Motl Robert W, Lein Donald H, Morris David M, Lowman John D, Perez Patricia, Bullard Cara
Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois, USA.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Phys Ther. 2022 Mar 1;102(3). doi: 10.1093/ptj/pzab266.
There is an increasing focus on health promotion in physical therapist research and practice. A clinical model (Health-Focused Physical Therapy Model) was developed for identifying major steps in the delivery of health promotion focusing on adoption of healthy lifestyle behaviors. One of the primary steps within this model is the design and delivery of behavior change interventions. Such interventions involve coordinated sets of activities that target change in a specific pattern of unhealthy behavior (eg, physical inactivity, smoking). This Perspective contends that the science and practice of behavior change interventions can be significantly advanced in the field of physical therapy (implementation science) through the integration of behavior change frameworks and techniques within the context of an experimental medicine approach for health behavior change. This perspective presents the integration of the Theoretical Domains Framework, the Behavior Change Wheel, including the Capability Opportunity Motivation-Behavior core system, and the Behavior Change Technique Taxonomy as a comprehensive approach for designing and delivering behavior change interventions in physical therapy. An experimental medicine approach is described, outlining a 4-step process in the design, delivery, and evaluation of behavior change interventions that can be applied to health promotion in physical therapist research and practice. The proposed integrative approach can advance public health and health promotion through healthy lifestyle behavior change in the field of physical therapy.
物理治疗师的研究与实践中对健康促进的关注日益增加。已开发出一种临床模型（以健康为重点的物理治疗模型），用于确定以采用健康生活方式行为为重点的健康促进实施过程中的主要步骤。该模型的主要步骤之一是行为改变干预措施的设计与实施。此类干预措施涉及一系列协调的活动，旨在针对特定的不健康行为模式（如身体活动不足、吸烟）进行改变。本文观点认为，通过在健康行为改变的实验医学方法背景下整合行为改变框架和技术，行为改变干预措施的科学与实践在物理治疗领域（实施科学）可得到显著推进。本文观点介绍了理论领域框架、行为改变轮（包括能力-机会-动机-行为核心系统）以及行为改变技术分类法的整合，作为在物理治疗中设计和实施行为改变干预措施的综合方法。文中描述了一种实验医学方法，概述了行为改变干预措施设计、实施和评估的四步过程，该过程可应用于物理治疗师研究与实践中的健康促进。所提出的综合方法可通过物理治疗领域的健康生活方式行为改变来推进公共卫生和健康促进。
