A Survey of US Chiropractors on Clinical Preventive Services☆

Abstract 

Objective

To assess attitudes of current chiropractic students, public health faculty, and practitioners toward the topics of clinical preventive and health promotion services.

Design and Population

Survey of samples of students and faculty at 10 US chiropractic colleges and random sample of US chiropractors stratified by zip code region using proportional allocation.

Data Analysis

Descriptive statistics were computed for all 3 samples and statistical modeling was used to explore relationships between practitioner characteristics and their responses concerning counseling on health indicators.

Results

A total of 582 students, 45 faculty, and 496 practitioners were surveyed; the response rate for practitioners was 27%. Over 80% of practitioners reported providing information to patients on musculoskeletal risk reduction, exercise, diet, stress reduction, and injury prevention. Over 80% also reported obtaining information from patients on physical activity, stress, dietary habits, obesity, medication use, and occupational hazards. Concerning immunization information, a much higher proportion of faculty (91%) and students (80%) than practitioners (62%) felt chiropractors should provide both pro and con information to patients. In general, female, younger, and more recently graduated practitioners appeared to be somewhat more likely to agree that chiropractors should provide counseling and to report providing it. An association was seen between attitudes toward health indicator counseling and respondent education. Practitioners with at least a bachelor's degree were statistically significantly more likely to report providing counseling for physical activity and to agree that chiropractors should provide counseling and to report actually providing counseling within the last month for substance abuse, responsible sexual behavior, mental health, and injury and violence prevention (P < .05).

Conclusions

Our results indicate that a substantial proportion of the US chiropractors and students who completed our survey, as well as a number of key faculty, have a positive attitude toward providing clinical preventive services, particularly those related to physical activity and diet. However, the results also suggest that there may be areas where chiropractic training is not consistently meeting the newly established national guidelines for clinical preventive services.