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Any ideas for Podiatric Health promotion?

Discussion in 'General Issues and Discussion Forum' started by Tess Bowen, Aug 22, 2006.

  1. Tess Bowen

    Tess Bowen Member

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    To fellow podiatrists,
    anyone out there in public health who has suggestions on health promoting activities or sessions which they have/are currently running and would be prepared to share, these would be much appreciated. Any aspects of foot health promotion including: specific foot information including delivery format (ie. lectures, group sessions), shopping trips under podiatric supervision, as well as evaluation of effectiveness. Basically any resources other podiatrists are using which have proven beneficial in terms of educating low risk clients in the public health system.


  2. Cameron

    Cameron Well-Known Member


    Surprised you have not been inendated with replies?

    I suppose the first thing to establish is are you referring to podiatry promotion (in which case it is not health education) or promoting empowerment among client groups (health education). Many so called health promotions such as foot health week's mascarade as the latter but are really encouraging patient dependency on podiatry services. There is nothing amiss with this but it seldom results in establishing behavioural change in the targeted demographic.

    Moons ago I did a qualitative review of one to one foothealth education versus footcare classes (The Chiropodist circa 1982)and found the one to one was more likely to result in behaviour change. Recent research would seem to concur. Foot health classes are cheaper to run but the outcome questionable. Where foot care is tagged alongside diabetes education for example most program reviews would suggest there is too much content, misplaced emphasis and inadequate time to establish real behavioural change in the clientgroup.

    Reviewing outcomes of health education programs are fraught with complexity and seldom if ever does the review include post attendance behaviour. These means it remains impossible to judge the influence the program has on the target audience. I think there may be merit in phone coaching but am unaware of anything in podiatry

    On the negative side there is some evidence to support that well controlled diabteics derive little benefit from supporting foothealth education given during routine footscreenings and the implication this might lead to ignoring symptoms later in life, rather worrying. HE research on the high fear approach suggests it is not successful.

    Inter rater realiabilty for foot screenings is poor especially when done cross discipline (which was a surprise to me) and increased recognition of need for better control in Type II has led to more blanket screenings of well controlled types.This may be excellent for research purposes but rarely results in meaningful behavioural change. Better recognition of higher risk clients by medical and nursing staff might improve outcomes and recognition of peripheral neuropathy asan entity would ensure better preventative health care, I feel.

    Set syllabi in the form of formal lesson plans prevent free interchange with the audience and adhoc teach ins need an experienced facilitator if all the participants questions are to be addressed.

    There is a plethera of leaflets and pamphlets, webites and community linkages and it is best to know your demographic and their environment.

    A really useful interactive CD was produced by SARRAH for Aboriginal and Torres Strait Ilanders <http://www.sarrah.org.au/idf/>. It contains short video clips with commentary then associated links with more details. This is simple yet very effective communication and in a medium that can be used on a laptop and anything it sticks into. I am sure a similar approach could be used for any audience with content customed to their specific needs. Meantime have alook at the Australasian Podiatry Council Continuing Education webpage at <http://www.apodc.com.au/cpd/seminar-2005.htm>
    The Public Sector and Aged Care Seminar, February 28 - March 1, 2005 - 'Empowering Podiatrists'

    Hope this promotes some more contributions to a very interesting and important theme

    What say you?

  3. Cameron

    Cameron Well-Known Member

    Can send you a couple of lesson plans if you send me your email


  4. levyleon

    levyleon Welcome New Poster

    Podiatric Medicine in Health Promotion Not Podiatric Health Promotion

    It is time for members of the podiatric medical profession to begin to change the way they think. We do not or at least should not treat feet. We treat people who may have problems that affect the pedal extremity. This is not a play on words but a shift in how we participate as part of the army of health professionals. Without getting in to a long discourse about what I mean, let me give an example of an area of health care as well as health promotion that is a truly integrated thought that demonstates the importance of podiatric medical practitioners in health care and the role of other physicians in recognizing the importance of podiatric health. This example is the patient who visits the primary care physician (e.g., internist or family practice physician) or the the cardiologist and who is told that they need to exercise and should walk for 20 minutes daily. Almost never (if ever) do these practitioners even ask if their feet are painful. Have we in podiatric medicine ever studied how many people do not engage in daily exercise because of podiatric problems? Has any one ever determined the effect of the condition of the pedal extremities on cardiovascular health? How much of cardivascular morbidity is affected by the condition of the feet and ankles? How many deaths from cardiovascular disease could be prevented if these victims had the benefit of podiatric medical care? Remember, cardi ovascular disease is the single most important cause of death in the western world. Let us begin to think abut health not just foot health.

    Leonard A. Levy, DPM, MPH
    Associate Dean for Education, Planninga and Research
    Professor of Family Medicine/Professor of Public Health
    Nova Southeastern University College of Osteopathii Medicine
    Fort Lauderdale, Florida
  5. Couldn't agree more. In the UK I recall a profession-led marketing campaign almost two decades ago that emphasised that very point, so it's good to see you guys State-side finally catching up ;) There was a fairly comprehensive article in the Sunday Times promoting the benefits of walking - stragely enough no mention of the podiatric profession graced its pages.

  6. Cameron

    Cameron Well-Known Member

    Share you sentements entirely Leonard and I know this toipic has been discussed at some length before on this list. However since then there has been major changes within the public health in Western Society to encorporate an holistic approach to negociated care especially with people coping with chronic disease. The challenge for foot physicians now is to provide networks of meaningful communication which will allow clients to recognise, contain and act on symptoms of peripheral vascular disease and the more neglected morbidiity peripheral neuropathy. Surprisingly despite the ocean of foot health material available there appears to be a dearth of appropiate syllabi and opportunity to meaningfully contribute.

  7. cazfoot

    cazfoot Member

    Cameron has hit the nail on the head in regards to health promotion vs profession promotion. The area of health promotion looks at making changes from a population health perspective and outcomes need to be measured whilst daunting , this can provide some vary powerful results. Health promotion strategies are multi - layered strategies which provide a number of methods to address issues and promote behaviour change. An example of a recent health promotion activity which podiatrists along with other health professionals were involved in was the 10,000 steps campaign, where people with chronic health conditions were encouraged to become involved in a structured program which involved the use of the pedometer. Those that through the broader process were not able to participate in this health promoting activity due to foot problems, got a b- line straight to the podiatrist. This provided a direct link for our skills to be clearly demonstrated in the broader holistic health approach, and its amazing how many people don’t walk because of sore feet!

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