ON-LINE APPROACHES IN THE PHYSICAL ACTIVITY PROMOTION OF SLOVENIAN PHYSIOTHERAPISTS WORKING IN THE PRIMARY HEALTH CARE DURING THE COVID-19 EPIDEMIC

A. Backović Juričan¹, T. Knific¹

Background: Promoting and enabling varied, safe and regular physical activity (PA) has a beneficial effect on the resilience and health of individuals and population. It can protect against communicable and chronic diseases. During epidemic, vulnerable groups are more prone to deteriorating health, so regular access to health services is even more important. During the COVID-19 epidemic physiotherapists (PTs) were forced to adapt their way of working with patients/clients.  

Purpose: In consequence of population aging and the global pandemic of chronic diseases, the need for PTs in the area of health promotion and prevention is increasing. In Slovenia they work mostly in the primary health care, performing individual counselling and group workshops. The latest COVID-19 epidemic took them by surprise, so they had to change their approaches fast and accordingly. They came up with some innovative, feasible and safe approaches in their everyday work.

Methods: At the primary health care level 31 Health education centers (HECs) and 28 Health promotion centers (HPC) have been operating countrywide. The HECs have a standard interdisciplinary team consisting of a nurse, a psychologist and a physiotherapist, while the HPCs have an extended team additionally including a dietician, a kinesiologist and a medical doctor. Staff is a part of a national program called Together for health, which is fully financially covered by a Health Insurance Institute of Slovenia (HIIS) and managed by a National Institute of Public Health (NIPH). The program offer a wide range of structured and standardized non-medication interventions, which are aimed for people with risk factors and chronic patients. PA interventions, performed by 75 PTs countrywide, include individual approaches for adults (e.g. screening for functional disability and individual PA counselling) and group workshops (including PA assessment and fitness testing, behavior change, patient empowerment, pre-natal exercise classes). PTs have many opportunities to work in the local community too.

Results: During COVID-19 and with the professional support of the NIPH, Slovenian PTs (for the first time in history) were enabled to perform online services such as e-individual counseling and e-workshops for patients/clients, with which the HIIS agreed. Furthermore they started regularly producing short exercise videos for different age population/target groups and creating e-promotional materials with PA content for local community. Exercise videos and e-promotional materials were posted at their own HECs/HPCs website and different social media such as Facebook or YouTube, so the much wider range of population could benefit from it even during COVID-19 epidemic.  

Conclusion(s): In the past PTs services were executed only live/in person, but COVID-19 epidemic forced them to shift to e-Health and start performing on-line services. With this innovative approaches they started reaching some target groups that were mostly unreachable before, such as younger adults, work occupied individuals and some disabled groups.

Implications: Within the HECs/HPCs team PTs play an important role in the promotion of PA, both within the health care system and in the local community. Due to their specific knowledge and COVID-19 epidemic a need emerged for them to adapt their regular public health approaches to more innovative ones such as on-line approaches.

Funding, acknowledgements: Special thanks to National Institute of Public Health, the Health Insurance Institute of Slovenia and involved physiotherapists from the practice.  

Keywords: Primary health care physiotherapists, Physical activity interventions during COVID-19, On-line approaches

Topic: COVID-19

Did this work require ethics approval? No

Institution: National Institute of Public Health in Slovenia

Committee: National Medical Ethics Committee

Reason: Authors work for the NIPH and are obligated to support/nationally manage PA interventions performed by PTs in the primary health care.