Adolescent Idiopathic Scoliosis Screening For School, Community, and Clinical Health Promotion Practice Utilizing the PRECEDE-PROCEED Model

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SOURCE:   Chiropractic & Osteopathy 2005 (Nov 30); 13: 25 ~ FULL TEXT

Timothy A Mirtz, Mark A Thompson, Leon Greene, Lawrence A Wyatt, and Cynthia G Akagi

Department of Health Sport and Exercise Science, University of Kansas, Lawrence, Kansas, USA.

Background   Screening for adolescent idiopathic scoliosis (AIS) is a commonly performed procedure for school children during the high risk years. The PRECEDE-PROCEDE (PP) model is a health promotion planning model that has not been utilized for the clinical diagnosis of AIS. The purpose of this research is to study AIS in the school age population using the PP model and its relevance for community, school, and clinical health promotion.

Methods   MEDLINE was utilized to locate AIS data. Studies were screened for relevance and applicability under the auspices of the PP model. Where data was unavailable, expert opinion was utilized based on consensus.

Results   The social assessment of quality of life is limited with few studies approaching the long-term effects of AIS. Epidemiologically, AIS is the most common form of scoliosis and leading orthopedic problem in children. Behavioral/environmental studies focus on discovering etiologic relationships yet this data is confounded because AIS is not a behavioral. Illness and parenting health behaviors can be appreciated. The educational diagnosis is confounded because AIS is an orthopedic disorder and not behavioral. The administration/policy diagnosis is hindered in that scoliosis screening programs are not considered cost-effective. Policies are determined in some schools because 26 states mandate school scoliosis screening. There exists potential error with the Adam’s test. The most widely used measure in the PP model, the Health Belief Model, has not been utilized in any AIS research.

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Conclusion   The PP model is a useful tool for a comprehensive study of a particular health concern. This research showed where gaps in AIS research exist suggesting that there may be problems to the implementation of school screening. Until research disparities are filled, implementation of AIS screening by school, community, and clinical health promotion will be compromised. Lack of data and perceived importance by school/community health planners may influence clinical health promotion practices.


From the FULL TEXT Article:


The PRECEDE-PROCEDE (PP) model is a planning model that provides structure for applying theories so the most appropriate intervention strategies can be identified and implemented. [1, 2] The PP model has been utilized in public health and holds potential for use by school, community and clinical health promotion practice in preventing a number of disorders. [3] Adolescent idiopathic scoliosis (AIS) is defined as a lateral curvature of the spine greater than 10 degrees accompanied by vertebral motion and is the most common spinal deformity affecting children with the most common form being the idiopathic form. [4-6]

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