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Physical Activity Counseling Education: The Use of Theory in Development, Implementation, and Evaluation
Hattie Shu1, Kathleen A Martin Ginis, Kenedy Olsen
1Dr. Shu: Resident physician, University of British Columbia, Vancouver, British Columbia, Canada. Dr. Martin Ginis: Professor, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC) University of British Columbia, Vancouver, British Columbia, Canada; School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada and Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna British Columbia, Canada. Ms. Olsen: Research assistant, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC) University of British Columbia, Vancouver, British Columbia, Canada; School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada and Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna British Columbia, Canada. Ms. Cao: Research assistant, University of British Columbia, Vancouver, British Columbia, Canada and Arthritis Research Canada, Vancouver, British Columbia, Canada. Ms. Le Cornu Levett: Clinical assistant professor, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Dr. McBride: Executive director of Spinal Cord Injury, Spinal Cord Injury BC, Vancouver, British Columbia, Canada. Ms. Walden: Associate director of Praxis Spinal Cord Institute, Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada. Ms. Thorson: Peer coach for Spinal Cord Injury, Spinal Cord Injury BC, Vancouver, British Columbia, Canada. Ms. Colistro: Clinical instructor, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Ms. Plashkes: Physiotherapist, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Ms. Bass: Physiotherapist, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Dr. Ma: Assistant professor, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC) University of British Columbia, Vancouver, British Columbia, Canada and Arthritis Research Canada, Vancouver, British Columbia, Canada.
Introduction:
Implementing evidence-based physical activity (PA) counseling for clients with spinal cord injury (SCI) may help address the decline in PA typically observed after discharge from rehabilitation. Engaging practitioners in educational intervention development may improve uptake of such a practice change. The purpose of this study is to (1) describe the theory-based development of a PA counseling education intervention and (2) evaluate the intervention's effects on PA counseling behavior and determinants (eg, knowledge, skills, confidence) among rehabilitation hospital physiotherapists and community SCI peers.
Methods:
The Knowledge to Action (KTA) Framework supplemented by the quality implementation framework was used to guide the engagement of physiotherapists and SCI peers in developing a PA counseling education intervention. A within-subjects, repeated measures design was used to evaluate the effects of the intervention. PA counseling behavior and determinants were evaluated using a survey guided by the theoretical domains framework, administered before and immediately after training, 2 months post, and 6 months post-training. Data were analyzed using one-way repeated-measures ANOVAs.
Results:
Physiotherapists and SCI peers (n = 10) demonstrated significant, medium-large-sized effects on PA counseling behaviors from baseline to 2 and 6 months ( P' s < 0.05). These behavioral improvements were supported by significant increases over time in all theoretical domains framework assessed ( P' s < 0.05), except intentions.
Discussion:
The combined use of the KTA and quality implementation framework provides a structure for engaging practitioners in education intervention design. This work shows promise for the use of theory to develop an education intervention that improves both PA counseling knowledge and behavior.
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