A survey of Alabama chiropractors regarding health promotion, primary prevention, and primary care (original) (raw)
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Journal of Chiropractic Education, 2010
To retrospectively review patient files in two teaching clinics in the United States and to assess the documented attempts to deliver health promotion messages when a chart indicated a need for health promotion or a red-flag condition that could be helped with positive behavioral changes. Methods: Approximately 100 patient files were randomly selected from each of two separate chiropractic teaching clinics, for patients seen after January 2007. Files were assessed for pertinent family history of diseases, personal medical history, and red-flag conditions of patients that would warrant intervention with health promotion. Results: Health promotion advice on at least one occasion was noted in 108 (53.7%) patient charts. Only 7 of 98 overweight or obese patients and none of those with family history of obesity were advised on weight management. Among 23 hypertensive patients, only 5 were advised and 17 of the 97 patients with risk of cardiovascular disease were advised. Conclusion: Chiropractic teaching clinics should assess what they are doing to help Americans reach their health goals. There is an opportunity to shape future practitioners so they include primary prevention as a part of what they do if the profession cares to move in that direction. Future research should look at mechanisms of delivery for health promotion, including better tracking of patients who need it and how staff doctors are trained to deliver oversight to interns in the area of primary prevention. (J Chiropr Educ 2010;24(2):159-164)
Journal of Manipulative and Physiological Therapeutics, 2011
Objective: The purpose of this study was to determine the familiarity with and stated advocacy of Healthy People 2010 objectives by member doctors of the Mississippi Chiropractic Association. Methods: Peer experts established face validity of a questionnaire regarding the Leading Health Indicators. This survey was distributed to 157 Mississippi Chiropractic Association members in 2009 during a conference and a follow-up by postal mail. Results: Most doctors of chiropractic in the sample (n = 68, or 43% response) consider themselves wellness-oriented health care providers. Forty-two percent had read, 29% had not read, and another 29% were unsure whether they had read the Healthy People 2010 national objectives. Almost half (44%) strongly or somewhat agreed that their office practice reflects support for the Healthy People 2010 objective. In contrast, 27% disagree and 29% were unsure if their practice reflects the Healthy People 2010 objectives. There were differences between support and practice behaviors for some of the objectives. Chiropractors who have read the objectives tend to be more supportive of the national goals. Doctors of chiropractic in this sample are supportive of most Leading Health Indicators, and the majority reports that they incorporate these public health goals into their practices. Conclusion: Familiarity with reading the Health People objectives seems to be related to reported practice behaviors. There is a need to improve the percentage of practicing doctors of chiropractic who are familiar with Healthy People objectives. Future health education initiatives may assist doctors of chiropractic in further incorporating public health objectives into their practice behaviors and improving quality health care. (J Manipulative Physiol Ther 2011;34:394-406)
A Survey of US Chiropractors on Clinical Preventive Services
J Manip Physiol Ther, 2004
Objective: To assess attitudes of current chiropractic students, public health faculty, and practitioners toward the topics of clinical preventive and health promotion services. Design and Population: Survey of samples of students and faculty at 10 US chiropractic colleges and random sample of US chiropractors stratified by zip code region using proportional allocation. Data Analysis: Descriptive statistics were computed for all 3 samples and statistical modeling was used to explore relationships between practitioner characteristics and their responses concerning counseling on health indicators. Results: A total of 582 students, 45 faculty, and 496 practitioners were surveyed; the response rate for practitioners was 27%. Over 80% of practitioners reported providing information to patients on musculoskeletal risk reduction, exercise, diet, stress reduction, and injury prevention. Over 80% also reported obtaining information from patients on physical activity, stress, dietary habits, obesity, medication use, and occupational hazards. Concerning immunization information, a much higher proportion of faculty (91%) and students (80%) than practitioners (62%) felt chiropractors should provide both pro and con information to patients. In general, female, younger, and more recently graduated practitioners appeared to be somewhat more likely to agree that chiropractors should provide counseling and to report providing it. An association was seen between attitudes toward health indicator counseling and respondent education. Practitioners with at least a bachelor's degree were statistically significantly more likely to report providing counseling for physical activity and to agree that chiropractors should provide counseling and to report actually providing counseling within the last month for substance abuse, responsible sexual behavior, mental health, and injury and violence prevention (P < .05). Conclusions: Our results indicate that a substantial proportion of the US chiropractors and students who completed our survey, as well as a number of key faculty, have a positive attitude toward providing clinical preventive services, particularly those related to physical activity and diet. However, the results also suggest that there may be areas where chiropractic training is not consistently meeting the newly established national guidelines for clinical preventive services.
Chiropractic care is among the more commonly used Complementary and Alternative Medical (CAM) therapies. Spinal co-morbidities include many of the most common causes of premature death and disability. Health promotion and disease prevention have been used in the profession and taught in educational settings but not yet fully embraced in usual practice. This manuscript reviews areas in which health promotion has been emphasized in chiropractic education along with instances in which health behavior theories (HBTs) have been applied. Chiropractic clinical and educational programs should consider application of HBTs to move clinicians and interns forward regarding better advising roles with patients related to prevention and health promotion.
