Prevention, Health, and Wellness (week 15)

Health

General physical, mental, or spiritual condition of the body

Wellness

A state of good health often achieved through healthy lifestyle choices

Goals of Healthy People 2020

Attain high quality longer lives free of preventable disease, disability, and injury

Achieve health equity: improve health of all groups

Create social and physical environments that promote health for all

Promote healthy development and behaviors across all ages of the life span

The Role of Physical Therapy in Healthy People 2020

Screening

• Identify individuals who would benefit from education, intervention, or referral to appropriate health-care providers

Education

• Provide information on prevention, health, wellness and fitness

Intervention

• Provide intervention and programs identified in the screenings

Consultation

• Provide expertise and knowledge

Critical Inquiry

• Utilize and contribute to research

Administration

• Plan, develop, and manage wellness projects and programs

Three Types of Prevention Activities

Primary Prevention

• Preventing a target problem or condition

• Example: develop fitness programs to prevent childhood obesity

Secondary Prevention

• Decreasing the duration and severity of disease

• Example: develop resistance programs for patients with osteoporosis

Tertiary Prevention

• Decreasing the degree of disability with chronic or irreversible diseases

• Example: develop fitness programs for patients with SCI

Identifying Risk Factors

Pre-participation screening

• Prescreening questionnaire

Risk assessment

• Specific to condition like CAD or osteoporosis

• Provides guidelines and helps the therapist know to refer to physician or to proceed and monitor pt progress within established guidelines

behavioral change theories

Social cognitive theory - looks at a patient’s belief system (have to want to change and believe you can be successful)

Health belief model - patient must have sufficient concern about developing an illness and believe that it is possible to achieve the desired outcome despite possible barriers

transtheoretical model – 5 stages of change

Precontemplation – no thought about making any changes in the next 6 months

Contemplation – intends to make changes within the next 6 months

Preparation – has taken steps to making a change in behavior and plans to make changes in the next 30 days

Action – the behavior has changed for less than 6 months

Maintenance – has changed the behavior for more than 6 months

Additional factors affecting the ability to change

Motivation – how we move ourselves to act

Self-efficacy – one’s belief or confidence in completing a task or needed change

Physical

Exercise

• Muscular strength

• Muscular endurance

• Flexibility

• Cardiorespiratory endurance

• Body composition

Diet

• Fresh fruit and vegetables

• Small amount of meat (if any)

• Minimize sugar, processed and packaged foods

• 2 liters of water a day

Emotional

Maintaining a positive and joyful approach to life

Identifying and expressing thoughts, feelings, and behaviors in a controlled way

Stress reduction and relaxation

Intellectual

Involves creative activities

Stimulating mental activities to enhance neuroplasticity

Social

Someone’s ability to interact with others

Involves good communication skills

Involves healthy and respectful relationships

Creating support systems

Spiritual

Could involve meditation to become more aware of your inner self

Ability to practice your beliefs; helps us connect to others – Religion

Environmental

involves protecting and respecting our environment

Occupational

Working with integrity

Earning an income

Building supportive and relevant workplace relationships

You can find purpose and satisfaction by working

What makes someone continue an exercise program?

Effective leadership

Part of regular routine

No injury

Fun

Family support

Support group with peers

Regular updates on progress

Developing and Implementing a Program

Step 1: Assess the Need

• Id target audience

Step 2: Set Goals and Objectives

• Id purpose of the program

• Id goals

• Id objectives

Step 3: Develop the Intervention

• Screenings

• Education

• Exercise

• Logistics

Step 4: Implement the Program

• Recognize that adaptation and being flexible are important

Step 5: Evaluate the Program

• Participants do surveys about the program

• Get feedback

• Compare baseline to ending program

Additional Considerations

Exercise or activity has to be specific to the goals of the patient

Ask patient what would motivate them to participate

For children, program should be fun and less structured but have a specific time to do the program

For older adults, the program should start slowly, should incorporate activities into their daily routine, and should be easily accessible

Give handouts for screenings on the results and follow-up recommendations

Remember your audience when making handouts. Larger print for older adults, limit medical terminology

Include pictures of exercises

Consider the time commitment for yourself and the patient as well as the cost