Economic evaluation in health care 3. Life tables and extrapolation 4.
By Eric Ries May When it came to choosing a dissertation subject for her doctorate in health promotion and wellness, Rupal Patel, PT, PhD, targeted a field about which she's passionate—diabetes prevention—and an understudied population—Asian Indians in the United States.
Type 2 diabetes is the fifth-leading cause of death among Asian Americans, and Asian Indians have the highest prevalence of it within that population.
Asian Indians who immigrate to Western countries are at risk of developing type 2 diabetes for reasons linked to the metabolic impact of a westernized diet and tissue resistance to insulin.
She developed a week group-based lifestyle-modification program to reduce diabetes risk factors. It included sessions on physical activity and diet behaviors, while also seeking to debunk cultural myths with which she was all too familiar—such as the belief among many Asian Indians that "physical activity that makes you breathe hard is harmful to your heart.
There's a built-in trust factor there. For several years, TWU students have been meeting the needs of people with early-stage dementia at a day facility in Houston named Amazing Place. It's part of Patel's effort to provide doctor of physical therapy students with experiential opportunities as part of a course on community health promotion.
Among other activities, students have helped redesign group exercise classes to better meet participants' needs, trained nurses to perform balance screens, and even encouraged attendees to drink more water by working with the facility's chef to infuse it with fruit and herbal flavors.
But we did our due diligence by identifying this need in our targeted population. We looked at the literature and developed a solution that could be implemented and sustained. More on that later. Bezner describes community health promotion as an inexact term that can mean different things to different people.
It's a bucket term for activities that can address a range of social and environmental factors. The goal is to give people more control over their health and greater ability to improve it. With the money, she's trained students to lead activities at 4 different locations.
They can't believe that such a simple thing as walking can really improve their quality of life. We talk about the importance of adopting healthy behaviors such as eating properly and managing stress.
They helped 1 person, for example, achieve her goal of walking down the aisle at her daughter's wedding with only her husband's arm as support, rather than a walker. They addressed another individual's boredom with exercise by creating a program that alternates treadmill sessions with yoga.
Tara Pearce, the school's associate director of clinical education in physical therapy, explained in UAB Magazine that maintaining a healthy lifestyle "can be a bigger challenge with students with disabilities because they sometimes need 1-on-1 support to participate" in physical activities.
Already, she's taught community education classes in falls prevention, strength training, balance and walking to older adults; has been active in the formation and development of the Council on Prevention, Health Promotion, and Wellness; and was installed as the council's chair at APTA's Combined Sections Meeting in February.
Last fall, Berglund signed on with Lifesprk, a home health company serving older adults that promotes what it calls "7 elements of well-being"—including aspects of health and wellness.
Berglund says she is looking forward to helping Lifesprk develop a robust community health promotion and injury-prevention program. Her enthusiasm is palpable. And we must do everything that we can toward—as APTA's vision statement says—"transforming society by optimizing movement to improve the human experience.
We must consider new delivery models. We need to step up and become leaders in health promotion. With conditions such as cancer, heart disease, and diabetes, risks are greatly lessened by behaviors such as engaging in physical activity, eating healthfully, getting sufficient sleep, and managing stress," Bezner notes.
So, we need not only to address these issues in the clinic during the course of physical therapy but also to figure out ways to do that with groups in our communities.
Community health promotion extends, too, to citywide mobility programs, direct-to-employer health services, and pro bono health clinics.
To read more about these efforts, see "Resources" at left. But while there's no single way to do it, there is a specific health care provider who's uniquely qualified to provide it: That trust facilitates discussion of behavior change—so, Berglund notes, many PTs already are comfortable asking health questions, discussing options, and referring out when individuals need help with exercise and physical activities.
PTs also are well-positioned to discuss with patients such lifestyle matters as healthful eating, getting sufficient sleep, managing stress, and smoking cessation—although, Berglund says, too few PTs tend to feel comfortable discussing those issues.
PTAs, too, are well-suited to roles in community health promotion, Bezner adds. They certainly have the needed abilities—although they may in some instances need some additional instruction in areas such as motivational interviewing and health coaching.
See "A Relevant Model" on page Addressing Barriers Ask PTs why they don't engage in community health promotion efforts, and they'll most likely cite 3 factors, say the PTs contacted for this article: Berglund suggests a possible strategy to address the first 2. Still, she says, it's important that PTs and PTAs seek opportunities to get involved in their local communities—whether or not they're getting paid for it.
We don't necessarily have to look very far, or venture into unfamiliar settings," she adds.Scrutiny of the use of antipsychotic medications in nursing homes has increased exponentially in the last 24 months, driven largely by congressional mandates to the Office of the Inspector General and the Centers for Medicare and Medicaid Services.
The clinical center offers group programs as well as individual services including oncology massage, acupuncture, physical therapy, nutrition, meditation, health psychology, and music therapy.
Our clinical model [Figure 1 ] is based on the bio-psychosocial model of care, first espoused by George Engel, seeking to incorporate therapies that. Sheri Robb talks about the fascinating and growing field of Music Therapy. On June 3, Sheri Robb and Ben Folds will team up for Breakthroughs with Music Therapy: Recovery, Resilience & Quality of.
Music therapy is a form of healing that uses music to provide care to patients, in a manner that is outside of the box. While this is different than routine physical therapy or prescribing medicine, it should not be thought of as a form of alternative medicine.
A growing body of research supports the health benefits of massage therapy. Educate your clients with AMTA's resources. Massage Can Improve Health and Wellness. of all health-care professional interventions.” 2 Quality of life is regarded as a key determinant of overall health.
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