, 445–446
measurement of adherence in, 438–439
multimorbidity and adherence in, 436
nonadherence in, 433–434
polypharmacy and adherence in, 436
prescription protocols for, 432–433
once-daily dosing, adherence improvement in older people using, 440–441
oncologic encounters, triadic, 141–142
oncologists, telling patients about the survival benefit of palliative chemotherapy, 110
one-to-one experiential sessions, in CST (communication skills training), 120
online learning, via internet websites or CD-ROMs, 119
online research, adherence models and role of, 331
open-ended questions, adherence assessment, 378–379
(p. 510) operant conditioning, health-related behaviors and, 346–347
opinion leaders, clinical champions, 170
opportunities, including in CST (communication skills training), 116–117
oppressor, 136
optimistic bias, for many illnesses, 195
oral communication, making clear and understandable, 28
oral sex, adolescent sexual risk behaviors and, 416
orders, instructions given by physicians as, 160
organizational factors, understanding the influence of, 159–160
OSCEs (objective structured clinical examinations), 121, 127
outcome research, focusing on a restricted range, 66
outcomes, 188–189
communication reform and, 492–494
determined as in the self-regulatory model, 189
expectations and, 340–341
related to physician nonverbal behavior, 42
relationships with health literacy skills, 24–25
socioeconomic status and, 326–327
out-group, standard belonging, 256
outpatient oncology clinic, follow-up consultation in, 72
overhelping behaviors, family members speaking for older adults, 146
overweight/obesity
in adolescents and risk of, 419
in African Americans, 269–271
stigmatization of, 270
P
packaging design, adherence intervention in older people and, 442
PAPM (precaution-adoption-process model), 3, 394–395
parallel-process model of nonverbal communication (PPNC), 44–45
parental influences
in adolescence, 408–410
adolescent diabetes management and, 423–424
alcohol use in adolescents and, 412–414
essential in decision making, 140
influence on health, 56
nonsupportive of the child’s involvement, 139
pediatric diabetes, adherence and self-management, 471–473
parent self-efficacy, pediatric adherence and, 393
participants, rights and duties of, 72
partner, physician’s role as, 65
partners, focusing on, 16
partnership building, 75, 93
Partners in Health program, 490–494
pas de trois (a dance of three people), 139
passive communication style, of individuals with LHL, 25
passive participant, third person as, 137
past behavior, strong predictor of future behavior, 182
paternalism, 43
paternalistic decision-making model, 86
paternalistic physician-patient relationship, 43
pathways, 92
Pathways to Change system, 237
patient(s)
allowing to talk about illness experiences, 15
anxious less dissatisfied with physicians sounding angry, 41
approaches to involving, 85–86
beliefs and perceptions influencing motivation to adhere, 15
believing consequences of nonadherence are high, 16
calling into question physician’s clinical judgment, 74
as care receiver, 72
checking with, 113
with chronic diseases admitted to an ICU, 164–165
coaching on how to raise issues and express preferences, 98
with cognitive loss, 149
compliance with treatment, 177
distinction between education and persuading them, 207
encouraging to contribute, 112
experiencing illness gaining knowledge and confidence, 90
failing to recall information given during medical visits, 14
involving, 113
knowing as people, 15
with LHL (limited health literacy) more likely to make mistakes taking medications, 32
matching vocabulary of, 29
not involving in decision making to the level that they would wish, 111
not objective observers, 46
not often taking initiative during treatment discussions, 65
not viewing precision in carrying out recommendations as terribly important, 11
overcoming barriers to adherence, 16
partnering with and involving, 84–104
perceptions of communication and partnership main predictors of increased patient satisfaction, 93
physician intimacy with, 47
preference for involvement, 89
presenting themselves, 63, 64
rating physician’s nonverbal behavior, 46
retaining only a fraction of information given, 79
seen in primary care, 61
as source of feedback, 123
25% nonadherent, 10
understanding, checking, 112
wanting to be involved in treatment decisions, 14
patient activation, 94
patient active involvement, in the encounter for accurate recall, 61
patient adherence, 10, 42, 128
patient adherence and compliance, body of literature on, 10
patient anxiety, as leading barrier to shared decision making, 99
patient barriers, to patient partnerships, 99
patient-centered approach, 85–86
patient-centered care, 85–86
implementation of, 101–103
improving patient-physician relationship, 269
patient-centered clinical method, 57–58, 66
patient-centered communication
components of, 86
reform and public policy initiatives, 490–494
patient-centered intervention, 279
patient-centered model, 57–58
patient centeredness
affiliativeness and dominance as two core dimensions of, 43
components of, 94
of consultation, 93, 96
describing a moral philosophy of core values, 86
notion of, 43
patient-centered physicians, understanding the patient as a whole person, 43
patient characteristics, moderating influence of affiliative behaviors, 41
patient choice, providing freely available information to improve, 102
patient cues, doctors are poor at picking up, 110
patient education, 177–179
patient emotion cue test (PECT), 49
patient emotions, as a barrier to participation, 99
patient empowerment
changes affecting, 85
improving patient’s affective states, 94
patient factors
in adherence assessment, 378
adolescent obesity intervention and, 421–422
(p. 511) education interventions for adherence in older people and, 443
medication adherence in general population, 434–435
mental health care adherence and, 454–465
patient involvement
interventions impacting outcomes, 98–99
in medical decision making, 86
outcomes of, 92–95
patient and provider perspective toward, 89–92
patient outcomes and, 92–93
question asking, and perception of control, 98–99
shift toward, 84–85
patient knowledge, 96, 97
patient knowledge and recall, 98–99
patient participation
affected depression severity through adherence, 94
historical context of, 84–85
patient partnerships
