CCP Patient Engagement & Behavioral Change Strategies 2 — Questions and Answers
Question 1: A patient with type 2 diabetes consistently misses medication doses when traveling for work. Which behavioral strategy best addresses this barrier?
- Increase the medication dose to compensate for missed doses
- Conduct an environmental redesign by linking medication to an existing travel routine (Correct answer)
- Refer the patient to an endocrinologist for injectable therapy
- Instruct the patient to avoid travel until glucose is controlled
Correct answer: Conduct an environmental redesign by linking medication to an existing travel routine
Environmental redesign (habit stacking) links a new behavior to an established cue, improving adherence in variable settings like travel.
Question 2: Which principle of Self-Determination Theory is MOST directly supported when a care manager helps a patient choose their own chronic disease management goals?
- Competence
- Relatedness
- Autonomy (Correct answer)
- Extrinsic motivation
Correct answer: Autonomy
Autonomy—the sense of volitional choice—is the SDT principle most directly reinforced when patients select their own goals.
Question 3: During a follow-up call, a patient with COPD says, 'I know I should quit smoking, but I'm not ready to set a quit date.' Which response best reflects motivational interviewing principles?
- Remind the patient that smoking is the primary cause of their COPD progression
- Explore the patient's ambivalence by asking what concerns them about quitting (Correct answer)
- Provide a pamphlet on nicotine replacement therapy and end the call
- Document the patient as non-compliant and escalate to the physician
Correct answer: Explore the patient's ambivalence by asking what concerns them about quitting
Exploring ambivalence without confrontation is a core MI technique that helps patients articulate their own reasons for change.
Question 4: A care manager wants to evaluate a patient's readiness to increase physical activity. Which tool is MOST appropriate for assessing stage of change?
- PHQ-9
- Transtheoretical Model staging algorithm (Correct answer)
- SF-36 functional status questionnaire
- CAGE-AID substance use screen
Correct answer: Transtheoretical Model staging algorithm
The Transtheoretical Model (Stages of Change) staging algorithm directly classifies a patient's readiness to adopt a behavior.
Question 5: Which technique involves asking a patient to teach back information just provided to confirm understanding?
- Reflective listening
- Teach-back method (Correct answer)
- Motivational enhancement
- Cognitive restructuring
Correct answer: Teach-back method
The teach-back method asks the patient to explain information in their own words, verifying comprehension and identifying gaps.
Question 6: A patient with heart failure reports that her husband handles all the groceries and doubts she can make diet changes alone. Which construct of Social Cognitive Theory should the care manager target?
- Outcome expectations
- Self-efficacy (Correct answer)
- Observational learning
- Reciprocal determinism
Correct answer: Self-efficacy
Self-efficacy—one's belief in their ability to perform a behavior—is low here and must be strengthened for the patient to attempt dietary changes.
Question 7: Which action BEST characterizes the 'Ask-Tell-Ask' communication framework?
- Asking for permission, delivering information, then checking comprehension (Correct answer)
- Asking three assessment questions before any teaching begins
- Telling the patient what to do, asking if they agree, then telling them again
- Asking about barriers, telling the patient to address them, then asking if they will comply
Correct answer: Asking for permission, delivering information, then checking comprehension
Ask-Tell-Ask begins by eliciting the patient's current knowledge, provides targeted information, then checks understanding or reaction.
CCP Patient Engagement & Behavioral Change Strategies 2
A patient with type 2 diabetes consistently misses medication doses when traveling for work.
Which behavioral strategy best addresses this barrier?