Physical therapists’ professional beliefs, knowledge, and environmental demands influence health promotion, wellness, and disease prevention practices in outpatient physical therapy

Introduction: Physical therapists (PTs) have been called to address the chronic preventable disease burden in the United States by incorporating health promotion, wellness, and disease prevention (HPWP) in practice. Irregular HPWP practice has been reported, with few studies looking beyond physical activity. Methods: A cross-sectional survey design assessed the frequency of conversations about physical activity (PA), nutrition, sleep, stress management, and tobacco cessation with patients in an outpatient PT practice and the factors related to their inclusion. Results: Aside from frequently including PA, other topics were included less often. Chi-square analysis and a Cramer’s V were used to assess relationships and effect size, respectively. Significantrelationshipswerenotedbetween professional beliefs and conversations about tobacco cessation (V =.375; X² [2, 45] = 6.34, p =.042) and sleep (V =.387; X² [2, 45] = 6.75, p =.034). Depth of HPWP knowledge was also strongly associated with sleep (V =.422, X²[6, 45] = 16.00, p =.014) and stress management (V =.402; X²[6, 45] = 14.54, p =.024) conversations. Barriers to HPWP inclusion included lack of reimbursement (V =.420; X²[2, 45] = 7.93, p =.019), and employer support (V =.393; X²[2, 45] = 6.93, p =.031), and inappropriate work environment (V =.431; X²[2, 45] = 8.37, p =.015). Conclusion: Findings support exploring deficits in knowledge depth, beliefs about PT role, and care-model barriers to better elucidate clinical implementation considerations.