Semester

Summer

Date of Graduation

2013

Document Type

Dissertation

Degree Type

PhD

College

School of Public Health

Department

Occupational & Environmental Health Sciences

Committee Chair

Anne K Swisher

Abstract

The goal of this research was to promote the use of evidence-based TCC guidelines in physical therapist practice and education by applying principles of knowledge translation as defined by the National Institute on Disability and Rehabilitation Research (NIDRR). According to the NIDDR, research should be framed so that knowledge gained is ultimately applied in a manner geared towards improving the lives of people with disabilities.;Study 1 resulted in a perspectives paper which established a sound clinical rationale for the inclusion of TCC as a component of physical therapist practice. This rationale is based on the pathophysiologic effects of smoking on all systems of the body, and the potential for smoking cessation to enhance treatment outcomes in all areas described by the Guide to Physical Therapist Practice, including cardiovascular, pulmonary, neuromuscular, musculoskeletal, and integumentary health. The paper derived from study 1 also provided a template for implementation of the AHRQ clinical guidelines for TCC within the context of physical therapist patient assessment and management.;Study 2 consisted of an assessment of the existing need for TCC training in entry-level physical therapist education, and examined the prevalence and scope of TCC training, as well as the opinions of physical therapy educators towards the inclusion of TCC in the academic and clinical environment. Methodology for Study 2 involved a cross-sectional survey of faculty at accredited entry-level physical therapist programs across the United States. Data were analyzed using frequency counts and percentages. Logistic regression was employed to assess factors that influence curricular inclusion of TCC training in entry-level physical therapist education, such as perceived barriers and facilitators to TCC in the clinical environment, and the perceived relevance of TCC within the physical therapist's scope of practice and professional obligations.;Study 3 involved pilot testing of a curricular blueprint for TCC training as a component of entrylevel physical therapist education. Results of Study 3 demonstrated the feasibility and impact of TCC training for student physical therapists in producing positive changes in knowledge, skill, and intention to apply evidence-based TCC guidelines when working with physical therapy clientele.;Results: Due to higher prevalence of smoking among people with disabilities, and the negative influence of tobacco use on physical therapy treatment outcomes, TCC is an important element in physical therapist practice. Barriers to the implementation of TCC clinical guidelines in the clinical environment include limited training for entry-level physical therapists. A tailored TCC training program for student physical therapists was successful in improving knowledge, skill, and intention to apply AHRQ/ USDHHS evidence-based TCC guidelines during subsequent clinical practice.;Conclusions: There is a need for dissemination and adoption of evidence-based TCC guidelines in physical therapist practice and education. Study 1 resulted in a perspectives paper that described the scientific rationale for TCC as a component of physical therapist practice based on the detrimental impact of tobacco use on all aspects of rehabilitative care. Study 2 provided data highlighting the existing need for evidence-based TCC training in entry-level physical therapist education. Study 3 consisted of a pilot training program. Results of Study 3 supported the efficacy of a tailored curricular blueprint specifically designed to enhance the knowledge, skills, and intentions of student physical therapists towards the application of TCC guidelines as a component of future practice. (Abstract shortened by UMI.).

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