CHAPTER 2

Prevention, Health,
and Wellness
DR.NOUREEN FAROOQ
LECTURER,ISRA UNIVERSITY
Definitions
• Health:
• General physical, mental, or spiritual condition of the
body
• Wellness:
• A state of good health often achieved through healthy
lifestyle choices
• Health promotion:
• Contributing to the growth and development of health
Identifying Risk Factors
• For identification it is important to conduct
pre-participation screenings and risk
assessments:

• Pre-Participation Screening
• Risk Assessment
Activity prescreening
questions
Contd…
• Risk Assessment
• The participant should be assessed for risk
factors associated with specific conditions such
as coronary artery disease (CAD) and
osteoporosis.
• If multiple risk factors are identified, a
participant may need to be referred to a physician
prior to initiating a program.
Example: Risk factors
Determining Readiness to
Change
• There are multiple theories and models related to
health promotion interventions that explain how
change occurs:

• Behavioral Change Theories

• Social cognitive theory.
• Health belief model
• Trans theoretical model.
Social cognitive theory
• This theory looks at the belief systems of individuals.
• An individual must believe that he or she can change a
particular behavior and changing that behavior will lead
to the desired outcome.
• Example:
• A patient may want to lose weight, to change the
behavior causing the increased weight, the patient needs
to believe that he or she is capable of succeeding and that
the outcome will improve his or her health.
Health belief model

• Health belief model (HBM) is based on several factors:

• First an individual must have sufficient concern about
developing an illness (perceived threat).
• Next the individual needs to believe that by following
the health recommendations it is possible to achieve the
desired outcome (perceived benefits) at an acceptable
cost (perceived barriers).
Contd…
• Example:
• An individual would have to believe that being
overweight puts himself or herself at a greater risk for
developing heart disease (perceived threat).
• The individual may understand that modifying the diet
can help with weight loss
• The person may consider joining a weight loss program
but may not be sure he or she can afford the weekly fee
(perceived barrier).
• If the perceived threat is sufficiently high, the individual
may chose to join the weight loss program to obtain the
desired benefit
Trans theoretical model
• The trans theoretical model (TTM) looks at the stages required to
make changes.
• There are five stages of change:
• Precontemplation: No intention of making any changes within
the next 6 months.
• Contemplation: Intend to make changes within the next 6
months.
• Preparation: Has begun to take steps toward making the desired
change in behavior and plan to make the changes within the next 30
days.
• Action: Has changed the behavior for less than 6 months.
• Maintenance: Has changed the behavior for more than 6 months.
Contd…
• Knowing what stage patients are in and knowing
the beliefs they have regarding the need to
change, the physical therapist can assist in
planning the intervention.
Developing and Implementing
a Program
Additional Considerations for Developing
Prevention, Health, and Wellness
Programs

• The following are additional points to consider:

• The exercise or activity has to be specific to the goals of
the individual.
• For children, the program should be fun and less
structured but should take place for a specified period of
time.
• For older adults, the program should start slowly to allow
the participants to experience success
• Include pictures of exercises whenever possible.
Contd…
• Consider the time commitment for you and the
participants and the cost involved.
• If screenings are conducted, handouts with the results and
with follow-up recommendations should be given to the
participants.
• For children, make them colorful and fun.
• For older adults, make the print larger.
• Keep the language simple. Limit the amount of medical
terminology used.
Issues Affecting Exercise
Adherence