Secondary prevention:
decreasing duration of illness, severity of disease and number of sequelae through early diagnosis and prompt intervention
population who has disease and limit the effect-- e.g. relatively short educational experience for people with respiratory disease. She did educational sessions about these diseases and most of them had asthma.
Tertiary prevention:
Limiting degree of disability and promoting rehabilitation and restoration of function in patients with chronic and irreversible disease.
function for people with an irreversible disease
Trends: % of elderly over 85, years of baby boomers, when will BB become 65, prevalence of chronic disease, chronic disease and minority populations?
↑ percentage of elderly are > 85 yo
Baby boomers
born between 1946-1964
will become 65 yo between 2011-2025
↑ prevalence chronic diseases (e.g. CAD, CHF, asthma, diabetes)
Chronic diseases have disproportionate impact on minority populations, women, children
Why weren't there a lot of studies being done on women, children, and minorities initially?
women- hormones cycle, they can be pregnant, children- stunt growth, challenging in minority populations- communication barriers (language), educational barrier (it should be at the 8th grade level),
Healthy People 2020: website, what is it, created by, when did it start?
www.healthypeople.gov
Healthy People 2020 = US health promotion agenda
Goals and objectives
Created by consortium of national organizations and state agencies
Since 1990, recreated every 10 years
What is healthy people 2020 basically?
Every ten years they make new objectives- we are in healthy people 2020, there is always a progress report
Goals of Healthy People 2020?
Attain high quality, longer lives free of preventable disease, disability, injury and premature death
Achieve health equity, eliminate disparities, and improve the health of all groups- this is new objective that wasn't focused on previously
Create social and physical environments that promote good health for all
Promote quality of life, healthy development, and healthy behaviors across all life stages
Healthy People 2020: A Cardiovascular Objective?
Category: Heart Disease and Stroke
Reduce the proportion of the persons in the population with hypertension, including
Adults
Children and adolescents
Healthy People 2020: Cardiovascular Objective Measure
1.) Baseline: 29.9 percent of adults aged 18 years and older had high blood pressure/hypertension in 2005-08 (age adjusted to the year 2000 standard population)
2.) Target: 26.9 percent
3.) Target-Setting Method: 10 percent improvement
Healthy People 2020: A Respiratory Disease Objective?
Decrease the proportion of children with asthma who miss school days
Healthy People 2020: Respiratory Disease Objective Measure?
Baseline: 58.7 percent of children aged 5-17 years old who had an asthma episode or attack in the past 12 months missed school days due to asthma in the past 12 months in 2008
Target: 48.7% percent
Target-Setting Method: Minimal statistical significance (the smallest improvement that results in a statistically significant difference when tested against the baseline value)
How can PTs help?
PT intervention:
education of the child and family of causes and starting to intervene more quickly
Healthy People 2020: A Physical Activity Objective
Increase the proportion of adolescents who meet current Federal physical activity guidelines for aerobic physical activity
Healthy People 2020: Physical Activity Measurable Objective?
Baseline: 18.4 percent of adolescents met current physical activity guidelines for aerobic physical activity in 2009
Target: 20.2 percent
Target-Setting Method: 10 percent improvement
PTs help?
PA with adolescents- incorporating in everyday practice, talk about it with pt., educators, and and schools.
Relationship to Physical Therapy Practice? How might a physical therapist incorporate the Healthy People 2020 goals/objectives into daily PT practice?
Goal 1 (cardiovascular health)
Goal 2 (pulmonary health)
Goal 3 (physical activity)
Goal 1- preach good diet and PA to decrease BP, also take BP so that the pt. awareness is increased.
Goal 2- educate the pt. and family members of the disease of asthma and how to decrease its onset.
Goal 3- eduction
Question: What screening activities might a PT be involved in directed at wellness and health promotion and where might these activities take place?
screening at a community health care or on a run
ergonomic screening
screening for fall prevention
screening for jobs
scoliosis screening and change the way they carry their backpack
soccer leagues, schools, or teams
Five Stages of Behavioral Change?
Precontemplation: has no intention to take action within the next 6 months
Contemplation: intends to take action within the next 6 months
Preparation: intends to take action within the next 30 days and has taken some behavioral steps in this direction
Action: has changed overt behavior for < 6 months
Maintenance: has changed overt behavior for > 6 months
What should you do if you ask the pt. if they have though about smoking cessation and they say no?
Stop the conversation right there.
Why should you always ask a person if they have thought about stopping smoking?
high # of health care professional-- it adds to the cumulative effect, the more someone reminds them the high chance they have to getting into the precontemplative stage.
"Move California" ? what is it, where to find it, and # of presentations?
CA-APTA public education initiative
Power Point presentations created by CA-APTA, available at http://www.ccapta.org
Downloadable and available for use by CA-APTA members
Currently 16 presentations.
Move California Presentations?
Putting the Doctorate in Physical Therapy
Cycling: Proper Bike Fit
Female Urinary Incontinence
Splashing into Aquatic Physical Therapy
Run More Efficiently
Low Back Pain
The Golf Swing: How Your Posture Affects Your Golf Swing
Practicing Good Posture
Infants Sleeping, Playing and Eating Positions: Influences on Motor Development, SIDS and Torticollis
Throwing a Safe Game: PTs Helping Young Arms Stay in the Game
Senior Wellness
Prevention of ACL Injuries in Female Athletes
Healthy Bones
Fit Families
Backpack Safety
Balance and Fall Prevention