1. Adherence "active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behavior to produce a therapeutic result“ It is the term used to indicate the actual cooperation of a patient in carrying out recommended directions and actions for the prevention or treatment of a diseas "active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behavior to produce a therapeutic result“ It is the term used to indicate the actual cooperation of a patient in carrying out recommended directions and actions for the prevention or treatment of a diseas

2. Compliance "the extent to which a person's behavior coincides with medical advice"

3. Noncompliance Means that patients disobey the advice of their health care providers

4. Compliance is the one area that providers can't control It is estimated that 30% to 70% of the recommended regimens are not followed

5. To improve patient adherence, it is important to understand why nonadherence occurs ???!!!!

6. The greatest success adherence is attained: 1- Believes that he or she is susceptible to the disease 2- Is Convinced that the disease can be prevented 3- Understands that prevention is preferable to disease. 4- Knows that he or she can modify the course of the disease

7. SELECTING METHODS OF INFLUENCING BEHAVIOR ALTERATION Many patients are willing to cooperate in employing health care procedures if they understand the reasons behind the recommended treatment The approach used to influence or to inform the patient should be guided by individual’s needs, motives, and self-established value

8. Authoritarian or Nonauthoritarian Styles The two ways for health professional to relate to patients

9. Authoritarian -Forceful -doing most of the talking and -Advice giving -with the patient expected to listen and to obey -Forceful -doing most of the talking and -Advice giving -with the patient expected to listen and to obey

10. Advantages of the Authoritarian Style 1-Some patients welcome the authoritarian approach, because it frees them from the responsibility of decision making; in this scenario the responsibility for initiating, altering, or maintaining the desired behavior remains in the hands of the authoritarian not in the hands of the patient

11. 2-Sometimes the authoritarian approach is absolutely necessary like in times of emergency when correct decisions must be made quickly to avoid life-threatening events 3-It is justified in dealing with individuals not capable of decision making; such as the young and the mentally retarded

12. Disadvantages of the Authoritarian Style 1-Authority often generates resentment and temporary grudging compliance, as long as the external pressure is being applied

13. 2-Excessive fear arousal leads to unpredictable behavior and the blocking out of other important information 3-Also, direct frontal attacks on personal value systems are often counterproductive. The confronted person may avoid the professional in the future or may even retaliate

14. Nonauthoritarian approach seeks to develop the potential of the patient's desire to satisfy his or her needs The health professional and the patient conjointly explore the various preventive options and planning objectives

15. Nonauthoritarian approach Learning and change best take place when a person is free to reject change This freedom of choice allows the patient to be his or her true self, thus increasing the possibility of learning new behavior (Carl Roger’s Paradox self theory)

16. Failure to show sensitivity to the feelings of others destroys the foundation of mutual trust and cooperation

17. Accurate Empathy: Emotional Understanding Human communication is essentially an exchange of feelings not information …. People seldom think. They always feel (Mittelman) Human communication is essentially an exchange of feelings not information …. People seldom think. They always feel (Mittelman)

18. Accurate Empathy Patients are allowed to have their own feelings and are appreciated for being themselves, regardless of their behavior Even though we have great difficulty in sharing our patients emotions, we should appreciate and be aware of those feelings Patients are allowed to have their own feelings and are appreciated for being themselves, regardless of their behavior Even though we have great difficulty in sharing our patients emotions, we should appreciate and be aware of those feelings

19. Environment

20. One of our most important tasks as professionals and as employers is to provide a growth enhancing environment If we create a repressive, inhibiting, or punitive environment, those around us will fail to self-actualize (eg, their natural growth processes will become distorted or diminished)

21. Modeling or Vicarious Learning One of the most important ways that people learn new behaviors and are motivated to maintain such behaviors is by observing others

22. Credibility gap To us as health professionals this means that our patients are going to look at us as being important models, especially in the area of health behavior If we don’t act as we say this gap often results in distrust or cynicism on the part of those exposed to such situations To us as health professionals this means that our patients are going to look at us as being important models, especially in the area of health behavior If we don’t act as we say this gap often results in distrust or cynicism on the part of those exposed to such situations

23. Behavioral Change Strategies for the Patient What strategies are available to eliminate the old behavior to substitute the new? 1- Positive thinking 2- Behavioral self-control

24. 1-Positive Thinking States that: "you can, if you think you can“ It concentrates on developing a positive attitude about succeeding at any given task and of developing a positive self-image The fundamental quality that an individual must possess to engage in such an approach is will power States that: "you can, if you think you can“ It concentrates on developing a positive attitude about succeeding at any given task and of developing a positive self-image The fundamental quality that an individual must possess to engage in such an approach is will power

25. 2- Behavioral Self-Control Behavior and attitudes are learned and then are maintained or altered by both environmental influences (cues) and the resultant consequences of that behavior Michael Mahoney and Carl Thoresen) )

26. For successful self-control: (1) Self-Observation specification of the behavior to be changed, (2) Environmental Planning identification of the behavior's previous environmental cues, and (3) Behavioral Management implementation of a plan to alter the cues or consequences or both as needed

27. 1-Self-Observation Paying attention to the behavior of interest and, very importantly, recording the level of occurrences of the behavior

28. Several benefits arise from careful monitoring of one's own behavior: (1) increased self- awareness, (2) immediate quantitative feed­back on what we are doing or not doing, and (3) information about the environmental cues and subsequent consequences

29. Research has demonstrated that keeping careful records of behaviors alone can alter their frequency

30. 2- Environmental Planning involves changing the environment so as to change the cues preceding a behavior Often this requires the elimination or avoidance of situations that trigger the undesired behavior

31. 3- Behavioral Management Deals with changing the consequences of a behavior rather than the triggering event or situation One approach commonly used is the “when-then" principle

32. Client Reinforcement External Reinforcement & Internal Reinforcement

33. Positive Reinforcement (External) Desired behavior must be rewarded to enhance the probability of its being repeated

34. Internal Reinforcement In terms of self-praise and feelings of accomplishment as means of motivating the maintenance of our new behavior

35. Patients deserve to know the cause of their dental diseases and how they can prevent them This is a responsibility for the health educator Once armed with the knowledge, however, the patient reserves the right to remain sick

36. In the final analysis, prevention is a shared responsibility between the practitioner and the patient