barriers to implementation of, 99–101
implementing financial incentives for, 101–102
patient perspective, 94
patient-physician-caregiver triads, interaction style of, 147
patient-physician communication, racial and ethnic disparities existing in quality of, 269
patient-physician-interpreter encounters, 142
Patient-Physician Partnership (Triple P), 276, 277–278
patient-physician relationship, long-term, 85
patient preferences, importance of, 87
patient privacy, compromised, 138
patient-provider communication, conceptual model of, 25
patient psychological distress, noticing more accurately, 42
patient recall
lack of attention to approaches to optimize, 110
medication adherence and, 327–328
patient involvement interventions and, 98–99
patient registration system, adherence improvements and, 325
patient reminder system, adherence improvements and, 325
patients
exposure to better-off producing more favorable outcomes, 260
not making use of knowledge, 178
patients’ active engagement, encouraging, 14
patients and clinicians, collaborative nature of relationship between, 9
patients and physicians, interaction of, 68
patient satisfaction
of consultation, 96
decision aids affecting, 98
as most widely measured outcome, 93
as patient outcome, 40–41
patient self-disclosure, positively influencing, 42
patient’s health, influencing communication dynamics in medical visits, 141
patient’s perspective, 110, 112
patient trust
defined, 41
nonverbal behaviors affiliated with, 41–42
patterns of behavior, interaction efforts of, 51
pay-for-performance system, 102
PBC (perceived behavioral control), 181
PECT (patient emotion cue test), 49
pedagogical communication, effective, 115
pediatric adherence, 387–403
assessment and self-management of pediatric diabetes, 470–473
automated data collection, diabetes management, 473
behavior promotion strategies, 398
data-analytic assessment techniques, 390, 392–393
diabetes management and, 469–482
educational interventions for, 398
evaluation of, 401–402
future research issues in, 401–403
future trends in diabetes management, 482
global clinical ratings, pediatric diabetes management, 471–472
health-care-system influences, 397
intervention-based diabetes management, 477–482
monitoring systems, 390–391
peer support and, 397
promotion interventions, 395–400
real-world settings and promotion of, 402–403
scientific evaluation of interventions in, 400–401
self-report questionnaires, diabetes adherence and self-management, 472
single-parent families, diabetic management in, 476
social factors in diabetic management, 476–477
structured interviews, diabetes management, 472–473
suboptimal diabetes management, normative characteristics, 473–474
pediatric emergency room, interactions in, 138
pediatric encounters
future research on the triad in, 141
mother-reported satisfaction and recall, 61
pediatric intensive care unit (PICU), team communication in, 355–356
pediatric patients
effects of nonadherence in, 388–389
family and cultural influences on adherence in, 396–397
health behaviors in, 387–403
impact of nonadherence in, 388–389
influences on adherence in, 393–397
prevalence of nonadherence in, 388
psychological factors in adherence in, 396
research on nonadherence in, 389–395
pediatric visits, triadic medical encounters, 138–141
peer feedback, 123
peer role-playing, in CST (communication skills training), 121
peer support
adolescent diabetes adherence and, 480
adolescent sexual risk behaviors and, 416
enhancement of health behaviors, 315–316
in middle adolescence, 409–410
pediatric adherence, 397
pediatric diabetes management, 477
PEN-3 Model, 274–275
pentadic (five-person) medical encounter, 137, 150
perceived barriers, pediatric adherence and, 393
perceived behavioral control (PBC), 181
perceived benefits, pediatric adherence and, 393
perceived personal relevance or importance, of the communication, 253
perceived risk
associated with skin cancer prevention behaviors, 206
communication formats affecting, 201–204
conceptual and theoretical views of, 195–199
higher associated with more favorable outcomes related to tobacco use, 206
higher often a precursor to engagement in positive health behaviors, 205
relationship to health-related decisions and behavior, 193–208
understanding, 194
perceived severity, pediatric adherence and, 393
perceived susceptibility, pediatric adherence and, 393
percent days abstinence (PDA), 233, 234
perceptions of risk
changing in response to behavior, 194
as inherently subjective, 193
perceptual limitations, 158
peripheral route, of persuasion, 253
persistence, adherence and, 387–388, 454
in mental health care, 456
(p. 512) personal control, perception of, 183
personality traits, 184, 185
personalized counselor calls (PITT), 237
personalized health risk assessment tools, 204
personalized tailored materials, capitalizing on personal relevance, 261
personal model of diabetes, 183
Personal Models of Diabetes Interview (PMDI), 185
personal relevance, 253
persons of color, 271
persuasion
defined, 251
depending on how the content of a persuasive message is cognitively processed, 253
interconnectedness with social comparison, 252
lessons from, 252–253
stages of, 252
persuasion theory, research inspired, 263
persuasion variables, list of relevant, 253
persuasive messages, tailoring to a target’s attributes, needs, and interests, 261
pessimistic people, unrealistically overestimating risk, 195
pharmacy information system, adherence improvements and, 325
phases of change, speaking of rather than stages, 244
photonovellas, 276
physical activity
environmental attributes associated with, 270
pedometers encouraging an increase in, 281
social support and, 309–310
physical and social environments, contributing to dietary patterns, 270
physical closeness, associated with higher patient understanding, 93
physician(s). See also clinicians; health-care professionals
acting as a guardian of the patient’s best interests, 86
affiliative behaviors, 40
affiliativeness, 40–41
answering patient questions, 14
ceding some of their power to interpreters during triadic interactions, 145
concerned about family interpreters filtering information, 144
control over the conversation, 47
deciding which role to adopt in the conversation, 68
disadvantages for highly sensitive, 49
displaying affiliative behavior, 40
displaying controlling behavior, 40
