Chiropractic and Medical Use of Health Promotion in the Management of Arthritis: Analysis of the 2006 National Health Interview Survey

Ndetan, Harrison; Evans, Marion Willard; Felini, Martha; Bae, Sejong; Rupert, Ronald; Singh, Karan P.

doi:10.1016/j.jmpt.2010.06.008

« Previous Next »Journal of Manipulative and Physiological Therapeutics
Volume 33, Issue 6 , Pages 419-424, July 2010

Chiropractic and Medical Use of Health Promotion in the Management of Arthritis: Analysis of the 2006 National Health Interview Survey

Harrison Ndetan, MSc, MPH, DrPH
- Assistant Professor, Parker College of Chiropractic, Dallas, Tex
- Submit requests for reprints to: Harrison Ndetan, MSc, MPH, DrPH, Assistant Professor, Parker College of Chiropractic, Research Institute, 2500 Walnut Hill Ln, Dallas, TX 75229
Marion Willard Evans Jr., DC, PhD
- Director of Wellness Initiatives, Parker College of Chiropractic, Dallas, Tex
Martha Felini, DC, PhD
- Assistant Professor of Epidemiology, University of North Texas Health Science Center, Fort Worth, Tex
Sejong Bae, PhD
- Professor of Biostatistics, University of North Texas Health Science Center, Fort Worth, Tex
Ronald Rupert, MS, DC
- Dean of Research, Parker College of Chiropractic, Dallas, Tex
Karan P. Singh, PhD
- Professor/Chair, Department of Biostatistics and Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth, Tex

Received 17 February 2010; received in revised form 9 April 2010; accepted 13 June 2010.

Abstract

Objective

The importance of integrating healthy behavior counseling into routine health care is universal but may depend on the type of medical care provider as well as the conditions presented by patients. The purpose of this study was to evaluate whether health promotion (HP) recommendations for known risk factors of arthritis differed between general medical doctors and doctors of chiropractic (DCs) in a nationally representative US population with arthritis.

Methods

Multiple logistic regression models were used for analyses of data from the Sample Adult Core component of the 2006 National Health Interview Survey (n = 6374 diagnosed with arthritis). Analyses were performed separately for recommendation of weight loss and increase in exercise by health profession subtype (chiropractor and medical doctor).

Results

Comparing the reported HP efforts between DCs and medical doctors (MDs), while adjusting for the effect of physical therapist and body mass index, we observed no significant differences (weight loss: adjusted odds ratio [95% confidence interval] = 0.76 [0.50-1.18]; increased exercise: adjusted odds ratio [95% confidence interval] = 0.87 [0.59-1.29]).

Conclusion

Health promotion efforts to patients with arthritis do not differ significantly between MDs and DCs, as reported by National Health Interview Survey 2006. This investigation makes it difficult to suggest that DCs or MDs are doing all they can do to manage arthritis through suggested modification of lifestyle in their patients. More research specific to what is and can be recommended to those with arthritis should be conducted particularly because it relates to health-promoting behaviors. Given the recent implementation of required clinical competencies in HP into chiropractic college curriculums, future studies regarding translation of HP messages into public practice should be more informative.

Key Indexing Terms: Arthritis, Chiropractic, Physician, Health Promotion, Weight Loss, Exercise