Use of the Health Improvement Card by Chinese physical therapy students: A pilot study

Abstract

This study investigated the perceptions of Chinese physical therapy students on use of the Health Improvement Card (HIC) as a clinical tool to assess lifestyle and prescribe health education to others. The biometrics and health indices/attributes/lifestyles of these students were also evaluated with self-administration of the HIC. After a tutorial on the HIC and its clinical application, physical therapy students (n = 82) from two Chinese universities, completed the Chinese translation of the HIC followed by a questionnaire on students’ perceptions of it. Second, they invited a friend/relative to complete the HIC. Then, they provided feedback on the HIC’s strengths and challenges related to its administration. The data were analyzed with descriptive statistics and content thematic analysis. Response rate of self-completed HICs was 100% (n = 82) and that of questionnaires was 99% (n = 81). Participants’ age range was 20–34 years; mean body mass index (BMI) was 23.9±5.4 for men and 20.5±2.6 kg/m 2 for women. Generally, participants had low-risk BMIs (82%) and blood pressures (BPs) (91%), moderate-risk dietary habits (90%), but fewer had low-risk exercise habits (41%). Of 81 friends/relatives who participated, 25% had high-risk exercise habits. Student participants concurred the HIC is useful in developing lifestyle education programs. Challenges included uncertainty about obtaining laboratory data, serving-size quantities and confidence to effect lifestyle change in others. Although students appeared receptive to assessing health and lifestyle behaviors using the HIC, they reported being unconfident to prescribe long-term effective lifestyle advice. We recommend introducing the HIC in physical therapy curricula as an effective way of sensitizing emerging physical therapists to their responsibility to assess health/attributes/lifestyle non-communicable diseases (NCDs) risk factors. Prescribing lifestyle education/counselling warrants greater curricular focus. Further research will establish how HIC data and information can be effectively used as a clinical assessment and education tool to target health and lifestyle, and track behavior change over time.

A Randomised Controlled Trial to Evaluate the Administration of the Health Improvement Card as a Health Promotion Tool: A Physiotherapist-Led Community-Based Initiative

“…Dependent variables were measured or assessed at baseline and at three-month follow-up. First, the Chinese version of the HIC [8] was administered to participants by assigned supervised physiotherapy students. As part of the HIC, the following data were collected for each participant: (1) demographic data including gender, age, measured height, weight, and waist circumference (WC); (2) biometric data calculated body mass index (BMI), including random rather than fasting blood sugar (RBS), total cholesterol (TC), and systolic and diastolic blood pressures (SBP and DBP).…”

“…Twenty fourth-year physiotherapy students who received formal didactic and practical instruction in administering the HIC during their third year of study, as described by Wu et al [8], volunteered to participate. The study and its requirements were explained to the students by the investigators and signed consent was obtained.…”

“…Feedback from participating students about their experience with lifestyle education in the community was obtained using a modified, previously established questionnaire [8]. They were asked to rate their experiences based on twelve closed-ended questions using a four-point Likert rating scale (i.e., strongly agree, agree, disagree, and strongly disagree).…”

“…Open-ended comments on how the use of HIC could further be improved were also sought. The first seven of these twelve questions were from our previously published questionnaire [8].…”

“…Recently, the HIC has been translated into Chinese and integrated into the entry-level curriculum of the Department of Physical Therapy, Shanghai University of Traditional Chinese Medicine [8]. In the HIC Chinese translation study, physiotherapy students reported being receptive and confident in administering the HIC to assess an adult's health attributes and lifestyle behaviours, and prescribe a lifestyle behaviour change programme based on that assessment [8]. Although the HIC was developed for purposes of health promotion, there are no studies of either its effectiveness in modifying lifestyle practices, in turn, biometric health indices; or evaluation of it, as a routine clinical tool used by health professionals.…”