effect of verbal and nonverbal behaviors, 14
expressiveness, 50
facial expressiveness, 42
gender, 41
giving sparse information, 110
infrequently implementing SDM (shared decision making), 91
infrequently taught about the management of multiparty encounters, 138
missing most cues and concerns, 111
negative behaviors, 60
nodding related to patient satisfaction, 40
nonsupportive of the child’s involvement, 139
not providing adequate information, 100
not using tools for promoting recall consistently or effectively, 62
receiving lowest ratings in patient surveys for their communication skills, 13
relatively poor levels of interpersonal sensitivity, 48
role of, 67–68
seeking to help patients manage their treatment, 65
sensitivity to emotional expression, 49
tending to underestimate amount of information patients desire, 100
touch increasing patient adherence, 42
traditional form of communication, 43
unlikely to directly address the child concerning medical matters, 139
physician behaviors
manipulations not always feasible, 48
related to at least one positive patient outcome, 40
physician communication-skills training modules, 102
physician-initiated monologues, on newly prescribed medications, 64–65
physician interpersonal sensitivity
assessing, 48–50
described, 38
physician nonverbal behavior
evidence of impact on patients, 50
majority of studies investigating, 51
types of, 40
physician-older-patient-companion relationship, 150
physician-parent-child interactions, turn-taking patterns during, 139
physician-patient communication, critical to foster a relationship of trust, 164
physician-patient information exchange, analysis of, 71–78
physician-patient nonverbal communication, theories and models, 43
physician-patient relationships
health outcomes and, 149
highly correlated with patients’ adherence to treatment, 163
types of, 43
typology of, 43–44
physician’s communication behavior, varying in consequence, 68
physician’s questions, misinterpretation and omission of by an ad hoc interpreter, 143
physician’s role, guises of, 68
physics, phase transitions in, 229
physiological and psychological health outcomes, impact of provider communication-skills training on, 96–97
The Picker Institute, initiative aiming to highlight future of patient partnerships, 101
pictographs, 31, 32
pictures, 30, 31
PICU (pediatric intensive care unit), team communication in, 355–356
pillboxes, simplifying process of taking multiple medications, 33
pillbox systems, technology improvements for, 328
pill-counting
clinical practice adherence assessment, 374
older people’s adherence measurements, 439
plain language, 28–29
PMDI (Personal Models of Diabetes Interview), 185
political issues
adolescent sexual activity interventions and, 418
team-based communication, 352–353
polypharmacy
adherence improvement in older people using, 440–442
adherence in older people and, 436
diabetes care communications, 357–360
PONS (Profile of Nonverbal Sensitivity), assessing nonverbal sensitivity, 49
populations, with higher rates of LHL (limited health literacy), 24
pork, as meat eaten by African Americans, 269
positive behaviors, advantageous to the individual, 275
positive frame, 159
positive prognosis, combined with a positive consultation, 59
positive reinforcement, health-related behaviors, 346–347
postgraduate training, reasons to incorporate CST (communication skills training) into, 127–128
post-traumatic stress disorder (PTSD), 455–456
post-treatment programs, alcohol/substance abuse in adolescents, 415–416
(p. 513) posture, nonverbal behavior expressed through, 39
poverty, barriers to health care services, 339–342
PPNC (parallel-process model of nonverbal communication), 44–45
practical clinical trials, adherence promotion through, 401
practice and rehearse
in CST, 124
providing opportunities for learners, 118
practicing clinicians, CST (communication skills training) provided for, 128–129
pragmatic process, patients engaged in, 64
precaution-adoption-process model (PAPM), 3, 394–395
precautionary behavior, 254
preclinical or early CST (communication skills training), structuring as a curriculum, 126
precontemplation
direct effect on action, 226
justification to ignore individuals who are not ready to change their behavior, 240
precontemplation stage, 215
precontemplators, 230, 239
predictive validity, 231
of TTM (transtheoretical model), 244–245
predictors, of outcome of treatment for alcohol problems, 232
pregnancy rates, adolescent sexual risk behaviors and, 416–418
preparation stage, 215, 222
prepared cases, effective use, 122
preparers, benefited most from self-efficacy-enhancing information only (SE condition), 239
prescribed drugs, increase in the number of causing problems with adherence, 165
prescription protocols
cost issues, fills and refills, 327
for older people, 432–433
presidents commission model, 87, 88
pretreatment assessment, 227
prevalence of nonadherence, pediatric patients, 388
preventive action, taking, 257
preventive health behaviors, 306–307
adherence and illness management, 311–312
adolescent sexual activity, intervention and delaying tactics, 416–417
gender and race in, 312–313
mental health care and, 458–459
obesity treatment in adolescents and, 419–420
screening behaviors, 310–311
social networks and support, 308–310
primacy, of the nonverbal, 39
primary-care physicians, involving caregivers, 148
primary-care settings, mental health adherence and, 463–464
primary nonadherence, 9, 372
private events, 69
probabilistic principles, laypeople not having a firm grasp of, 199
probabilistic risk information
aspects of communicating, 202
as inherently uncertain, 202
problem-based approach, to experiential sessions, 120
problem severity, factor representing, 226
problem solving
focusing feedback on, 123
pediatric diabetes, interventions targeting, 478
processes of change, 216, 231
process of communication, 109
professional communication, context of, 69
professional consultation, 57
professional interaction, 70
professional interpreters, 145
professional standards, developing to advocate for patient involvement in health care, 101
Project MATCH, 235–236
Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity), 219, 232
Project Sugar 2, 277–278, 280
promotion strategies
adolescent health-risk behaviors and, 412–424
clinical significance of adherence promotion, 401–403
