The leading cause of morbidity and mortality in the United States is chronic, or noncommunicable, diseases. The impact of chronic diseases on health and wellness can be significantly altered by individual health and behavior choices or modifications. Furthermore, the burden of chronic disease goes beyond health and the health care system and may influence an individual's wellness. The purposes of this article are: (1) to provide a basis for understanding the terms “health” and “wellness,” (2) to identify the knowledge and skills physical therapists need to address behaviors that promote health and wellness and treat and protect against chronic disease, and (3) to discuss barriers and opportunities associated with integrating the promotion of health and wellness into physical therapist practice.

Objective: Physical therapists are well positioned to meet societal needs and reduce the global burden of noncommunicable diseases through the integration of evidence-based population health, prevention, health promotion, and wellness (PHPW) activities into practice. Little guidance exists regarding the specific PHPW competencies that entry-level clinicians ought to possess. The objective of this study was to establish consensus-based entry-level PHPW competencies for graduates of US-based physical therapist education programs.Methods: In a 3-round modified Delphi study, a panel of experts (N = 37) informed the development of PHPW competencies for physical therapist professional education. The experts, including physical therapists representing diverse practice settings and geographical regions, assessed the relevance and clarity of 34 original competencies. Two criteria were used to establish consensus: a median score of 4 (very relevant) on a 5-point Likert scale, and 80% of participants perceiving the competency as very or extremely relevant.Results: Twenty-five competencies achieved final consensus in 3 broad domains: preventive services and health promotion (n = 18), foundations of population health (n = 4), and health systems and policy (n = 3).Conclusions: Adoption of the 25 accepted competencies would promote consistency across physical therapist education programs and help guide physical therapist educators as they seek to integrate PHPW content into professional curricula.Impact: This is the first study to establish consensus-based competencies in the areas of PHPW for physical therapist professional education in the United States. These competencies ought to guide educators who are considering including or expanding PHPW content in their curricula. Development of such competencies is critical as we seek to contribute to the amelioration of chronic disease and transform society to improve the human experience.

Lifestyle behaviours are a contributing factor in approximately 80% of chronic diseases, making them a primary target for employee wellness programmes (EWPs). To effectively change health behaviours, EWPs should implement evidence-based strategies. One strategy is health behaviour change coaching, which is often delivered in a one-on-one format. While limited research exists, group health behaviour change coaching (group coaching) has potential to be an efficient alternative, impacting more people. The purpose of this study was to determine whether group health coaching improved psychological constructs related to physical activity and physical fitness among university employees in an EWP. Employees (n = 100) were randomly selected from a pool of volunteers who registered for the EWP, were overweight/obese, and at risk for cardiovascular disease. The intervention consisted of three group coaching sessions based on the Transtheoretical Model and Self-Determination Theory. Paired t-tests compared pre/post-measures of psychological constructs related to physical activity and physical fitness. Additionally, multivariate regression analysis with post-coaching self-efficacy as the dependent variable was performed. Overall, 84 participants (83% female, average BMI = 31.2) completed the intervention, attending an average of 2.26 sessions. Stages of change, seven processes of change, self-efficacy, perceived competence, and the health care climate score improved. Attending group coaching sessions predicted post-test self-efficacy. All but one measure of physical fitness improved. Group coaching can be effective in improving physical fitness and psychological constructs related to physical activity behaviour. In programmes with limited funds, group coaching has potential to be an important EWP component to support health behaviour change.

(2017). Health behaviour change coaching in physical therapy: improving physical fitness and related psychological constructs of employees in a university setting. European Journal of Physiotherapy: Vol. 19, European Journal of Physiotherapy, publishing partner of the 18th World Confederation for Physical Therapy, WCPT, Congress, held in July 2017 in Cape Town, South Africa, pp. 1-2.

ObjectivePain is a multifaceted phenomenon; therefore, innovative, multisystem approaches are recommended as a path to pain recovery. Pain Resilience Therapy (PRT) was developed as a novel, resilience-focused approach to pain management. MethodsThree people with chronic pain received tele-physical therapy using PRT. The primary aim of PRT was to facilitate the development of pain resilience. Addressing vulnerability was a secondary aim. Treatment results were assessed using validated self-report measures for pain intensity, resilience, vulnerability, interference, patient outcome expectations, expectancies, and perspectives. ResultsAll patients demonstrated a reduction in pain intensity and pain interference (PROMIS®) with associated improvements in activity, sleep, mood, and stress measured by the Defense and Veterans Pain Rating Scale (DVPRS 2.0). Resilience (positive affect/coping) and self-efficacy increased, as measured by the Pain Self-Efficacy Questionnaire (PSEQ), Self-Efficacy for Rehabilitation (SER), Chronic Pain Acceptance Questionnaire (CPAQ), and the Pain Resilience Scale (PRS). Certain measures related to vulnerability (negative mood and fear avoidance) also improved. The PRT intervention was safely delivered and patients reported their health as very much improved measured by the Patient Global Impression of Change (PGIC) survey. ConclusionThis case series supports the application of PRT’s resilience-focused approach to attenuate pain and vulnerability while improving physical and psychological well-being. Although there is a need for research elucidating change mechanisms, assisting patients/clients in accessing resources that facilitate resilience is a valid pathway to pain recovery. This case series is a step toward integrating an understanding of resilience within the broader context of pain and disability.

Chronic pain management increasingly emphasizes patient self-management behaviors such as regular physical activity, restorative sleep, stress regulation, and healthful nutrition. Education is commonly used to support these aims; however, improving knowledge alone rarely produces sustained behavior change. In this Perspective, an argument will be made that effective chronic pain management requires a deliberate shift from education-focused approaches alone toward clinician-supported behavior change. Education may be necessary to reconceptualize pain and reduce perceived threat, though it is insufficient to help patients consistently adopt and sustain health-promoting behaviors in the context of pain. Drawing on pain science, health behavior change theory, and behavioral medicine, behavior change will be distinguished from education, and practical techniques will be outlined that clinicians can use to support patients in translating knowledge into action. Key principles include tailoring interventions to a patient’s stage of change, fostering self-efficacy through graded mastery experiences, using motivational interviewing to elicit values-based motivation and address ambivalence, and employing collaborative goal setting and action planning. The role of action planning, graded tasks, and motivational interviewing approaches to sustain behavior change will be emphasized. This paper will provide a clinician-focused roadmap for supporting behavior change in pain care. By moving beyond education toward intentional behavior change support, clinicians can better foster resilience, functional recovery, and sustainable self-management among individuals living with chronic pain.