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Coaching & Counseling Patients Time Tools For Nurses Launch Page
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A Resource from the American College of Preventive Medicine

There is little question that our daily behaviors, from lifestyle habits to self managing medical conditions, have a powerful effect on our health and quality of life. But a large gap exists between what the evidence shows that people should be doing and what they actually are doing. The statistics are daunting – a majority of Americans are overweight, inactive and not eating healthy, nearly one in four adults still smokes, many are non-compliant with their prescriptions and relatively few are doing a good job self managing their chronic disease. Until individuals are motivated to become more active participants in their own health management, the trends in escalating costs and poor health outcomes are likely to continue.

Clinician advice has been consistently shown to stimulate attempts to improve health-related behaviors. But, unfortunately, advice alone seldom results in long term success. Many patients want to change, but just don’t know how. Patients who are counseled in behavior change strategies have a much greater chance of success. However, clinicians face multiple barriers in providing such counseling, including lack of time, insurance disincentives, and lack of confidence in their ability to counsel and the patient’s ability to change. Consequently, few patients receive effective behavior change counseling.

This situation can be improved by several changes in office systems and provider practices. One promising development is the growth of health "coaching”. It is a simplified type of counseling that focuses strictly on developing and supporting a behavior change plan that the patient believes in. Patients with underlying psychological issues or more complex behavioral issues (e.g., addictions) require credentialed counselors or therapists. But, for many patients, a simple coach is sufficient. The advantage of coaching is that non-clinical staff can be trained to provide it, thus it serves well as a complement to physician advice.

The Coaching and Counseling Time Tool developed by the American College of Preventive Medicine is an innovative educational tool designed to assist the clinician in a more systematic approach to behavior change interventions. The tool includes a practical approach for a clinical visit using an assistant in a "coach” role; it also includes a robust clinical reference document delineating behavior change strategies, guidelines and recommendations, overcoming practice barriers, office system enhancements, along with additional tools and resources, and a patient handout.

This educational activity is intended for nurse practitioners.

After completing this program, participants should be able to:

· Describe barriers that must overcome to improve the delivery of behavior change interventions

· Describe strategies to improve the number of patients who are coached in behavior change

· Assess the readiness of a patient to consider a behavior change

· Describe principles of motivational interviewing

· Describe the 5A model for counseling on behavior change

· Assess the practice to identify ways to enhance office systems regarding behavior change

This continuing nursing education (CNE) activity was approved by the American Association of Occupational Health Nurses (AAOHN), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation

The American College of Preventive Medicine designates this educational activity for a maximum of 1.0 credit.

The estimated time to complete this activity is 1.0 hour.

To earn CNE credit for this educational activity:

  1. Read the CNE information on this page.
  2. Read the Time Tool and Clinical Reference.
  3. Complete the CNE post-test exam with a score of at least 70%.
  4. Complete the CNE evaluation survey.
  5. Your CNE certificate will be sent to you via email.


September 2010 through August 2012. Original release date: September 2010


These materials have been reviewed by the following nurse practitioners to ensure the continued scientific accuracy and medical relevance of information presented and its independence from commercial bias.

· Linda Turner, RN

Procter and Gamble

· Phyllis Symuleski, RN

Procter and Gamble

In the interest of providing an educational experience free of commercial bias the American College of Preventive Medicine was responsible for decisions regarding educational content and allocation of funds. All individuals involved in the planning, development, and delivery of educational activities are required to sign a conflict of interest statement in which they disclose any relevant financial interests or other affiliations with industry or other associations which may have direct and substantial interest in the subject matter of the CNE activity. Such disclosure allows program participants to better evaluate the objectivity of the information presented in the program.

  • Larry Mattson, Medical Writer, has disclosed no financial relationships.
  • Linda Turner, RN, has disclosed no financial relationships.
  • Phyllis Symuleski, RN, has disclosed no financial relationships.
  • Jennifer Edwards, ACPM staff, has disclosed no financial relationships.

The AAOHN’s support of this Time Tool for CNE does not imply any endorsement by the AAOHN of ACPM or its products/services.


This ACPM Time Tools series has been funded through an unrestricted educational grant provided by MDVIP.


If you have questions regarding this CNE activity, please contact cme@acpm.org





Copyright 2010 American College of Preventive Medicine. All Rights Reserved.

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