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LEARNING OBJECTIVES

  1. Explain the importance of health promotion and wellness initiatives.

  2. Describe the role of physical therapists in health promotion.

  3. Differentiate among the terms health and wellness, illness and disease, quality of life, primary, secondary, and tertiary prevention, population health management, health promotion, health education, physical activity, and exercise.

  4. Discuss the evolution of models of health from the biomedical model to the current International Classification of Functioning, Disability, and Health (ICF) biopsychosocial model of human functioning.

  5. Identify measures of health and wellness, health behaviors, and quality of life.

  6. Describe key modifiable personal health behaviors.

  7. Identify and discuss key theories of behavior change.

  8. Explain health coaching and motivational interviewing.

  9. Explain how physical therapists can incorporate health promotion and wellness concepts into the plan of care for individuals with impairments and disabilities.

THE IMPORTANCE OF HEALTH PROMOTION AND WELLNESS INITIATIVES

An individual’s health is determined by the interaction of numerous factors, including biology and genetics, social and physical environments, health services, and individual behaviors.1 Unhealthy behaviors are contributing to an increase in chronic disease and disability in the United States and other countries, affecting both the health of individuals and their quality of life.2,3 It is estimated that over a third of premature deaths in the United States are caused by lack of exercise, poor diet, and cigarette smoking.4 Obesity rates in the United States continue to climb contributing to the development of chronic diseases associated with obesity such as heart disease, stroke, type 2 diabetes, and certain types of cancer.5 According to the 2015 Behavioral Risk Factor Surveillance System (BRFSS), the annual telephone survey of more than 400,000 adults in the United States, over 65% of the adult population is overweight or obese6 (Fig. 29.1). In the same survey, when asked if they participated in any physical activities during the past month, 22.3% of respondents answered no, and 17.5% of respondents indicated they currently smoke.6 Fruit and vegetable consumption continues to be low among adults in the United States, with only 13.1% meeting current fruit intake recommendations, and only 8.9% meeting vegetable consumption recommendations.7

Figure 29.1

Weight Classification by Body Mass Index (BMI). (From Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data [online]. 2015. Accessed August 20, 2017. URL: www.cdc.gov/brfss/brfssprevalence/.)

There is also mounting evidence of the importance of sleep to an individual’s health. Sleep insufficiency has been linked to increased risk of motor vehicle and industrial accidents and an increased risk for developing chronic diseases such as hypertension, diabetes, depression, obesity, and cancer.8 Data from 444,306 adult respondents in all 50 states and the District of Columbia on the 2014 BRFSS indicated that more than one-third of ...

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