pediatric adherence, 395–403
prompts, health-related behaviors, 346–347
prophylactic surgery, effects of, 205
prostate cancer population, decision aids affecting, 97
prostate-specific antigen (PSA) testing, decision aids affecting, 98
protection motivation, 181
protection-motivation model, 253
protection motivation theory, appraisal processes, 181
protective actions, representations of, 197
prototype, for a standardized medication label, 32
proven communication skills, flexibility in the use of, 66
provider barriers, to patient participation, 100
provider-based adherence strategies
mental health care adherence and, 460, 462–464
pediatric adherence promotion, 403
pediatric diabetes management, 476–477
provider communication-skills training intervention, 95
provider knows best, attitude, 100
provider-patient encounters, routinely involving meeting of strangers, 164
provider-patient relationships
adherence assessment, 370–371, 374–375, 378–380
adherence in older people and, 437–438, 443
age barriers, 343
clinical practice adherence assessment, 373–374
communication barriers in, 354–355
communication reform and public policy initiatives, 490–494
diabetes care communications, 357–360
pediatric adherence, 397, 399
pediatric diabetes management, 477
technology improvements, 329
trust erosion in, 333
providers
communication skills training, 95–97
preferences for involvement, 91–92
proximal outcomes, 92
proximal precepts, 40
proxy
having as much potential as, 255
sharing personal characteristics, opinions, experiences, and related attributes and modeled successful health behavior change, 262
pseudostages, charge of being, 219
pseudo-stage theory, TTM (transtheoretical model) as, 229
psychological constraints, 79
psychological context, of communication, 68
psychological factors
in adolescence, 409–410
adolescent diabetes management and, 423
chronic illness in adolescence, 411
medication adherence in general population, 435
mental health care nonadherence and, 454–465
pediatric adherence, 396
pediatric diabetes management, 474–475
psychological interventions, superiority in reducing glycated hemoglobin (HbA1c), 179
psychological perspective, change to, 55
psychological stress, considered the major cause of high blood pressure, 272
psychological theory, dearth of interventions incorporating, 61
psychological well-being, 94
psychosocial treatment, forms of, 235
(p. 514) PTSD (post-traumatic stress disorder), 455–456
pubertal development, early adolescence, 409
public events, 69
public policy, communication reform proposals, 490–494
punishments, health-related behaviors, 346–347
pure rationality, 79
pure stage model, 228
Pygmalion in the Classroom study, 340
Q
QALE (quality adjusted life expectancy), costs of nonadherence, 324
QI (quality-improvement) research, pediatric adherence evaluation, 402
QPLs (question prompt lists), 98–99
QPS (question prompt sheet), 61
qualitative approaches, 66
qualitative interpretations, of numerical risks, 200
qualitative manner, conveying uncertainty in a more, 202
quality, maxim of, 160
quality adjusted life expectancy (QALE), costs of nonadherence, 324
quality-improvement (QI) research, pediatric adherence evaluation, 402
quality issues, team-based communication, 353
quality of life (QoL), questionnaires assessing, 188
Quality Outcomes Framework, pay-for-performance initiative in the United Kingdom, 102
quantitative approaches to the analysis of communication, extremely limited, 66
quantitative information, reducing cognitive effort for, 158
quantity, maxim of, 160
quantity of information, team-based communication, 353
question asking, encouraging, 29–30
question design, data-analytic assessment techniques, 378–379, 390, 392–393
questionnaires, for assessing stage of change, 218
question prompt lists (QPLs), 98–99
question prompt sheet (QPS), 61
questions, encouraging, 27
Questions Are the Answers, 30
quick method, in RCQ (Readiness to Change Questionnaire), 220
R
race/ethnicity, differences in risk perceptions by, 199
race issues
adolescent obesity intervention and, 421
adolescent sexual risk behaviors and, 416
early adolescence, 409
social networks and support, 312–313
socioeconomic status and, 342–343
random clinical trials (RCTs)
adherence in older people and, 445–446
impact of nonadherence in, 389
randomness, using a dynamic, scattered icon array, 204
Rapid Estimate of Adults’ Literacy (REALM), 27
rational choice economics, 196
RCQ[TV] (Readiness to Change Questionnaire [Treatment Version]), twelve-item edition based on data from the UKATT, 220
RCQ (Readiness to Change Questionnaire) instruments, representing a simpler and more efficient approach to measuring stage of change, 223
RCQ (Readiness to Change Questionnaire) scale
quick method, 244
yielding a high coefficient a, 226
reactions, to importance of communication skills, 113
read-backs, use of standard, 166
readiness ruler, assessing readiness to change, 223
readiness to change
better seen as a continuum or as stages of change, 223–229
better viewed and measured as a continuum rather than as stages of change, 244
conceiving by analogy with phase transitions in physics, 244
continuous measure of, 219
defined, 216
shorter measures of, 223
Readiness to Change Questionnaire (RCQ), 217, 219–223
real patients, in CST (communication skills training), 121–122
real-world settings, pediatric adherence promotion in, 402–403
recall, of medical information, 42
recall abilities
adherence in older people and, 437–438
mental health care adherence and, 460
recall-promoting communication behaviors (RPCBs), 61–62
recapitulator, interpreter as, 143
reciprocity, in dominance behavior, 42
recognition scale, 223
recording encounters, with patients, 117
recycling, 215
redefined method, in RCQ (Readiness to Change Questionnaire), 220
refined method, using future research, 244
refined method of stage allocation, 222
reflection
defined, 116
specific materials for, 119
regulating gestures, 39
rehearsal, 118, 122
reinforcers, health-related behaviors, 346–347
relapse prevention techniques, 235
related attributes, 255
relational communication scale for observational measurement (RCS-O), 47
relational context, of communication, 68
relational discontinuity, 164
relationship-building communication skills, patient outcomes and, 59–61
relationship-centered care, 44
