Seizing the Teachable Moment: A Pilot Study of Preventive Lifestyle Education in the Emergency Department

Abstract

Background Preventive measures are critical in avoiding and limiting the severity of diseases. Key lifestyle behaviors include sleep hygiene, habitual exercise, a healthy diet, and avoidance of risky substances, particularly the use of tobacco. The transtheoretical model (TTM) of change suggests that patients can move towards healthful changes through education. This emergency department (ED) pilot study assessed patients' readiness and confidence to adopt healthy lifestyle behaviors after receiving a brief video educational intervention. The study also investigated the impact of this preventive education on patient satisfaction. Methods Adult patients with low-acuity chest pain were prospectively randomized to a 10-minute video-based educational intervention. The sample size of 105 patients was chosen to demonstrate feasibility and provide data that could be used to design a larger study with a more diverse population. The outcome of this study used validated Readiness-to-Change and Confidence-to-Change questionnaires, along with selected questions from the U.S. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Patient Satisfaction Survey. A Student t-test was used to measure the difference in means between comparison groups where normal distribution could be assumed. A logistic regression model assessed the relationship between various factors and participants' readiness in changing their lifestyle behaviors. Results Of the 105 subjects enrolled in the study, 63 were female, and 42 were male. This pilot study found a nonsignificant increase in Readiness-to-Change among those older (40-80 years) who watched the video, more than those younger (18-39 years). This study shows positive trends toward patients being receptive to change and increased patient satisfaction when an educational video is shown. Feasibility was demonstrated by using a video prevention tool in the ED. Conclusion The ED presents a unique "teachable moment" for preventive lifestyle health education. However, lifestyle behavioral health interventions have been largely absent from this setting. This pilot study demonstrates the feasibility of a video teaching model for use while patients wait for their episodic care. Studies with more robust and diverse populations are needed to confirm these findings and to implement more engaging models of behavior change.

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