Reducing the personal risk of perceived disease: the chiropractic patients' self-care endeavor

Prescribing Wellness: A Case Study Exploring the Use of Health Information Brochures

OBJECTIVE

A case study was undertaken to ascertain the potential usefulness of brochures as a strategy for encouraging short-term and longer-term acquisition of healthy behaviors at the consumer-health care system interface.

METHOD

Purposive sampling of chiropractic clinics and convenience sampling of patients attending these primary contact practitioners were undertaken. Patients were asked to complete a questionnaire. Interested patients were given a health information brochure on topics of their choice. Patients who had requested health information brochures were phoned at 3 weeks, 3 months, and 1 year after completing the initial questionnaire and asked if they had implemented any of the suggestions for health promotion or risk prevention. A minimum of 4 attempts were made to contact each participant by telephone. Data were analyzed using descriptive statistics.

RESULTS

Twenty-one chiropractic clinics and 781 patients participated. Although every third patient requested one or more health information brochures, fewer than 1 in 4 of those receiving brochures implemented some health-promoting behavior. Although some patients persisted with their newly initiated health-promoting behaviors, compliance diminished over time. Exercise and dietary change were the behaviors most likely to be modified.

CONCLUSION

Implementation of even one healthy behavior can have a ubiquitous health benefit. Despite dwindling compliance, it is therefore suggested that suitably formulated health information brochures that inform and encourage adoption of healthy behaviors by motivated patients deserve consideration by all health professionals working at the consumer-health care system interface.

Health information and promotion in chiropractic clinics

OBJECTIVE

To explore the current health education behaviors of chiropractors, ascertain their willingness to provide patient counseling, and compare this with topics of interest to chiropractic patients.

METHODS

This study involved a postal survey of 400 randomly selected members of the Chiropractic Association of Australia (35% response rate) and a semistructured interview of 316 patients attending one of 20 purposively selected chiropractic practices. Data were collated, and the current health information practices of chiropractic respondents and their willingness to undertake counseling on various topics was identified and compared with the information interests of participating patients. Particular emphasis was placed on injury prevention both with respect to patient counseling and chiropractic practice risk.

RESULTS

Respondents expressed varying degrees of willingness to provide health information on diverse topics, but no clear health education chiropractic practice pattern emerged. Although expressing willingness to undertake counseling, respondents were more likely to provide health information brochures than develop a tailored health promotion contract. Health education topics ranged from exercise (91%) to osteoporosis prevention (23%). Seventy-eight percent of chiropractors were prepared to offer counseling on injury prevention, yet 45% of respondents themselves reported having some work-related injury. Maintenance care failed to emerge as a global term for describing a common core of topics or chiropractic health education practices.

CONCLUSION

This study demonstrated an interest by chiropractors in providing and by chiropractic patients in obtaining health information that extends beyond spinal health. The range of relevant topics covered and modes used for health information transmission in chiropractic practice requires clarification. The prevalence of work-related injury among chiropractors suggests a need to develop safe chiropractic clinical practice protocols.