relative control, adopting a perspective of, 44
relative risk, 31, 194
relevance
maxim of, 160
team-based communication, 353
reminders, adherence intervention in older people and, 442
repetition, reinforcing information, 112
reporter, interpreter as, 143
representations, subcategories of, 69
representative heuristic, 200
representativeness heuristic, 197
requests, of all types, 69
research data, quantitatively derived informing educational programs, 66
research/data-collection system
adherence improvements and, 325
limitations of adherence interventions in older people and, 445–446
limitations of adherence studies in older people and, 446–447
residents, facing different challenges from undergraduate clinical learners, 128
resistance to change, countering, 169–170
Resnicow’s model of cultural sensitivity, 275
resource constraints, compounding communication challenges, 162–163
resource-related factors, mental health care adherence, 462
responder, interpreter as, 143
response set, 226
responsibility, poorly defined boundaries of, 162
resumption lag, cost of, 162
revised protection motivation theory, 196
rewards, health-related behaviors and, 346–347
risk
ability and/or willingness to estimate, 200
(p. 515) communicating, 202
communicating in a biased way, 111
lay and expert views of, 201
meanings of, 193
mental models of, 197
risk-action link information, 203
risk-as-feelings perspective, 197
risk awareness, increasing, 170
risk information, stimulating fear and worry, 198
risk judgments, influenced by prior information, 196
risk-likelihood information, adherence models and, 332
risk perception, many names for, 193
risk perceptions
excessively high problematic if causing anxiety, 195
going awry, 194–195
motivators of health-protective behavior, 204–207
topics for additional research, 207
risky behaviors
adolescent sexual activity, risk reduction interventions, 417–418
alcohol/substance abuse in adolescents, 414–416
obesity in adolescents and, 419–420
social support and networks and, 310
RMSEA (Root Mean Square Errors of Approximation), 228
role asymmetry, physician and patient, 67–68
role of speech, rhetorical in nature, 67
role-play, with simulated or real patients, 95
roles, of third party in an interaction, 136
Root Mean Square Errors of Approximation (RMSEA), 228
Roter Interaction Analysis System (RIAS), 46, 71, 276
Royal College of General Practitioners, 127
Royal College of Physicians, 127
RPCBs (recall-promoting communication behaviors), 61–62
S
sadness, 186
safety alerts, overridden, 169
SAM (selective accessibility model), 256
sanctions, team-based communication and, 352
SARF (social amplification of risk framework), 198–199
SAS Proc Traj procedure, adherence assessment, 393–394
satisfaction, of patients, 98–99
SBNT (social behavior and network therapy), 226
scheduling system, adherence improvements and, 325
schizophrenia, adherence in patients with, 455
school environment
alcohol use in adolescents and, 412–414
pediatric diabetes management in, 476–477
scientific evaluation, pediatric adherence, 400–401
SCMs (social cognition models), explaining relationship between beliefs and behaviors, 179–183
screening behaviors
adolescent diabetes management and, 423
defined, 307
mental health adherence and, 462–464
social networks and support and, 310–311
screening programs, barriers most important determinant of attendance, 181
screening questions, single-item, self-report, 27
SCSM (Social Cognitive Stage Model), tests of, 238–240
SDM (shared decision making) publications, exponential increase in, 89
SE condition, information on enhancing self-efficacy only, 239
Segue framework, 66
selective accessibility model (SAM), 256
self-affirmation, 256–257
self-assessment, difficult in regard to communication skills, 117
self-blame, leading to an emotional response, 180
self-defense, involving general sense of self-worth, 256
self-determination, increasing feelings among society, 85
Self-Determination Theory (SDT), 3
self-efficacy, 180, 182
mediating mechanisms, 313
mental health care limitations on, 461
pediatric adherence and, 393–395
perception of, 183
social cognitive theory, 393–394
social influences, 307–308
self-efficacy and temptation, measures of, 215
self-efficacy theory, 182
self-enhancement, 254, 255–256
self-esteem, natural tendency to protect, 254
self-evaluation, 254–255
self-fulfilling prophecy, poverty and, 339–341
self-help programs, kinds of, 237
self-management
adherence and illness management, 311–312
adherence assessment and, 379–380
chronic illness, 307
chronic illness and mental health issues in, 456–458
cognitive-behavioral therapy and self-monitoring, pediatric diabetes management, 479–480
pediatric adherence and, 398, 474–475
pediatric diabetes, assessment of, 470–473
pediatric diabetes, interventions targeting, 478
of rewards, 346–347
tasks relying on mastery of numeric concepts, 31
self-management behavior, achieving, 179
Self-Management of Type 1 Diabetes in Adolescents (SMOD-A) scale, 472
self-monitoring, technology aids for, 333–334
self-quitters, research on, 259
self-regulation, 2
self-regulatory model (SRM), 181, 182–183
self-regulatory theory, 182
self-report questionnaires, pediatric diabetes adherence and self-management, 472
senior clinicians, communication with junior counterparts, 162
sensitivity to dialogue, improving physician-patient communication, 67
serum cholesterol levels, downward trend, 1
severity (benign vs. life-threatening), 57
sex-education programs, adolescent sexual activity and, 417–418
sexual activity
barriers to health care and, 343–344
health-risk behaviors in adolescence and, 416–418
in late adolescence, 410
in middle adolescence, 409–410
sexually transmitted infection (STI), adolescent sexual activity and, 416–418
sexual orientation
barriers to health care, 343
in late adolescence, 410
in middle adolescence, 409–410
shame-free environment, establishing, 29
shared beliefs or knowledge, cornerstone of any mutual understanding between two people, 69
shared decision making (SDM)
achieving among lower education and literacy populations, 104
being taught at a university or professional level, 102
in clinical practice, 89
conceptual definitions, 87–89
core stages, 87
(p. 516) current practice has not embraced, 111
elements and qualities in prominently cited models, 88
growth and popularity of, 89
