National Foot Health Questionnaire

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Netizens

I have a cyber class of eager podiatry students at Charles Sturt University and we have been discussing the role of the clinical scientist. Bennett's Foot Health Questionnnaire is part of the pre-reading for the program and the class pose an interesting question, which I would like to open up to the community.

Why has there never been a national survey of foot health ? This base line data if collected both from the foot challenged (patients) and normals would provide a worthwhile database with which to plan podiatry services to the community and may give much stronger argument to the cost effectiveness of screening both the young and elderly populations for leg morbidity.


Maybe this should become the focus of future National Foot Health Campaigns. By consistantly and steathily collecting data from across the globe a much clearer picture of foot related epidemiolgies could be made.

What say you?

Cameron
Hey, what do I know.
.

 

Craig

It is the same as Kinsey, we do not know the full extent of foot health within the "community" . A foot physicians we have a skewed prespective of need but may be missing much because we have nothing to compare with.

Cameron
PS As to cost if it became the focus for a foot health week with community based activities and trained data collectors it would not cost that much more than what happens now. I suppose it all comes down to Plato's cave, where ignorance is bliss

 

National Health Survey

Cameron and Craig,

The ABS and AIHW both collect info on the general health of the poulation. Every 5 or so years the ABS conducts a compulsory National Health Survey.
http://www.abs.gov.au/ausstats/abs@...e1dfff6fa69e478dca256c5d0001fd9d!OpenDocument
Which includes information on visits to health professionals including podiatrists as well as much, much more. It costs $33 to download, but is free to download from Australian Universities.
The AIHW document on the podiatry labour force also includes some relavent information. This document is free for everyone
http://www.aihw.gov.au/publications/hwl/podilf99/podilf99.pdf

 

Cameron, Craig and Steve,

I agree with Cameron - such a study is long overdue. There's some good epidemiological studies that have been conducted overseas (eg: the Cheshire Foot Pain and Disability Survey and the Feet First Study of older people in the US). In Australia, all we have is some smaller studies in elderly people (eg: the Health Status of Older People Project). The National Health Survey, as far as I am aware, still doesn't include foot problems.

Prevalence studies may not the most exciting research projects as far as clinicians are concerned, but prevalence data would be very useful to have when applying for research grants, and this sort of information is necessary as the basis for policy development. The problem is, they're extremely expensive to undertake, and response rates in Australia are generally lower than other countries.

Cheers,

Hylton

 

I think thats my issue - it is the weighing up the cost of obtaining that information vs the usefullness of the information gained. There is no doubt the information is useful, but at what cost?

 

To take a line from the recent Starskie and Hutch movie

"Do it!" because as Hylton reminds us without the baseline data , the profession is up the Swanee without a paddle. No point in arguing for when there is no real need.

I am grateful to Chris Klein from CSU for bringing my attention to the following:

Barnett S, Campbell R, Harvey I. The Bristol Foot Score: developing a patient based measure of foot health. Journal of the American Podiatric Medical Association. <http://www.japmaonline.org/cgi/content/abstract/95/3/264>

and thanks Stephen and Hylton for the other sources.

There is infomation out there about foot morbidity and access to podiatry services there was a large survey done in Southhampton two decades ago, and the Outer Hebrides in Scotland slightly early . Winkler and Kemp wrote a book on the subject in the 80s and Ashford in England wrote of the association with low socio-economical groups and ethnicity in the Nrth of England and access to podiatry sevices. There was also a paper from the States which compared ethnicity and access to podiatry across the States. Incredibly illuminating but little more, and of course limited because it is all set within the time and location of the individual studies themself.

So people seek professional help with sore feet (whatever that may mean) , but we also know from a handful of studies that the general public will either self treat or seek other services than podiatry for foot health care. This volume (which could be significant) is currently lost to podiatry type surveys
and impossible to tease out from larger surveys with any reliability.

My point is ask the people what their opinion is of foot health in accordance with life style and we all may get a surprise.

Again on the matter of costs, in Australasia there is a Foot Health Campaign in existance there is a workforce membership of 2000+ with an expectation of participation. We also do have a sizable student population in training. Developing these groups through CPD and modified curriculum to canvas public opinion would be reasonably simple. A simple phased system of data collection to appropriate times in the year such as corrsponding to State and National Conferences would give added advantage of local and national PR for Media etc. which would be sustained throughout the calandar year. Lookat the worldwide press the Australian University got for their recent anthropometic survey.

