Models for provider-patient interaction: Applications to health behavior change

(from the chapter) In this chapter, we first describe the barriers to delivery of behavior change interventions in health care settings. Then, we describe several models which may be used to enhance provider–patient interaction to facilitate patient adherence and behavior change. We review a Systems Model described by J. M. Walsh and S. J. McPhee (1992) and a Patient Path Model (F. A. Pommerenke & A. Dietrich, 1992), both of which integrate patient and provider factors with the health care delivery system and organizational factors which impact the delivery of care and patient outcomes. We also discuss 3 models which focus in more detail on the provider–patient interaction: the Transtheoretical Model (J. O. Prochaska & C. C. DiClemente, 1986); Motivational Interviewing (W. R. Miller & S. Rolnick, 1991); and a Patient-Centered Patient Education model (U. Grueninger, F. Duffy, & M. Goldstein, 1995). The latter approach integrates features from the first two, and emphasizes the importance of tailoring interventions to the specific needs of patients and utilizing counseling skills to enhance the outcome of the encounter. Examples of interventions are given to illustrate potential applications of these models. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)