BackgroundBy adaptation of the face-to-face physiotherapist-training program previously used in the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) feasibility trial, an asynchronous, interactive, Web-based, e-learning training program (E-SOLAS) underpinned by behavior and learning theories was developed.ObjectiveThis study investigated the effect of the E-SOLAS training program on relevant outcomes of effective training and implementation.MethodsThirteen physiotherapists from across Ireland were trained via E-SOLAS by using mixed methods, and seven physiotherapists progressed to implementation of the 6-week group-based SOLAS intervention. The effectiveness of E-SOLAS was evaluated using the Kirkpatrick model at the levels of reaction (physiotherapist engagement and satisfaction with E-SOLAS training methods and content), learning (pre- to posttraining changes in physiotherapists’ confidence and knowledge in delivering SOLAS content and self-determination theory-based communication strategies, administered via a SurveyMonkey questionnaire), and behavior (fidelity to delivery of SOLAS content using physiotherapist-completed weekly checklists). During implementation, five physiotherapists audio recorded delivery of one class, and the communication between physiotherapists and clients was assessed using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behaviour Scale (CCBS), and an intervention-specific measure (ISM; 7-point Likert scale). A range of implementation outcomes were evaluated during training and delivery (ie, acceptability, appropriateness, feasibility, fidelity, and sustainability of E-SOLAS) using a posttraining feedback questionnaire and individual semistructured telephone interviews.ResultsWith regard to their reaction, physiotherapists (n=13) were very satisfied with E-SOLAS posttraining (median 5.0; interquartile range 1.0; min-max 4.0-5.0) and completed training within 3-4 weeks. With regard to learning, there were significant increases in physiotherapists’ confidence and knowledge in delivery of all SOLAS intervention components (P<.05). Physiotherapists’ confidence in 7 of 10 self-determination theory-based communication strategies increased (P<.05), whereas physiotherapists’ knowledge of self-determination theory-based strategies remained high posttraining (P>.05). In terms of behavior, physiotherapists delivered SOLAS in a needs supportive manner (HCCQ: median 5.2, interquartile range 1.3, min-max 3.7-5.8; CCBS: median 6.6, interquartile range 1.0, min-max 5.6-7.0; ISM: median 4.5, interquartile range 1.2, min-max 2.8-4.8). Fidelity scores were high for SOLAS content delivery (total %mean fidelity score 93.5%; SD 4.9%). The posttraining questionnaire and postdelivery qualitative interviews showed that physiotherapists found E-SOLAS acceptable, appropriate, feasible, and sustainable within primary care services to support the implementation of the SOLAS intervention.ConclusionsThis study provides preliminary evidence of the effectivenes...

Background: The Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) (ISRCTN49875385) feasibility trial included physical therapists (PTs) completing two days small group face-to-face training to deliver the six week group-based intervention. While the effectiveness of this training program has been established, potential upscaling to a definitive national trial and future implementation is limited by travel, time, and cost constraints for PTs. Therefore, an asynchronous, interactive, web-based E-learning training program (E-SOLAS) underpinned by behavior and learning theories was developed.Objective: This study investigated the effectiveness of the E-SOLAS training program on relevant outcomes for effective training and implementation.Methods: Thirteen PT's from across Ireland were trained via E-SOLAS using mixed methods and seven PTs progressed to intervention implementation. The effectiveness of E-SOLAS was evaluated using the Kirkpatrick model at the levels of (1) Reaction: PTs engagement and satisfaction with E-SOLAS training methods and content, (2) Learning: pre to post-training changes in PTs a) confidence and b) knowledge in delivering SOLAS content and self-determination theory (SDT)-based communication strategies, administered via a SurveyMonkey questionnaire and (3) Behavior: Fidelity to delivery of SOLAS content using PT-completed weekly checklists. During implementation, five PTs audio-recorded delivery of one class and the communication between PTs and clients was assessed using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention specific measure (ISM; 7-point Likert scales). A range of implementation outcomes were evaluated during training and delivery (i.e. acceptability, appropriateness, feasibility, fidelity and sustainability of E-SOLAS) using a post-training feedback questionnaire and individual semi-structured telephone interviews. median CCBS = 6.6 (1.0); 5.6-7.0; median ISM = 4.5 (1.2); 2.8-4.8). Fidelity scores were high for SOLAS content delivery (total % mean (SD) fidelity score = 93.5% (4.9)). The post-training questionnaire and post-delivery qualitative interviews showed PTs found E-SOLAS acceptable, appropriate, feasible and sustainable within primary care services to support the implementation of the SOLAS intervention. Conclusions:This study provides preliminary evidence of the effectiveness, acceptability and 2 feasibility of an e-learning program to train PTs to deliver a group-based self-management complex intervention in primary care settings that is equivalent to face to face training outcomes and would support inclusion of PTs in a definitive trial of SOLAS.Keywords: technology-enhanced learning; evaluation; e-learning; digital learning; program evaluation; effectiveness; physical therapy; implementation; osteoarthritis; low back pain. 3 IntroductionInternational clinical guidelines for osteoarthritis (OA) and low back pain (LBP) endorse selfmanagement (SM), exercise and phy...