Rocky Mountain University of Health Professions, Provo, Utah.
Doctor of Physical Therapy Division, Duke University, Durham, North Carolina.
J Geriatr Phys Ther. 2021;44(1):25-34. doi: 10.1519/JPT.0000000000000289.
Physical activity (PA) promotion delivered by physical therapists is effective. However, little is known about how much PA promotion is integrated into outpatient US physical therapist practice. The purpose of this study was to determine the current PA promotion practices and factors that influence those practices among outpatient US physical therapists.
A sample of outpatient US physical therapists from the Academy of Orthopaedic Physical Therapy and American Physical Therapy Association (APTA) Geriatrics completed an adaptive online survey that included questions related to PA promotion practices and factors that influence those practices. We dichotomized levels of PA promotion as regular and irregular. Multivariable logistic regression was used to determine what factors predicted regular PA promotion.
A total of 522 individuals participated and 393 surveys were included in the analyses (75.3%). Most participants (58.5%) irregularly promoted PA and few reported always screening for patients' PA levels (12.7%). The strongest predictor of regularly promoting PA was screening for baseline PA (odds ratio = 5.07, 95% confidence interval = 2.23, 11.57). Physical therapists' own PA levels compared favorably to the US adult population and other health professionals and predicted PA promotion. Other factors related to capability, opportunity, and environment were predictors of PA promotion. Perceived lack of financial support from insurance companies, lack of support from clinical employers, and a perception of competing priorities were barriers to PA promotion. Despite being a public health priority, the majority of physical therapists surveyed infrequently screen for baseline PA and irregularly promote PA. Perceived financial barriers, lack of organizational support, and prioritizing other patient problems hinder PA promotion in the outpatient setting.
Despite guidance from national and international governing bodies, US outpatient physical therapists do not regularly promote PA to patients and perceive financial constraints and competing priorities as key barriers. Professional and patient stakeholders should be involved in designing pathways to improve PA promotion practices among outpatient US physical therapists.
物理治疗师进行的身体活动(PA)促进是有效的。然而,对于 PA 促进在多大程度上融入美国门诊物理治疗师的实践中知之甚少。本研究的目的是确定当前美国门诊物理治疗师的 PA 促进实践以及影响这些实践的因素。
来自矫形物理治疗学院和美国物理治疗协会(APTA)老年病学分会的美国门诊物理治疗师样本完成了一项适应性在线调查,其中包括与 PA 促进实践和影响这些实践的因素相关的问题。我们将 PA 促进水平分为常规和不规律。多变量逻辑回归用于确定哪些因素预测常规 PA 促进。
共有 522 人参与,其中 393 份调查被纳入分析(75.3%)。大多数参与者(58.5%)不规律地促进 PA,很少有报告总是筛查患者的 PA 水平(12.7%)。定期促进 PA 的最强预测因素是筛查基线 PA(优势比=5.07,95%置信区间=2.23,11.57)。物理治疗师自身的 PA 水平与美国成年人和其他卫生专业人员相当,并预测了 PA 促进。与能力、机会和环境相关的其他因素也是 PA 促进的预测因素。从保险公司获得的经济支持不足、临床雇主缺乏支持以及认为存在竞争优先事项是促进 PA 的障碍。尽管这是公共卫生的重点,但接受调查的大多数物理治疗师很少筛查基线 PA,并且不规律地促进 PA。感知到的经济障碍、缺乏组织支持以及将其他患者问题视为优先事项,阻碍了门诊环境中 PA 的促进。
尽管有国家和国际管理机构的指导,美国门诊物理治疗师并没有定期向患者推荐 PA,并且认为经济限制和竞争优先事项是主要障碍。专业和患者利益相关者应参与设计改善美国门诊物理治疗师 PA 促进实践的途径。