从指令到影响：物理治疗博士教育中关于残疾人士健康的社会决定因素和健康公平性教学的探索。

Instructing to Impact: Exploration of Doctor of Physical Therapy Education Instruction of Social Determinants of Health and Health Equity for People With Disabilities.

机构信息

College of Health and Human Sciences, Northern Illinois University, DeKalb, Illinois, USA.

Doctor of Physical Therapy Program, The University of Texas at El Paso, El Paso, Texas, USA.

出版信息

Phys Ther. 2024 Sep 4;104(9). doi: 10.1093/ptj/pzae070.

DOI:10.1093/ptj/pzae070

PMID:38738784

Abstract

OBJECTIVE

The aim of this study was to explore the instruction of social determinants of health (SDOH) for people with disabilities (PWD) in doctor of physical therapy (DPT) education programs.

METHODS

A sequential mixed methods study informed by a five-member disability community advisory panel was conducted. Qualitative semi-structured interviews with educators (n = 10) across 4 DPT programs in the Midwest were conducted and analyzed thematically. The qualitative findings formed the basis of the quantitative phase. An online survey was conducted with faculty of DPT programs in the United States (n = 254) with the most knowledge of instruction of SDOH and health equity for PWD (n = 74; 29% response rate). Quantitative data were analyzed with descriptive statistics and triangulated with qualitative data.

RESULTS

SDOH for PWD is an emerging component of instruction in DPT curricula. Five themes included: emerging instruction of SDOH for PWD; conceptual frameworks informing instruction; instructional strategies; barriers to integration of SDOH for PWD; and facilitators to integration of SDOH for PWD. Quantitative analysis revealed that 71 respondents (95.9%) included disability in health equity discussions primarily focused on health care access. Limited time (n = 49; 66.2%) was the most frequently reported barrier, and educator interest in disability health equity was the most frequently reported facilitator (n = 62; 83.7%) to inclusion of the SDOH for PWD in health equity discussions.

CONCLUSION

Opportunities exist in DPT curricula to build on instructional strategies, integrate SDOH frameworks, and amplify facilitators to integration of SDOH for PWD.

IMPACT

To meet the needs of the 67 million Americans living with disabilities, students must have the knowledge and skills to address the complex needs of this historically marginalized population. Understanding the DPT education landscape around SDOH for PWD can guide DPT educators to more fully prepare their students to recognize and ameliorate health disparities faced by PWD.

摘要

目的

本研究旨在探讨物理治疗博士（DPT）教育项目中针对残疾人士（PWD）的社会决定因素健康（SDOH）教学。

方法

本研究采用了由五名残疾社区顾问小组提供信息的序贯混合方法，对中西部四个 DPT 项目的教育工作者（n=10）进行了定性半结构式访谈，并进行了主题分析。定性研究结果为定量阶段奠定了基础。一项针对美国 DPT 项目教师的在线调查（n=254；对 PWD 的 SDOH 和健康公平教学最了解的教师人数 n=74；回应率 29%）与定性数据相结合。使用描述性统计对定量数据进行分析，并与定性数据进行三角分析。

结果

PWD 的 SDOH 是 DPT 课程教学中的一个新兴组成部分。五个主题包括：PWD 的 SDOH 教学的出现；指导教学的概念框架；教学策略；将 PWD 的 SDOH 融入教学的障碍；以及促进 PWD 的 SDOH 融入教学的因素。定量分析显示，71 名受访者（95.9%）将残疾纳入健康公平讨论，主要侧重于医疗保健获取。时间有限（n=49；66.2%）是报告最多的障碍，教育工作者对残疾健康公平的兴趣（n=62；83.7%）是将 PWD 的 SDOH 纳入健康公平讨论的最常见促进因素。