: Integrative health is an emerging specialty inside multiple disciplines within the medical community, yet the practice of integrative physical therapy remains undefined. This perspective paper suggests a set of guiding principles to support the role of physical therapy in integrative health. These guiding principles, including therapeutic partnership, whole person health, living systems, movement as an integrative experience, and salutogenesis, are described and explored in-depth as they relate to all aspects of patient care and clinician experience. These guiding principles are articulated within the context of social determinants of health and the interrelated roles that environment, trauma, stress, and lifestyle all play within an integrative physical therapy plan of care. Examples of current integrative physical therapy practices that embody these principles are described. The 5 guiding principles are designed to elicit interprofessional inquiry into how integrative health models can be applied to the art and science of physical therapy practice. The expansion of integrative health into the field of physical therapy has the potential to improve individual and population health, as integrative physical therapy can be used to address prevention, health promotion, primary care, and wellness while acknowledging the complex, dynamic, and interconnected nature of the human condition. Impact: This perspective article presents 5 guiding principles to establish a framework to define and shape the growing application of an integrative health model to physical therapy practice. These integrative physical therapy guiding principles aim to improve the quality of whole-person, patient-centered care.

Background: Chronic pain is a global problem affecting approximately 20% of adults. The prevalence of opioid use for chronic pain has contributed to a widespread crisis of addiction and inadequately managed pain. Though national and international guidelines recommend nonpharmacological, integrative, multi-modal therapies for chronic pain, numerous systemic barriers limit access to these services for those with the highest need and fewest resources. Objective: This paper describes the development and testing of an innovative “Heals on Wheels” (HoW) community engagement and Group Medical Visit (GMV) program for underserved communities experiencing chronic pain in Hennepin County, Minnesota. Methods: The HoW program’s curriculum was collaboratively adapted from pre-existing Hennepin Health care GMV programs for chronic pain. Free community-based “Appetizer” workshops were developed alongside an 8-week “Full Meal” GMV program titled Easing Pain Holistically (EPH). Three pain-affinity variations of EPH were created (the “Body”, “Head”, and “Heart”) and delivered to 6 cohorts (2 cohorts of each variation). Feasibility was measured by attendance, demographics, and insurance provider information. To evaluate program acceptability, thematic analysis of patients post-GMV weekly progress sheets was performed. Results: The curriculum for the HoW program included experiential training and education in evidence-based integrative pain management strategies. Fourteen community appetizer workshops (n = 142) were offered in partnership with organizations representing underserved populations. Fifty-five patients completed EPH from 2022 to 2024 with the greatest number of patients in the Heart (n = 23), followed by the Body (n = 19), and the Head (n = 13). Feasibility for the GMV program was demonstrated with average attendance across 6 cohorts at 75.1%. Thematic analysis of qualitative data revealed themes highlighting appreciation for group connection (“sharing”) and the EPH program content. Conclusion: The HoW program shows promise as a feasible and acceptable model of community outreach and engagement to improve access to evidence-based integrative pain care.

Introduction: Chronic pain is a complex and pervasive issue that disproportionately affects marginalized and underserved populations, driven in part by healthcare access barriers. Chronic pain affects multiple domains of life, warranting the need for accessible, holistic, whole-person, evidence-based care. The Heals on Wheels (HoW) program’s multidisciplinary team developed and implemented community-based integrative pain care workshops for underserved communities throughout Hennepin County, Minnesota. Methods: The 4-week curriculum included 60-120 minute-long weekly workshops hosted by community organizations. A pre- and post-workshop weekly progress sheet questionnaire explored perceptions of pain, overall state, favorite moments, and future suggestions. Responses were analyzed thematically. Results: Throughout 2022-2025, 13 workshop series occurred with 9 different community organizations. Total attendance was 369 (average 7.10/session) with 265 weekly progress sheets completed by 163 unique individuals (71.82%). Average pre-visit pain was 5.40; post-visit was 3.26 ( - 2.14). Themes of before group state were: 1) Stable (2) Health Concerns (3) Overwhelm and (4) Hope. Themes after group were: (1) Relaxed, calmer, tired (2) Improvement, relief (3) Gratitude, hope and (4) Neutral. Roughly 1/10 participants highlighted the importance of sharing stories. Themes for future suggestions were mainly expressions of positive feedback; other themes included wanting more time, session structure, and specific activities. Conclusion: The HoW workshops are feasible as an innovative and accessible community-based integrative pain care model.

