IMPLEMENTATION OF A PHYSICAL THERAPY NEEDS ASSESSMENT IN NICARAGUA. Anne-Marie Dupre*; Shelley Goodgold Physical Therapy, Simmons College, Boston, MA UNIQUE: International physical therapy (PT) community health services for non-industrialized nations often consist of PT evaluation and the provision of basic therapeutic exercises and locomotion equipment. Assessment of the benefits of these services or the satisfaction of the recipients, however, is rarely performed. Therefore, to address the unique needs of the community, we worked collaboratively with a local physician to implement a physical therapy wellness needs assessment. PURPOSE: Wellness promotion and rehabilitation services are extremely limited in the rural villages of Nicaragua. The purpose of this project, therefore, was to develop and implement a PT wellness needs assessment for the rural village of San Juan del Sur, Nicaragua. This was in response to a request from a local physician interested in health reform. Her vision is to build a wellness promotion and health education community center. Results of the needs assessment will guide initial plans for training non-professional staff and developing PT wellness promotion programs to be offered at the center. FOUNDATION: Petersen and Alexander described the essential stages of developing a needs assessment for public health. These stages were used to develop the needs assessment in San Juan del Sur, Nicaragua DESCRIPTION: The visiting PT team, who lived with local families in San Juan del Sur, Nicaragua for two weeks, consisted of a PT faculty member with previous experience providing direct PT services to the residents, and four 2nd year PT students. During the physical therapy sessions offered to residents throughout this visit, demographic data on the characteristics of the residents seeking physical therapy services, types of health conditions, types of PT services provided, and client satisfaction information were collected. In addition, two local physicians, the village's physical therapist, and a mother caring for her child with a neurological disability were interviewed through a translator. OBSERVATIONS: Information collected during the PT sessions was coded, and descriptive statistics were performed to elucidate the community's physical therapy wellness needs. A total of 181 residents received physical therapy services during the two weeks. Most of the residents requesting PT services were women, 74% women and 26% males. The chief complaint reported by the clients was pain (95%). Only 12% of the clients complained of a decline in function. The most frequent diagnosis seen by PT was arthritis (37%). For those clients, significant impairments were noted in joint range (36%), strength (43%) and postural alignment (68%). The most common PT treatment provided was a home exercise program of stretching, strengthening, and instructions in use of ibuprofen. Most clients were satisfied with their PT, 78%. For the 9% who reported they were not satisfied with their PT, dissatisfaction was most often related to the client not receiving free ibuprofen. The three health care providers interviewed reported arthritis, diabetes, malnutrition in children, and poor medical education to be the primary health care concerns in San Juan del Sur. The mother, who was interviewed, identified malnutrition in children, poor diagnostics, and lack of medication as the greatest health concerns. Based on these findings, the initial focus of physical therapy at the community center will be on the development of wellness promotion and health education programs for pain management for individuals with arthritis. CONCLUSIONS: Due to cultural, epidemiological, and health care resource differences between nations, it is important to assess the needs of the community that is being served. Physical therapists providing international community health services can work collaboratively with local health providers and residents to identify key areas to focus development of PT programming and wellness services. To evaluate improvements in health, perceptions of well-being, and client satisfaction follow-up research is required. FUNDING SOURCE: The Simmons College Faculty Fund for Research supported this project. Potential for gain - none KEYWORDS: International Health, Needs Assessment, Wellness, Health Promotion, International PT Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.