implementation remaining limited in practice, 103
implementing based on assumptions on which patients may benefit, 91
information-communication technologies and, 333
model, 86–87
planning, 113
provider perceived barriers to implementation of, 91–92
shift toward, 87
theory, rise of, 87–89
shared mental model, establishing, 162
shared understanding, achieving, 112
sharing power and responsibility, Mead’s third dimension of, 86
shorter consultations, related to poorer physician-patient communication and lower patient satisfaction, 100
Short Message Services (SMS), systematic dosing using, 328
show-me method, 30
show-me technique, 33
side effects
adherence in older people linked to, 436–437
as a cause for nonadherence, 17
significant others
behavior of, 184
influence of, 180
sign-out templates, standardized, 166
similar expert, 255
similarity information, searching for, 256
simplification approach, to changes, 3
simulated patients, in CST, 121
single exposure condition, participants assigned to, 262
single-parent families
adolescent obesity intervention and role of, 420–421
adolescent sexual risk behaviors and, 416
pediatric diabetes management and, 476
single-subject time-series analysis, adherence assessment, 390, 392–393
situational context, of communication, 68
Situation Background Assessment Recommendation (SBAR), 166, 167
situation-specific control expectancies, stronger predictive value for behavior, 180
skills, health literacy-related, 24
skills-based counseling, 235
skills practice, involving opportunity to role-play clinical encounters, 120
small-group discussions, 95, 119
small group experiential sessions, in CST (communication skills training), 119–120
smart packaging, medication adherence and, 327–328
smoking, as main problem behavior with TTM (transtheoretical model), 214
smoking abstinence rates, among newly diagnosed cancer patients, 206
smoking cessation
reports of abrupt, 230
social support and networks and, 310
smoking cessation interventions, guiding by both the TTM and addiction theory, 242
Smoking Processes of Change scale, 230
smoking rates, continuing to fall, 1
social amplification, 198
social amplification of risk framework (SARF), 198–199
social attenuation, 198
social behavior and network therapy (SBNT), 226
social cognition models (SCMs), explaining relationship between beliefs and behaviors, 179–183
social cognitive models, 2
social cognitive self-efficacy theory, pediatric adherence and, 393–394
Social-Cognitive Stage Model, 3
Social Cognitive Stage Model, clear improvement on TTM (transtheoretical model), 246
Social Cognitive Stage Model (SCSM), tests of, 238–240
social cognitive theory, 274
combined with TTM (transtheoretical model), 246
hypothesized determinants derived from, 231
social common ground, prerequisites defining an implicit, 63
social comparison
defined, 251–252
lessons from, 254–256
social comparison theory, health promotion, 345–347
social context, role in behavior change, 241
social determinants of behavior and behavior change, ignoring TTM (transtheoretical model), 241
social-ecological model, 274
social-emotional competency
adolescent diabetes management and role of, 423
adolescent health behaviors and role of, 424–425
health care access and, 412–414
mental health care adherence and, 461–462
social engagement, mechanisms of, 308
social environment, in PPNC (parallel-process model of nonverbal communication), 45
social factors
adolescent diabetes management and, 423
health care access and, 345–347
medication adherence in general population, 435
mental health care nonadherence and, 456
pediatric diabetes management, 474–475
pediatric diabetes management and, 476–477
team-based communication and, 352
social influences, alcohol use in adolescents and, 412–414
social integration, defined, 306
social interaction, nonverbal communication occurring in, 39
socialization, in STEPS (Steps to Soulful Living), 280
social learning theories. See social cognitive models
social media
adherence models and role of, 332–333
pediatric adherence intervention, 399–400
social networks
behavioral change vs. maintenance, 313–314
communication reforms and, 493–494
conceptual definitions, 306
educating and alerting people to health hazards, 198
enhanced support for, 314–316
exercise and diet support and, 309–310
(p. 517) future research issues, 316–317
gender and race factors, 312–313
health-related behavior, 305–317
illness and management behavior, support and adherence, 311–312
mediating mechanisms, 313
preventive health behaviors, 308–310
risky behaviors, 310
screening behaviors and, 310–311
self-efficacy and, 308
sources of support, 314
theoretical mechanisms, 307–308
social-norm campaigns, 259
social-outcome expectancies, 182
social support
adherence in older people linked to, 438
behavioral change vs. maintenance, 313–314
conceptual definitions, 306
crucial for implementation of most health-related behaviors, 16
enhancement of, 314–317
exercise and diet behaviors and, 309–310
future research issues, 316–317
gender and race issues, 312–313
health-related behavior, 305–317
illness and management behavior, support and adherence, 311–312
lack of associated with nonadherence, 16
mediating mechanisms, 313
mental health care adherence and, 462
pediatric diabetes intervention and, 480
preventive health behaviors, 308–310
risky behaviors, 310
screening behaviors and, 310–311
sources of, 314
theoretical mechanisms, 306–307
sociocultural context, of communication, 68
sociodemographic correlates, of risk perceptions, 199
socioeconomic status (SES)
adolescent diabetes management, adherence linked to, 423–424
adolescent obesity intervention and role of, 420–421
barriers to health, 339–342
equitable access to eHealth, 334–335
in late adolescence, 410
patient outcomes, 326–327
race, ethnicity and culture and, 342–343
SOCRATES (Stage of Change Readiness and Treatment Eagerness Scale), 223
readiness to change measured by, 236
soft skills, 55
spatial structure, of geriatric triadic encounters in Taiwan, 148
speaking time, distribution of during a medical encounter, 44
speech acts, 69–70
spouses, focusing on, 16
SRM (self-regulatory model), 181
stability, 180
stage-based interventions, 235–240, 245
stage effects, 232–233
stage matching, in clinical settings, 235–237
stage measures, correlating positively, 225
stage model of obesity care, 418–420
