Brenda L. Rea


Purpose: The purpose of this study was to investigate physical therapy practice patterns in four focus areas of Healthy People 2010 (focus area #6, disability and secondary conditions by looking at psychological well-being; focus area #19, nutrition and overweight; focus area #22, physical fitness and activity; focus area #27, tobacco use) and identify self-efficacy and outcome expectations related to those practice patterns across California, New York and Tennessee using Bandura’s Social Cognitive Theory as a framework. It was hypothesized that physical therapists’ self-efficacy and outcome expectations in the four focus areas of Healthy People 2010 would be significantly associated with and predict health promotion practice patterns.

Method: The study employed a cross-sectional observational design and utilized a survey designed, pilot-tested, and distributed to 3,500 randomly selected, licensed physical therapists from three states in two waves of data collection: 1,050 from California, 1,200 from New York, and 1,250 from Tennessee. Interviews to saturation were conducted randomly via phone within all three states to facilitate creation of the survey and the pilot test was conducted with 23 physical therapists in the Loma Linda area.

Results: The health promotion behavior most commonly practiced by physical therapists was assisting patients to increase physical activity (54%), followed by psychological well-being (41%), nutrition and/or overweight issues (19%) and smoking cessation (17%). Physical therapists health promotion behaviors varied between states in the area of psychological well-being (p=.011), with CA being significantly higher than NY. No significant differences in the areas of physical activity, nutrition and overweight and smoking cessation were noted. Self-efficacy was significantly associated with all four behaviors beyond age, gender, ethnicity, hours/week working, year of graduation, number of years working in current setting, patients seen per hour. highest PT degree obtained and school setting with pediatric type patients.

Conclusion: Physical therapists address health promotion topics during practice in varying degrees and in lower than desirable percentages. This study demonstrated that a physical therapist’s confidence in being able to perform a specific behavior (selfefficacy) and the expected results of that behavior (outcome expectation) were related to the frequency the health promotion behavior occurred in each of the four focus areas of Healthy People 2010. Furthermore, self-efficacy alone predicted behavior in all four focus areas when all other variables were controlled. By targeting the factors that improve self-efficacy and outcome expectation in the four focus areas, the potential to increase the percentage of physical therapists that practice health promotion behaviors with patients is high.

LLU Discipline

Physical Therapy


School of Public Health

First Advisor

Helen Hopp Marshak

Second Advisor

Christine Neish

Third Advisor

Nicceta Davis

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Health Promotion; Preventive Health Services; Physical Therapy; Physical Therapy Modalities. Specialty



Page Count

ix; 103

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives