Index to Chiropractic Literature
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ID 18763
  Title Developing a spinal health promotion initiative: use of an expert seed panel and electronic delphi consensus process [platform presentation; the Association of Chiropractic Colleges' Thirteenth Annual Conference, 2006]
Journal J Chiropr Educ. 2006 Spring;20(1):29
Peer Review Yes
Publication Type Meeting Abstract
Abstract/Notes INTRODUCTION: Slouched posture is linked to many spinal disorders and is becoming pandemic in technologically advanced countries. Individuals in technologically advanced countries are also becoming increasingly sedentary in terms of lifestyle, contributing to skyrocketing levels of obesity, which has been linked to spinal disorders. In response to these problems, experts in the field of health promotion and spinal rehabilitation decided to develop a spinal health promotion exercise module for the public.

OBJECTIVES: Objectives included developing a short set of simple, engaging, postural improvement and spinal health exercises and obtaining buy-in and acceptance from the profession’s leaders, practitioners and the public.

METHODS: A consensus based seed and Delphi panel process was utilized for exercise module development. Because of the impact of health habits upon spinal disorders, lifestyle improvement recommendations also were incorporated as part of the spinal health initiative. A Delphi process expert was invited to help structure the module development process. A small group of healthcare practitioners with expertise in spinal health promotion and rehabilitation formed the seed panel to create a pilot exercise module. Seed panel members included individuals with diverse backgrounds and areas of expertise with strong international reputations lending credibility to the development process. Zoomerang electronic email surveys were chosen to facilitate pilot exercise module development. Using a series of electronic surveys, the seed panel shaped a short engaging set of standing spinal exercises aimed at improving posture and enhancing core stabilization. The seed panel also named the spinal health program “Straighten Up America” through a voting process and developed a short set of accompanying healthy lifestyle recommendations. Simultaneous to the creation of the pilot module and lifestyle recommendations, a 90-member Delphi panel was assembled, including many of the presidents and clinic directors of the ACC colleges; researchers; international, national and state chiropractic organization leaders; World Health Organization representatives; exercise physiologists; fitness experts and fitness champions. Utilizing Zoomerang electronic surveys, Delphi panelists voted on adoption of the individual slides of the module exercises and lifestyle recommendations. Slide adoption agreement level was set at 75%. In addition to adopting the exercises, the Delphi panelists provided very valuable feedback and refinements on the formatting and presentation of the program. The spinal exercise module was then presented to chiropractic college students and senior citizens for user feedback.

RESULTS: The seed and Delphi panels created and refined a simple set of postural improvement and spinal health exercises that has been broadly embraced by leaders and practitioners of the chiropractic profession in America and abroad. The exercise module has been presented and embraced widely in venues across the chiropractic profession. The program is currently being reviewed by the Congress of the United States of America for appropriations funding as a national health initiative. Analysis of user feedback surveys from pilot class participants indicates that practicing the module regularly is useful for facilitating perceived levels of postural improvement and enhancing levels of spinal comfort.

DISCUSSION AND LIMITATIONS: Project objectives have been met with a high degree of success. It would have been optimal to have a longer period of time to create the spinal exercise module and lifestyle recommendations. The Straighten Up America spinal exercise module and lifestyle recommendations are serving as simple enjoyable patient-active tools to facilitate improvement of posture and to promote habituation of positive spinal health behaviors. The vast majority of the state, national and international chiropractic organizations and the profession’s academic institutions are demonstrating enthusiastic support for the program.

This abstract is reproduced with the permission of the publisher.

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