stage movements, determinants of, 230–231
stage of change algorithm, 217–218
Stage of Change Readiness and Treatment Eagerness Scale (SOCRATES), 223
stage of change transitions, predicting changes in drinking over time, 222
stages of change, 215
captured imagination of scientists and practitioners in the addictions field, 216
confused with the full model, 242
discontinuity needing to be present, 225
measuring, 217–223
predictive validity of, 231–235
stages-of-change model, 274
stage tailoring, 237–240
staging algorithms, claimed advantage, 217
standard intervention, 279
standardization, 165–166
standardized coding schemes, 46–47
standardized interpersonal sensitivity tests, 49
standardized self-help manuals (ALA+), 237
standards, lack of, in health-care communication, 355
starting point, assessing the patient’s, 112
state of change, versus a stage of change model, 223
state of change model, 229
statistical analysis, 227
statistical illiteracy, in the medical profession, 111
statistical information, presenting, 31
status asymmetry, between junior physicians and senior counterparts, 159
Steps to Soulful Living (STEPS), 277–278, 280–281
STI (sexually transmitted infection), adolescent sexual activity and, 416–418
stigmatization, mental health care nonadherence and, 456
stimulated recall method, 144
stimulus control computer, 238
stochastic process, 71
s-TOFHLA (Test of Functional Health Literacy in Adults, abbreviated version), 27
strategy
not having a workable, 13
as third component of IMS (information-motivation-strategy) model, 16–17
strategy-related factors
in adherence models, 333–334
mental health care adherence, 462
stress management
mental health care adherence and, 461–462
pediatric diabetes adherence and, 479
structural conditions in society, affecting rates of addictive disorders, 241
structural equation modeling
measurement models tested by, 227
supporting the TTM (transtheoretical model), 228
a test of the TTM (transtheoretical model), 224
structured goals, 166
structured interviews, pediatric diabetes adherence assessment, 472–473
study-specific coding schemes, 45–46
subclinical depression, 186
subjective expected-utility theory (SEUT), 196
subjective health measures, improvements of, 60
subjective measures, of patient centeredness, 95
subjective norms, 3
subjective probabilities, multiplied by perceived utility, 196
suboptimal adherence to treatment, as a major clinical problem, 62
suboptimal diabetes management, pediatric adherence, normative characteristics, 473–474
subordinate status, placing the child in, 139
substance abuse
as adolescent health-risk behavior, 412–416
prevention in adolescents, 412–414
treatment programs for adolescents, 414–416
substantive knowledge, presentation of guiding learners, 116
summarizing, reinforcing information, 112
sunscreen, intentions to use, 206
supermarkets, in wealthier neighborhoods, 270
support groups, social comparisons playing an important role, 260
surface structures, 275
surgeons, more dominant tone more likely to be sued, 42
synchronous channels, 156
systematic reviews
of effectiveness of communication training, 95–96
evaluating the effectiveness of decision aids, 97
systemic barriers, to patient partnerships, 100–101
systemic issues, as main barrier for implementing shared decision making, 91
system inertia, 169
systemwide communication, 155–170
T
tailored interventions, 275–276
tailored messages, 261
taking steps scales, 223
targeted interventions, differing from tailored interventions, 275–276
teach-back method, 30
teaching communication skills, effective strategies, 118–124
teach-to-goal technique, 30
team-based communication
barriers to, 354–355
cognitive artifacts and cognition distribution, 361–366
(p. 518) cognitive systems engineering, 366
diabetes care, 356–360
in emergency department, 356–357
field settings, 355–360
health-care information, 351–353
in pediatric intensive care unit, 355–356
political and legal issues, 352–353
verbal exchanges, 360–361
teams, working with multiple, 162
technological tools, making possible entirely new risk communication strategies, 204
technologies, ideal for facilitating SDM (shared decision making) and patient-centered care, 103
technology
adherence improvements and, 324–330
adherence interventions in older people using, 440–442, 445–446
cost management using, 326–327
decision-making error management, 325
dosing reminders, 327–328
equitable access issues, 334–335
future directions in health care, 335
pediatric adherence interventions and, 399–400
pediatric adherence promotion, 403
pediatric diabetes intervention, 480–481
provider-patient relationships, 329
role of, 166–169
systematic dosing and schedules, 328–329
team-based communication of, 352
technology tools, improving information exchange and health education, 33
telecommunications technology, pediatric diabetes intervention, 480–481
telemedicine, resisted by rural physicians, 169
tertius gaudens, 136
Test of Functional Health Literacy in Adults (TOFHLA), 27
tetradic (four-person) medical encounters, 137, 150
tetradic interaction, 138
tetradic visit, excerpts from a transcript of, 150–152
texting, not guaranteeing receipt, 168
text messaging, pediatric adherence intervention, 399–400
theoretical frameworks or models, for the investigation of physician-patient nonverbal communication, 43
theories, directly addressing role of culture in health interventions, 274
Theory of Planned Action (TPA), 254
Theory of Planned Behavior (TPB), 3, 181, 196
Theory of Reasoned Action (TRA), 3, 181, 196, 395
therapeutic effects, evidence linking affective/emotional or relationship-building skills to, 59
thinking, sharing as appropriate, 113
thinness, de-emphasizing as an outcome, 271
thin slices, 46
third individual, as someone working with the physician, 138
third party, relationship to the patient, 138
third person
changing interactional dynamics of medical interviews, 146
taking on multiple roles, 137
those who are not ready to change, TTM (transtheoretical model) ignoring, 240
threat, 185
handling by providing reassurance, 259
inducing fear control rather than precautionary behavior, 254
threat appraisal, 181
threatening affect, reducing, 200
threat information, generating danger control, 182
threat or fear figures, 253–254
three-component model, 10
three-factor model, 10, 12–17
three-function model, 58–59
