Despite organizations such as the Centers for Disease Control and Prevention and the World Health Organization urging health care providers to address modifiable risk factors and risky health behaviors in patients, physical therapists are not “routinely” doing so, say authors of a recent study. The researchers believe a new clinical model could help bridge the gap between knowing and doing.
The model, known as the Health-Focused Physical Therapy Model (HFPTM), was developed by researchers at the University of Alabama at Birmingham (UAB), and is focused on encouraging smoking cessation and regular physical activity among PTs’ patients and clients. Results of their validation efforts were recently published in Physical Therapy (PTJ).
The HFPTM was developed as a preliminary model based on health promotion and education research. The model integrates community wellness programs with the PT's insight in anticipating health promotion needs for the population at large. From there, the PT screens for health promotion needs among patients and clients and then develops a health-focused management plan for those in need—a plan that could include referrals to other providers, treatment by the PT, or a combination. If the patient’s or client's care is not referred out completely, the PT then delivers "health-focused interventions" and analyzes outcomes. That outcome analysis creates a feedback loop that helps PTs further refine their understanding of health promotion needs at the community level.
To gather more insight and validate the model, the researchers convened a “Health Promotion and Education Initiative: UAB Summit,” in which a group of 21 health care researchers, educators, and practitioners from backgrounds as diverse as nutrition, medicine, public health, and physical therapy helped to flesh out the model by offering feedback and identifying which lifestyle behaviors are within the PT's scope of practice and which require referral to another discipline.
Summit participants viewed the interdisciplinary model as appropriate for the physical therapy profession and potentially useful for other professions. However, while participants perceived PTs as “well positioned” to provide health education and promotion services, they also suggested that PTs need to further develop “credibility” in areas such as stress management. Other areas were also identified as being in need of further attention by the physical therapy profession. These included handling payment and liability issues, developing screening tools and education materials, enhancing communication skills, and "building consultancy and referral systems to provide health-focused care for some unhealthy behaviors” outside of PTs’ scope of practice, authors write.
While the authors assessed the model’s content validity only for smoking cessation and regular physical activity, they hope the model will “prove particularly useful for physical therapists who do not feel equipped to provide health-focused care.” Researchers suggest that this model “could serve as a framework upon which educators may teach the integration of health promotion into customary clinical care to educate physical therapist students and clinicians.”
Authors of the study include APTA members Donald Lein, PT, PhD; Diane Clark, PT, DSc, MBA; Patricia Perez, PT, DScPT; David Morris, PT, PhD, FAPTA; and the late Cecilia Graham, PT, PhD.
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