Chiropractic & osteopathy, 2006
The chiropractic profession has long considered itself to be a preventive science. Recently the Council on Chiropractic Education (CCE) has defined a set of standards that must be implemented at all US chiropractic colleges as of January of 2007. These are specific to wellness measures and health promoting efforts that should be performed by chiropractors. This will mandate traditional health promotion and prevention methods be taught to students at accredited colleges and to practicing chiropractors. To present the idea of performing traditional health promotion and wellness-concepts in chiropractic practice as a call to action for clinicians and generate discussion on the topic. This manuscript discusses relevant topics of health promotion and prevention for chiropractors and other practicing clinicians that should be made priorities with patients in order to enhance both patient health and community and population health. All practicing chiropractors, as well as other clinicians ...
Journal of Chiropractic Education, 2009
The theory of reasoned action is a health behavioral theory that has been used to predict personal health behaviors and intentions as well as those of providers delivering health care. The purpose of this study was to determine interns' future practices regarding the use of health promotion using this model to develop survey questions and to determine attitudes and perceived influences on their prospective behaviors in general, toward the use of health promotion once in practice. Methods: Across the course of one year, all graduating interns at a chiropractic college were queried with a 20 question survey designed using the theory of reasoned action. Frequencies and inferential statistics were performed including prediction modeling using logistic regression. Results: A majority (>85%) of interns indicated they would use health promotion in practice. Differences were noted based on perceived skill levels, perception of educational emphasis, various normative beliefs, and gender. Conclusion: Most interns will use some form of health promotion in practice. Normative influences including those seen as key influencers are as powerful a predictor as perceived education or skill levels on future practice
Chiropractic and Public Health: Current State and Future Vision
Journal of Manipulative and Physiological Therapeutics, 2008
This article provides an overview of primary chiropractic issues as they relate to public health. This collaborative summary documents the chiropractic profession's current involvement in public health, reflects on past barriers that may have prevented full participation within the public health movement, and summarizes the relationship of current chiropractic and public health topics. Topics discussed include how the chiropractic profession participates in preventive health services, health promotion, immunization, geriatrics, health care in a military environment, and interdisciplinary care.
Journal of Manipulative and Physiological Therapeutics, 2010
Objective: The importance of integrating healthy behavior counseling into routine health care is universal but may depend on the type of medical care provider as well as the conditions presented by patients. The purpose of this study was to evaluate whether health promotion (HP) recommendations for known risk factors of arthritis differed between general medical doctors and doctors of chiropractic (DCs) in a nationally representative US population with arthritis. Methods: Multiple logistic regression models were used for analyses of data from the Sample Adult Core component of the 2006 National Health Interview Survey (n = 6374 diagnosed with arthritis). Analyses were performed separately for recommendation of weight loss and increase in exercise by health profession subtype (chiropractor and medical doctor). Results: Comparing the reported HP efforts between DCs and medical doctors (MDs), while adjusting for the effect of physical therapist and body mass index, we observed no significant differences (weight loss: adjusted odds ratio [95% confidence interval] = 0.76 [0.50-1.18]; increased exercise: adjusted odds ratio [95% confidence interval] = 0.87 [0.59-1.29]). Conclusion: Health promotion efforts to patients with arthritis do not differ significantly between MDs and DCs, as reported by National Health Interview Survey 2006. This investigation makes it difficult to suggest that DCs or MDs are doing all they can do to manage arthritis through suggested modification of lifestyle in their patients. More research specific to what is and can be recommended to those with arthritis should be conducted particularly because it relates to health-promoting behaviors. Given the recent implementation of required clinical competencies in HP into chiropractic college curriculums, future studies regarding translation of HP messages into public practice should be more informative. (J Manipulative Physiol Ther 2010;33:419-424)
Journal of Manipulative and Physiological Therapeutics, 2009
Objective: The causes of death in the United States have moved from infectious to chronic diseases with modifiable behavioral risk factors. Simultaneously, there has been a paradigm shift in health care provisions with increased emphases on prevention and health promotion. Use of professional complementary and alternative medicine, such as chiropractic care, has increased. The purpose of this study was to characterize typical conditions, modifiable risk behaviors, and perceived changes in overall general health of patients seeing chiropractors as compared with general medical doctors in the United States. Methods: Secondary analyses of the National Health Interview Survey 2005 adult sample (n = 31 248) were performed. Multiple logistic regression models were applied to assess associations of health conditions/risk behaviors of patients with the doctors (chiropractors vs medical doctors) they saw within the past 12 months. Results: Respondents who saw/talked to chiropractors were 9.3%. Among these, 21.4% did not see a medical doctor. Comparing chiropractor-only with medical doctor-only patients, we found no significant difference in smoking/alcohol consumption status, but chiropractor-only patients were more likely to be physically active (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.2-1.8) and less likely to be obese (OR, 0.7; 95% CI, 0.6-0.9). Respondents reporting acute neck (OR, 2.7; 95% CI, 2.2-3.2) and low back pain (OR, 2.4; 95% CI, 2.0-2.8) were more likely to have seen a chiropractor. Conclusions: Based on these analyses, Americans seem to be using chiropractic care for acute neck and low back pain more so than for other health conditions. However, there is no marked difference in their overall health promotion habits and changes in overall general health based on health care provider types. (J Manipulative Physiol Ther 2009;32:414-422)