tick-box medicine, 169
time constraints, 162–163
time domains, team communication and, 365–366
time interval, over which a risk occurs, 31
time line or course, of an illness, 183–184
time pressures, 91, 100
time-series models, adherence assessment, 390, 392–393
timing, of CST (communication skills training), 124–129
topic relevance, defined by the self-concept, 253
TPA (Theory of Planned Action), 254
TPB (Theory of Planned Behavior), 3, 196
TRA (Theory of Reasoned Action), 3, 181, 196, 395
training
in acquiring skills for patient involvement as vital, 91
for effective communication in healthcare settings, 109–132
lack of, in health-care communication, 355
training venues, options for, 129
train-the-trainers programs, for CST (communication skills training), 130
transitions in care, types of, 163
transportation, 261
Transtheoretical Model (TTM), 3, 214, 274
as atheoretical, 231
criticisms of, 216–217, 240–242
current status and future prospects, 245–246
descriptive rather than explanatory, 242
fitting a new paradigm for understanding addictive disorders, 243
ignoring many of the generally accepted determinants of behavior change, 245
integrated leading theory of human behavior and behavior change, 246
movement between stages not unidirectional, 229
new test of, 226–228
organizing and interacting constructs, 215
popularity of fundamentally ideological, 241
predictive validity, 244–245
stages of, 181
strengths of, 242–243
transtheoretical model of change (TMC; see also transtheoretical model), pediatric adherence, 394–395
treatment adherence, barriers and keys to, 9
treatment beliefs, 184
treatment effectiveness, 184
treatment efficacy, 180
treatment methods
alcohol/substance abuse in adolescents, 414–416
mental health adherence and, 463–464
mental health care adherence and information concerning, 460
treatment modalities, compared, 226
treatment representations, 187
triad, beyond, 150–152
triadic communication, in the geriatric medical encounter research agenda, 149–150
triadic encounters, content of, 149
triadic interactions, 136, 137
triadic medical encounters, example, 138–150
triadic partnership, between child patient, patient caregiver, and medical care team, 139
trust
in adherence assessment, 379–380
communication reform and building of, 492–494
of health professionals, 15
TRUST (Together, Responsible, Understanding, Satisfaction, and Thorough) encounter form, introducing, 61
trust relationship, breaking, 74
trustworthiness, of patients, 64
TSF (twelve-step facilitation therapy), 235–236
(p. 519) tuberculosis, qualitative studies on adherence to treatment for, 15
twelve-step facilitation therapy (TSF), 235–236
two-way exchange of information, between health-care professional and patient, 14
type 1 diabetes
in adolescents, management of, 422–424, 475–476
interventions for, 477–481
in pediatric patients, 469–470
type 2 diabetes
in adolescents, management of, 422–424, 475–476
behavior and lifestyle changes related to diet and physical activity, 271
interventions for, 481–482
in pediatric patients, 469–470
U
umbrella model, merging a continuous and a stage model of motivation to change, 229
uncertainty
within each new encounter, 55
surrounding health risk information, 202–203
uncertainty information, responses to receiving, 202
undergraduate students, communication skills taught to, 125–127
underlying general factor, representing problem severity, 228
understanding
aiding, 112
best achieved by talking and listening to patients, 13
confirming, 27, 30–31
lack of motivation, 13
unintentional adherence, in older people, 434
unintentional discontinuation of treatment, during care transitions, 164
unintentional nonadherence, 32
mental health care and, 460
United Kingdom, patient experience surveys, 102
United Kingdom Alcohol Treatment Trial (UKATT), 217, 226, 236–237, 245
United States, implementing legislation advocating for SDM (shared decision making), 101
universality, 180
universal precautions
in clear communication, 27
implementing, 28
versus screening, 26–28
University of Rhode Island Change Assessment (URICA), 218–219
unrealistic optimism, for many illnesses, 195
upward assimilation, outcomes of social comparison, 255
upward comparison, exposed to, 255
upward contrast, outcomes of social comparison, 255
URICA (University of Rhode Island Change Assessment), 218–219, 244
US Accreditation Council on Graduate Medical Education, 127
V
Venn diagrams, depicting shared mental model between communicating agents, 157
verbal behaviors, involved in relationship building associated with health outcomes, 60
verbal descriptors, merits and pitfalls of including, 202
verbal exchanges
metalinguistic aspects of, 69
team communication and, 360–361
video and audio recordings, in CST (communication skills training), 117–118
video recordings
capturing nonverbal and verbal behaviors, 117–118
of real consultations, 121
virtual reality technology, conveying health risk information related to gene-by-environment (GxE) interactions, 204
visual display, merits and pitfalls of including, 202
visual dominance, 39
visual methods, of conveying information, 112
voice, nonverbal behavior related to, 39
W
way to engage, with patients, 54–55
websites, providing information about health-care providers’ performance, 102
Webster packs, adherence improvement with, 328
weight loss, of women in the STEPS (Steps to Soulful Living) Study, 280
weight-loss interventions
for African Americans, 271
for African American women, 280
weight-loss programs, culture influencing success of, 271
wireless technology, coupled with portable handheld devices, 167
within-person variables, pediatric diabetes adherence, 474–475
women
barriers to health care for, 343–344
experiencing a heart attack, 197
higher absolute risk perceptions than men, 199
overestimating risk of developing breast cancer, 194–195
undergoing prophylactic mastectomy and/or oophotectomy, 205
word recognition test, 27
work environment, 355–360
World Health Organization (WHO), 9, 10, 85, 169
worry
about the consequences of a behavior, 198
stronger mediator than perceived risk, 206
X
XPERT program, 178, 179
Y
Yale approach, 252
younger age, associated with slightly higher risk perceptions, 199
younger patients, preferring a more active stance in medical decision making, 90
Z
zero tolerance approach, to risk taking, 195