Adopting an evidence-based lifestyle physical activity program: dissemination study design and methods

Abstract

Background There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. Purpose This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. Methods Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program’s textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. Results Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government, educational and medical sectors compared with fitness and other sectors, (p=0.02). More cases reported being involved in the decision to adopt ALED (p<0.0001). Data indicate that a low percentage of controls had ever heard of ALED despite repeated marketing and offering other types of physical activity programs and services. Finally, slightly over half of the adopters reported they had actually implemented the ALED program. Conclusion Dissemination research requires new perspectives and designs to produce valid insights about the results of dissemination efforts. This study design, survey methods and theoretically-based questions can serve as a useful model for other evidence-based public health interventions that are marketed by commercial publishers to better understand key issues related to adoption and implementation of evidence-based programs.

Dissemination and Implementation Research for Occupational Safety and Health

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Uptake of evidence-based physical activity programs: comparing perceptions of adopters and nonadopters

“…For this study, both programs included evidencebased behavioral strategies and social support and were effective in previous settings for helping diverse age groups and populations increase activity to meet US physical activity recommendations [34][35][36]. However, one was a research-developed program and more intensive than the other.…”

Dissemination of an evidence-based telephone-delivered lifestyle intervention: factors associated with successful implementation and evaluation

“…Evaluation of the program formed a major component of the doctoral student's dissertation research; the level of support provided was necessary due to limited knowledge, skills, and infrastructure on the part of the Medicare Local, as well as the demands of the PhD. The ability to report on the success of the program was critical to helping the Medicare Local advocate for and secure continued funding for the program DISCUSSION This account of the supports required to facilitate the successful dissemination of an evidence-based lifestyle intervention within the real-world is one of few within the literature [8,17]. Using the RE-AIM model, we highlighted what is optimally involved on the part of the researchers to facilitate successful dissemination efforts.…”

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