Over a calendar year sufficient data could be collected and processed. In the absense of available funds a small levee could be appended to membership fees (as was done in WA) on the pretext of public relations. Monies raised would support a researcher/ PhD student to plan and co-ordinate activities. Private sponsorship may follow, especially if the data provides key undeveloped windows of opportunity for requisite companies The money is out there it is just a question of pulling the right strings.

Big trees from small acorns grow I am reminded of a brilliant PR project masterminded by the podiatry students at CIT, New Zealand in 1992 when they walked through New Zealand. Cleverly planned this mamoth work took place during the academic year and the students asked for not one day from their studies.

The clever way Les and his team planned the PR cover meant the complete population of the country were aware of the project. That is no mean feet (no pun intended) and this marketing exercise was applauded by many experts at the time for the way it sustained media attention.

Cameron

 

Prevalence and correlates of foot pain in a population-based study: the North West Adelaide Health Study

Catherine L Hill, Tiffany K Gill, Hylton B Menz, Anne W Taylor

Journal of Foot and Ankle Research 2008, 1:2 (28 July 2008)

ABSTRACT: BACKGROUND: Few population-based studies have examined the prevalence of foot pain in the general community. The aims of this study were therefore to determine the prevalence, correlates and impact of foot pain in a population-based sample of people aged 18 years and over living in the northwest region of Adelaide, South Australia. METHODS: The North West Adelaide Health Study is a representative longitudinal cohort study of n = 4,060 people randomly selected and recruited by telephone interview. The second stage of data collection on this cohort was undertaken between mid 2004 and early 2006. In this phase, information regarding the prevalence of musculoskeletal conditions was included. Overall, n = 3,206 participants returned to the clinic during the second visit, and as part of the assessment were asked to report whether they had pain, aching or stiffness on most days in either of their feet. Data were also collected on body mass index (BMI); major medical conditions; other joint symptoms and health-related quality of life (the Medical Outcomes Study Short Form 36 [SF-36]). RESULTS: Overall, 17.4% (95% confidence interval 16.2 - 18.8) of participants indicated that they had foot pain, aching or stiffness in either of their feet. Females, those aged 50 years and over, classified as obese and who reported knee, hip and back pain were all significantly more likely to report foot pain. Respondents with foot pain scored lower on all domains of the SF-36 after adjustment for age, sex and BMI. CONCLUSION: Foot pain affects nearly one in five of people in the community, is associated with increased age, female sex, obesity and pain in other body regions, and has a significant detrimental impact on health-related quality of life.

Predictors of podiatry utilisation in Australia: the North West Adelaide Health Study

Hylton B Menz, Tiffany K Gill, Anne W Taylor, Catherine L Hill

Journal of Foot and Ankle Research 2008, 1:8

ABSTRACT: BACKGROUND: Foot problems are highly prevalent in the community; however no large population-based studies have examined the characteristics of those who do and do not access podiatry services in Australia. The aim of this study was to explore patterns of podiatry utilisation in a population-based sample of people aged 18 years and over living in the northwest region of Adelaide, South Australia. METHODS: The North West Adelaide Health Study is a representative longitudinal cohort study of 4,060 people randomly selected and recruited by telephone interview. The interview included questions regarding healthcare service utilisation in the past year. Data were also collected on education, income and major medical conditions. RESULTS: Overall, 9.5% of the total sample and 17.7% of those who reported foot pain had attended a podiatrist in the past year. Participants who had accessed podiatry treatment were more likely to be female, be aged over 45 years, be obese, and have major chronic medical conditions (osteoporosis, osteoarthritis, diabetes, cardiovascular disease and high blood pressure). Those who reported foot pain but had not accessed a podiatrist were more likely to be male and be aged 20 to 34 years. CONCLUSION: Only a small proportion of people who report foot pain have accessed podiatry services in the past year. There is a need to further promote podiatry services to the general community, particularly to men and younger people.

 

Now we know.

Interesting to see what multi-centre studies would now reveal. Definately a could do through the existing podiatry education centres (if they would only start to co-ordinate their undergraduate research on a national (even international) basis) then we could get a better prespective :bang:

toeslayer