Global health: NCDs (FS-13)

The third physical therapy summit on global health: health-based competencies

Elizabeth Dean (Canada), Gloria Umerah (Nigeria), Armele Dornelas de Andrade (Brazil), Anne Söderlund (Sweden), Margot Skinner (New Zealand)

Focused symposium

Sunday 3 May 2015, 16:00-17:30, Hall 406

The third physical therapy summit on global health: health-based competencies

Dean E. 1, Umerah G. 2, Dornelas de Andrade A. 3, Söderlund A. 4, Skinner M. 5

1University of British Columbia, Physical Therapy, Vancouver, Canada, 2University of Nigeria Teaching Hospital, Physiotherapy, Enugo, Nigeria, 3Universidade Federal de Pernambuco, Fisioterapia, Recife, Brazil, 4Mälardalen University, Västerås, Sweden, 5University of Otago, School of Physiotherapy, Dunedin, New Zealand

Learning objectives

  1. To review the outcomes of the action plans designed to promote health-based physiotherapy practice competencies and entry-level education, that were implemented across WCPT regions following the 2011 Summit (38 international co-authors, in press)
  2. To present an evidence-informed decision-making algorithm for prioritizing health-based competencies into physiotherapy practice and entry-level curricula considering regional health priorities
  3. To compile the proceedings of this Third Summit related to prioritizing health-based competencies into practice and entry-level education for distribution across WCPT regions (i.e., to practitioners, educators, and professional organizations), and evidence-informed health assessment/evaluation tools and interventions/strategies to effect multiple health behaviour change and continue dialogue through a dedicated blog.

Description

Physiotherapists are the leading established non-pharmacological health professionals. The profession's long-standing commitment to health and wellbeing is most notably evidenced by the adoption of the ICF by the WCPT and increasingly its member countries. The ICF reflects the social and physical contexts of people's health and wellbeing; factors that have been largely implicated in the pandemic of non-communicable diseases. Further, the ICF is predicated on the World Health Organization's definition of health in which health is viewed not as the remediation of impairment but as 'a complete state of physical, social and emotional wellbeing'. Finally, the literature unequivocally supports the association of healthy lifestyles with less morbidity and premature death, and improvement in quality of life in proportion to one's healthy lifestyle practices. Given this, this symposium is designed to facilitate the global engagement of physiotherapists with respect to prioritizing health-focused competencies within practice and education. Based on multiple reviews in the literature and previous Physical Therapy Summits on Global Health (WCPT Congresses 2007 and 2011), both the evidence and momentum within the profession globally, support this initiative and regard it as both urgent and a professional responsibility (see publications of participants). Non-communicable diseases including those related to lifestyle behaviors are leading causes of morbidity and premature death in middle-, low-and high-income countries.. Recommendations from the Second Physical Therapy Summit on Global Health (Physiotherapy Theory and Practice, in press), included the need to develop health-based competencies with attention to regional priorities and cultural variations. Systemic barriers that have limited the rate of this knowledge translation into physiotherapy practice and entry-level education, identified in previous Summits, are to be reviewed in this Summit in terms of their current status, improvement and outcomes. Health-based physiotherapy tools and strategies to be discussed include health assessment/evaluation tools (e.g., general and condition-specific tools, quality of life, and life satisfaction), and evidence-based multiple health behavior change interventions/strategies (e.g., trans-theoretical model of readiness to change health behavior, motivational interviewing, decision balance analysis, and the 5 A's endorsed by the WHO for individuals showing readiness to change and the 5 R's for those who are less ready to change). Tools and strategies will be selected based on how readily they can be integrated into practice across settings and patient/client groups and within the curricula of entry-level physiotherapy programmes. Health behavior change is best achieved through inter-professional collaborative practice (ICP), thus physiotherapists also need criteria/indications for referring to other professionals and means of following-up irrespective of which professional initiated the health behavior change programme. Finally, access to the health assessment/evaluation tools and interventions/strategies for health behaviour change will be made available to participants, to implement and provide feedback via a dedicated blog. In this way, refinements to existing tools and strategies can be implemented, and additional tools and strategies made available as needed.

Implications / Conclusions

The prioritization of health-based competencies in physiotherapy practice and entry-level education will enable practitioners and students alike to effectively address patients'/clients' health threats related to adverse lifestyle behaviours either as a primary concern or concurrently with other interventions. This will enable physiotherapists to more fully demonstrate their roles in averting non-communicable diseases through. non-pharmacological interventions and strategies for the prevention, reversal as well as management of these conditions. An inventory of evidence-informed tools to guide the assessment/evaluation of risk factors for non-communicable diseases (specifically, ischemic heart disease, hypertension and stroke, type 2 diabetes mellitus, obesity, smoking-related conditions, and cancer), and of interventions/strategies for effective multiple health behaviour change will be developed. The evidence-informed tools and interventions/strategies are those that are most amenable to being integrated within the physiotherapy context (patient types and settings). The use of a dedicated blog will enable the dialogue to continue after the Summit, and for tools for assessing health behaviours and risks, and interventions/strategies for effecting health behaviour change to be modified based on on-going feedback from practitioners and educators.

Keywords

Health-focused competencies; Non-communicable diseases; Lifestyle-related behaviours

Funding acknowledgements

None

Relevance to WCPT and expected audience

Although the construct of 'health' underpins the International Classification of Function, Disability and Health (ICF) (long advocated by the WCPT for adoption by its member countries), guidelines pertaining to health-focused competencies for physiotherapy practitioners and educators have not been clearly established. This Summit aims to provide a foundation for developing health-focused competencies (that can be integrated within standard physiotherapy practice) that are consensually-agreed upon across WCPT regions, considering their varying health priorities.

Target audience

Physiotherapists across settings and patient/client groups. , physiotherapy educators, researchers, administrators, professional body representatives particularly those responsible for professional development, policy and entry-level competencies.