The Role of Health Promotion in Physical Therapy in California, New York, and Tennessee

Abstract

Background and Purpose. As health care providers, physical therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. The purposes of this study were: (1) to investigate perceptions of practice patterns in 4 focus areas of Healthy People 2010 (disability and secondary conditions by assessing psychological well-being, nutrition and overweight, physical activity and fitness, and tobacco use) and (2) to identify related self-efficacy and outcome expectations in California, New York, and Tennessee. Subjects. A instrument was pilot tested and distributed in 2 waves to 3,500 randomly selected, licensed physical therapists from 3 states: California, New York, and Tennessee. Methods. Interviews were randomly conducted via telephone with 23 physical therapists in all 3 states until similar responses were identified in order to create the qualitative instrument, which was then pilot tested with 20 physical therapists in California. The total number of qualitative instruments used in the data analyses was 417 (145 from California, 127 from New York, and 145 from Tennessee) or 11.9%. Results. The health promotion behavior most commonly thought to be practiced by physical therapists was assisting patients to increase physical activity (54%), followed by psychological well-being (41%), nutrition and overweight issues (19%), and smoking cessation (17%). Self-efficacy predicted all 4 behaviors beyond the control variables. Minimal state-to-state differences were noted. Discussion and Conclusion. Physical therapists believe they are addressing health promotion topics with patients, although in varying degrees and in lower than desirable percentages based on Healthy People 2010 goals. This study demonstrated that a physical therapist's confidence in being able to perform a behavior (self-efficacy) was the best predictor of perceptions of practice patterns and is an area to target in future interventions.

Linking health promotion with physiotherapy for low back pain: A review

“…Recent research has indeed highlighted the interest of integrating health promotion in rehabilitation interventions and research (55,56,60). As rehabilitation professionals, physiotherapists, who can be consulted directly without medical referral (71), are well suited to integrate health promotion in their field of practice (21,39,76,90,91). Hence, efforts should be made further to link and integrate principles and practices of health promotion in the field of physiotherapy to improve interventions at the individual, community and population levels.…”

Physiotherapists' Perceptions of Their Role in the Rehabilitation Management of Individuals with Obesity

“…Exercise and physical activity are both key components of physiotherapy practice and important elements in the management of individuals with obesity. [23][24][25][26][27][28][29][30] Physiotherapists manage clients who have secondary conditions resulting from obesity. For example, an analysis based on data from the Canadian Joint Replacement Registry found that among hip-replacement patients (n ¼ 7,538), 73% were classified as overweight or obese at the time of surgery, as were 87% of knee-replacement patients (n ¼ 9,706).…”

Health promotion, wellness, and prevention in hand therapy: A survey study

“…The perception of lack of time and resources is consistent with reported barriers to HPWP across different health care practice settings and disciplines. 29,37,[49][50][51][52] However, the perceived lack of patient interest is not consistent with the literature. Black et al 53 found that patients believed that engaging with PTs in personal discussions of physical activity, weight management, and smoking was appropriate.…”

“…18,19,[22][23][24][25][26] The PT literature most frequently addresses physical activity as the primary focus of health promotion. 6,[27][28][29][30][31][32][33][34] The roles of OT and PT in diet, weight management, sleep hygiene, stress, and smoking cessation are also supported in the literature. 6,[34][35][36][37][38][39][40] Hand therapists represent a confluence of education, beliefs, and practice.…”

“…The survey questions were adapted from multiple sources reported in the literature addressing health promotion attitudes and beliefs, areas of HPWP in rehabilitation therapist practice, and Behavioral Risk Factor Surveillance System data reporting healthy lifestyle characteristics in the US population. 6,[27][28][29]31,34,45,46 The survey results reported here consisted of 4 primary sections that gathered information on participants' demographics and credentials, professional practice information, beliefs related to HPWP, and professional wellness practice. The questions were posed in a multiple-choice format with several allowing free text for further clarification.…”