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Upon completion of this chapter, the learner should be able to:
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Define, describe, compare, and contrast terms related to health promotion.
Define, describe, compare, and contrast major models of health and disablement.
State examples of and describe health behavior theories/models.
Discuss issues related to adherence.
Identify and describe professional mandates for therapists to address health promotion.
Describe and discuss the role of the therapist in health promotion.
Describe and apply components of health promotion in neurorehabilitation.
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Health promotion includes all factors, information, and activities that improve the health status of an individual or population. Health promotion comprises a large body of knowledge representing many academic and clinical disciplines including education, public health, and psychology. This body of knowledge is being integrated into the health professions—including occupational therapy and physical therapy—and members of the health professions in turn are contributing to the body of knowledge as it applies to each profession’s work. O’Donnell (2009) defined health promotion as “the art and science of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health, and supporting them in changing their lifestyle to move toward a state of optimal health.” Although different disciplines have different foci and corresponding areas of expertise, health promotion is ultimately transdisciplinary as it involves researchers, academicians, and clinicians who share the common goal of improving the health of individuals and communities.
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The integration of health promotion into the health professions has intersected with evidence-based practice as another major trend in health care with an explosion of evidence supporting not only the health benefits of physical activity, including exercise but also mind/body considerations, including mindfulness-based stress reduction, sleep hygiene, and cognitive-behavioral therapy. The intersection of health promotion and evidence-based practice is becoming increasingly apparent as the nation grapples with the prevalence of expensive health conditions that have the potential to strain the overall health delivery system—such as diabetes mellitus and overweight/obesity—affected by lifestyle choices.
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Certainly there are many promising opportunities for rehabilitation therapists to develop and participate in niche or specialty programs in health promotion for their patients/clients. However health promotion for patients/clients does not merely comprise niche or specialty programs but rather should be inherent to clinical practice and represents best practice. Health promotion for patients/clients reflects the assertion of the Guide to Physical Therapist Practice (American Physical Therapy Association [APTA] Guide, 2015) that physical therapists are providers of primary care defined by the Institute of Medicine as “the provision of integrated accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing within the context of family and community.” It also fits the broad perspective of the vision statement for the physical therapy profession: “Transforming society by optimizing movement to improve ...