Millions of Americans experience chronic pain. Integrative Group Medical Visits (IGMVs) often improve access to pain care and patient outcomes. This study assessed the feasibility of novel collection methods for intra-visit clinical information and the PROMIS-29 at three time-points throughout an 8-week pain-focused IGMV series called Easing Pain Holistically (EPH). Outcomes focused on clinically meaningful improvements in participants' pain and pain-related symptoms. Three variations of EPH were piloted with six cohorts within Minnesota's largest safety-net hospital system. Participants completed the PROMIS-29 at baseline, week 4, and week 8. Weekly progress sheets were administered to gather participants' intra-visit clinical changes. The percentage of participants demonstrating clinically meaningful differences on each PROMIS-29 subscale was calculated. Weekly progress sheet and PROMIS-29 collection was feasible. Positive shifts in intra-visit themes from the beginning to the end of each visit were observed. Seven PROMIS-29 mean domain scores improved at week 8, with ∼50% of participants reporting clinically meaningful improvements for Fatigue, Anxiety and Ability to Participate in Social Roles and Activities. Collection of outcomes was feasible and provided a novel viewpoint to assess intra-visit and longitudinal clinical changes. Improvements in function and positive qualitative themes were observed. Future studies could explore the validation of intra-visit patient-reported outcomes, such as the weekly progress sheets, in IGMVs.

Background/Objective: Adolescents experience stress, anxiety, depression, and chronic pain at rates comparable to adults. Opportunity youth are a unique subset of adolescents/young adults with a higher risk of chronic pain and mental health comorbidities. Group Medical Visits (GMVs) for adults are a well-established model supporting whole-person care for chronic pain and co-incident mental health challenges. Research on GMVs among adolescents is limited. This program evaluation explores the feasibility, acceptability, and sustainability of a chronic pain GMV curriculum adapted for opportunity youth at a residential employment-readiness center. Preliminary signals of program impact were explored as a secondary objective of the study. Methods: After completing a chronic pain GMV training program, two pediatricians adapted and piloted the curriculum for opportunity youth through an 8-week Group Visit Series (GVS) offering integrative and lifestyle-based approaches to mental health, stress, and chronic pain. This was a single-site, uncontrolled, mixed-methods pilot program evaluation. Attendance was recorded as a measure of feasibility. A weekly progress sheet captured pre-/post-visit participant feedback, and semi-structured interviews (n = 6), conducted one month post-GVS, were examined using rapid analysis to explore acceptability. Sustainability was observed by program continuation beyond the pilot. Exploratory participant-reported outcomes were collected through PROMIS-29 (n = 6), PROMIS Positive Affect (n = 5), and Patient Global Impression of Change (n = 6). Results: Fourteen participants enrolled, with nine completing ≥3 visits. Weekly progress sheets demonstrated intra-visit changes from pain, fatigue, and concern to calm. Interview analysis yielded concepts of appreciation for skills learned and the group experience. Sustainability was observed. Six of seven PROMIS-29 domains showed positive signals of improvement, with 6/6 (100%) of respondents meeting a minimal clinical important difference (MCID) threshold for depression and 5/6 (83%) for anxiety. PROMIS-Positive Affect and Patient Global Impression of Change showed positive trends at visit 8. Conclusions: This chronic pain and mental health GVS for opportunity youth was found to be feasible, acceptable, and sustainable. Positive trends in participant-reported depression and anxiety scores were also observed. Larger studies beyond program evaluation are needed to confirm these results.

Background/Objectives: Healthcare burnout is a pervasive problem affecting both professionals and patients. Resilience training may be especially important for healthcare teams practicing in underserved areas. This article describes the development and pilot testing of a curriculum innovation developed as part of California Area Health Education Centers’ (CA AHEC) resilience training program. Methods: A team of experts from CA AHEC and Hennepin Healthcare Systems led the development of a whole-person approach to resilience for health professionals, trainees, and other healthcare workers in medically underserved areas. A curriculum was piloted with 7 two-hour Train-the-Trainer video conferences and 1 six-hour in-person workshop. Participants (n = 44) included representatives from 12 CA AHEC centers. Attendance was tracked, and pre/post Knowledge, Skills, and Attitudes (KSA) and Mini Z Burnout Reduction surveys were administered. An engagement survey was fielded after training. Results: Attendance averaged 26 participants per session. Engagement surveys reflected high engagement, utility, and program appreciation, with KSA surveys reflecting large gains in understanding burnout mechanisms/prevention strategies (13.5% high pre- vs. 94.7% post-, p < 0.001; Absolute difference of 81.22, 95% CI 66.87–95.58), large Cohen’s h Effect Size (ES) of 1.9) and the perceived ability to use the training to cope with stress (8.11% high pre- vs. 94.7% post, p < 0.001; Absolute Difference of 86.63%, 95% CI 73.55–99.71, large Cohen’s h ES of 2.1). Mini-Z burnout scores remained relatively unchanged. Mindfulness, mind/body approaches to resilience, community support, and system change were rated as the most impactful curricular aspects. Conclusions: This whole-person resilience curriculum represents an emerging approach to healthcare burnout. While the curriculum was greatly appreciated by attendees, working conditions and burnout remained unchanged, suggesting a need for programs that address underlying systemic stressors.