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Bezner J.R.1, Ingman M.S.2, Black B.3
1Texas State University, Department of Physical Therapy, San Marcos, United States, 2St. Catherine University, Doctor of Physical Therapy Program, Minneapolis, United States, 3Oakland University, Physical Therapy Program, Rochester, United States
Background: Epidemiological data clearly reflect the association between noncommunicable or chronic diseases (cardiovascular disease, cancer, stroke, diabetes, etc.) and modifiable lifestyle risk factors (lack of adequate physical activity, smoking, inadequate sleep, unhealthy eating, etc.). Physical therapists are uniquely qualified and positioned within the health care system to assess, address and monitor these and other lifestyle behaviors in their patients/clients. PTs provide a dynamic link between health care and health because of their skill in creating a physical therapy plan of care that addresses the patient/client's functional limitations and is supplemented by their ability to provide a holistic and personalized plan focused on the modification of lifestyle behaviors. While PTs have the knowledge and skills to support patients/clients to adopt healthy lifestyle behaviors, they are not consistently capitalizing on the opportunities afforded to them in their daily clinical practices. Some of the barriers cited as to why there is a discrepancy between what physical therapists are capable of doing and what they are actually doing include low self-efficacy in how to advise/coach patients/clients on behavior modification and having low outcome expectations that the behavior changes made by their patients/clients will persist.
Purpose: The development, improvement, and practice of counseling skills by physical therapists in health behavior change and lifestyle coaching is paramount to successful adoption and maintenance of healthy behaviors in their patients/clients. The purposes of this effort are to develop and share an approach to integrating health behavior change coaching into physical therapist practice.
Methods: Selective theories of health behavior change, including the Transtheoretical Model, social cognitive theory, and self-determination theory, and contemporary counseling principles, including motivational interviewing, building self-efficacy, and assessing readiness to change, have been integrated into a methodology for providing health behavior change coaching by physical therapists. An assessment instrument PTs can use with their clients will be introduced.
Results: Few resources exist to guide PTs in the development and provision of health behavior change coaching, yet, PTs are in an ideal position to provide coaching for their patients/clients. The methodology developed by the authors is a useful resource for PTs worldwide to adopt and adapt to their unique practice settings.
Conclusion(s): The health behavior change coaching methodology developed by the authors is being integrated into physical therapist practice by PTs in the United States in a variety of settings, providing evidence that PTs can learn to effectively coach patients/clients on behavior modification.
Implications: The epidemic of noncommunicable disease worldwide will only abate when health care providers make it a priority to address modifiable lifestyle risk factors with their patients/clients. Physical therapists have an important role to play in this effort and must develop the knowledge, skills, and self-efficacy to facilitate behavior change in order to successfully address the societal burden caused by chronic disease.
Funding acknowledgements: This project was funded by a grant from the APTA (Black and Ingman) and by Texas State University (Bezner).
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: Ethics approval not required for this project as it did not involve human subjects.
All authors, affiliations and abstracts have been published as submitted.
