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

BL Rea, PT, RD, DrPH, is Assistant Professor, Department of Health Promotion and Education, School of Public Health, Nichol Hall, Room 1519, Loma Linda University, Loma Linda, CA 92350 (USA) (brea{at}sph.llu.edu).
H Hopp Marshak, PhD, is Associate Professor, Department of Health Promotion and Education, School of Public Health, Loma Linda University
C Neish, PhD, is Associate Professor, Department of Health Promotion and Education, School of Public Health, Loma Linda University
N Davis, PT, PhD, is Associate Professor, Department of Physical Therapy, School of Allied Health Professions, Loma Linda University

Address all correspondence to Dr Rea

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.

Key Words: Health promotion • Outcome expectation • Self-efficacy

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