Health Promotion Practices in Two Chiropractic Teaching Clinics: Does a Review of Patient Files Reflect Advice on Health Promotion?

Abstract

Purpose: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)

Consensus Process to Develop a Best-Practice Document on the Role of Chiropractic Care in Health Promotion, Disease Prevention, and Wellness

“…The literature search terms were limited and may have missed additional relevant or more recently published articles in the area of health promotion, disease prevention, and wellness. [78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97] There was meager evidence in the literature to inform the panel about whether periodic screenings and manipulation of asymptomatic joint and muscle dysfunction can reduce the recurrence of future episodes of musculoskeletal pain or slow down the degenerative process. Chiropractic care for prevention of injury is a theory that should be investigated in future longitudinal observational research and cost-effectiveness studies to determine the preventive benefits of such care.…”

Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services

“…It was intended that this program be evidence informed, and fortunately, there was already substantial evidence to support this assimilation. [2][3][4][5][6] The literature clearly shows that the current health care paradigm is inadequate to support long-term quality of health, especially from a cost perspective, although some progress appears to have been made. 16,17 Even though the life span for the average person in the United States has increased significantly over the last 100 years, 17,18 the quality of life may not have been elevated, with lack of compression of morbidity (COM) being a prime reason for the quality-of-life issue.…”

“…The concept of wellness being part of a curriculum 2 or taught in chiropractic clinics [3][4][5][6] has been explored with mixed outcomes by other learning institutions. Upon checking the catalog of our college and speaking with several faculty members, we confirmed that health promotion and wellness concepts were embedded into the syllabi of a few classes.…”

Are Patients Receiving Health Promotion Advice in the Chiropractic Teaching Clinic Setting?

“…16 The clinic involved in the current study had participated in a two-campus assessment of patient files and found fragmented record keeping and scant evidence of engagement of patients on behavior change and goals set to monitor that change. 17 However, in a previous assessment at this college, interns' intentions to use HP after graduation was over 80%. 18 If interns intend to do this but do not show efforts while in training, the authors believe there may be a disconnect in this intention; it is necessary to develop a skill set to be successful at the practice level.…”