Implementation of a Cost-Effective Physical Therapy Approach (Coach2Move) to Improve Physical Activity in Community-Dwelling Older Adults With Mobility Problems: Protocol for a Cluster-Randomized, Stepped Wedge Trial

Heij, Ward; Teerenstra, Steven; Sweerts, Lieke; Staal, J. Bart; Sanden, M.W.G. Nijhuis-van der; Hoogeboom, Thomas J.

doi:10.1093/ptj/pzz183

Cited by 8 publications

(10 citation statements)

References 30 publications

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“…Developing information on how to adapt a protocol-based approach to accommodate shared decisions may be warranted with future work. 36 To operate as intended, POFs should be viewed as a patient-centered and participatory approach that could be applied in combination with the context of the patient's life and preferences.…”

Section: Discussionmentioning

confidence: 99%

Impact of Personalized Outcomes Forecasts on Clinical Reasoning of Physical Therapists in Intermittent Claudication: A Vignette Study

et al. 2022

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Objective Guidelines recommend supervised exercise therapy and lifestyle counseling by a physical therapist as initial treatment of patients with intermittent claudication. However, guidelines provide only a crude estimate of the outcomes that therapists and patients might expect from treatment. The purpose of this study was to explore the impact of personalized outcomes forecasts (POFs) on the decision-making process of physical therapists and to learn lessons on facilitating the use of forecasts in daily practice. Methods A vignette-based, think-aloud interview study design was used. The participants were physical therapists trained in treating patients with intermittent claudication. Vignettes described fictitious patients diagnosed with intermittent claudication and included POFs. A directed approach was used to code, organize, and describe the data. Transcripts were analyzed using a thematic approach. Results Sixteen therapists participated in the study. Three themes were identified: (1) setting and contextualizing treatment expectations; (2) setting (shared) goals and (de)motivating the patient, and (3) establishing and monitoring the treatment plan. Therapists mentioned that POFs could be useful for setting expectations and realistic treatment goals, contextualizing expected treatment response, stimulating patients to achieve their goals, and deciding on treatment frequency and treatment timing. Therapists thought POFs would be of less use for changing treatment goals during follow-up visits or for establishing intensity or type of training. Conclusion To overcome challenges that may arise when adopting POFs in daily practice, adequate training of physical therapists should be conducted. Potential areas to address with training include statistical and data literacy as well as guidance on integrating POFs with existing treatment protocols. Impact The use of POFs by physical therapists might contribute to a more person-centered care approach. The insights provided by this study on the first use of POFs by physical therapists can serve as an example and lesson on how to optimally implement such supporting tools into daily practice.

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Section: Discussionmentioning

confidence: 99%

Impact of Personalized Outcomes Forecasts on Clinical Reasoning of Physical Therapists in Intermittent Claudication: A Vignette Study

et al. 2022

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“…The LAPAQ is a scale created to determine the level of physical activity in older individuals. The LAPAQ is also frequently used in the literature (19,20). However, upon examining the LAPAQ version studies, the number of the studies conducted is observed to be limited (21,22).…”

Section: Discussionmentioning

confidence: 99%

Lasa Fiziksel Aktivite Anketi’nin (LAFAA) Türkçe Versiyonunun Güvenirliği ve Geçerliği

Arslan¹,

Kocaman²,

Sertel³

et al. 2021

Osmangazi̇ Journal of Medicine

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LASA Physical Activity Questionnaire (LAPAQ) is frequently used for the elderly population in the literatüre, and its validityreliability studies have been carried out.There are also comparative studies with other physical activity questionnaires. This study's aim is to investigate the reliability and validity of the Turkish version of the LAPAQ (LAPAQ-T) for elderly individuals. One hundred and seven elderly were included in the study. LAPAQ-T and Physical Activity Scale for the Elderly (PASE) were administered to the individuals participating in the study on the first day. LAPAQ-T was reapplied by the same physiotherapist 1 week after the first evaluation to measure test-retest reliability. The test-retest took place with the participation of 27 people. The intra-class correlation coefficient (ICC) was used to evaluate test-retest reliability. The ICC value for test-retest reliability was found to be 0.977, which suggests excellent test-retest reliability. A high correlation was found between the LAPAQ-T total score and the PASE total score (r=0.703, p<0.001). The results of our study show that the LAPAQ-T is a reproducible, reliable and valid questionnaire that evaluates the level of physical activity for elderly individuals. Therefore the questionnaire will be useful for clinicians in evaluating physical activity.

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“…Next, we specified determinants for adoption and implementation. Researchers at University of Utah Health performed a literature review identifying factors associated with clinician delivery of behavioral interventions (13,(24)(25)(26)(27). We met with Coach2Move developers to identify prior implementation experiences and contrasted this with the literature review.…”

Section: Matrices Of Changementioning

confidence: 99%

“…They also find it difficult to elicit motivation, address ambivalence, and partner with patients on strategies that change PA in everyday life ( 25 ). In Coach2Move, physical therapists train in motivational interviewing to engage patients in identifying meaningful goals, monitor progress, and plan for self-management through sustainable changes in PA ( 26 ). Coach2Move has demonstrated acceptability with patients and physical therapists, effectiveness in sustaining PA beyond an episode of physical therapy care, and cost-effectiveness ( 15 , 27 , 28 ).…”

Section: Introductionmentioning

confidence: 99%

Implementing a Dutch Physical Therapy Intervention Into a U.S. Health System: Selecting Strategies Using Implementation Mapping

Thackeray

Waring

Hoogeboom³

et al. 2022

Front. Public Health

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BackgroundCoach2Move is a person-centered physical therapy intervention that has demonstrated success in changing physical activity behaviors among older adults in the Netherlands. In this manuscript, we describe how we developed an implementation plan for Coach2move in a U.S. population and healthcare system using Implementation Mapping.MethodsWe established an implementation planning team of researchers, patients, and clinicians. The Consolidated Framework for Implementation Research provided an overall structure for consideration of the context for implementation. Implementation Mapping guided the planning process. The implementation planning team worked sequentially through the five tasks of Implementation Mapping (1) Identify needs, program adopters and implementers; (2) Identify adoption and implementation outcomes, performance objectives, determinants, and matrices of change; (3) Choose theoretical models and implementation strategies; (4) Produce implementation protocols; (5) Evaluate implementation outcomes. In this manuscript, we identify our evaluation plan but not results as data collection is ongoing.ResultsClinic managers and physical therapists were identified as program adopters and implementors. Performance objectives necessary steps to achieving implementation outcomes were linked to Coach2Move fidelity indicators with implementation by the physical therapist. These included delivery of person-centered care, motivational interviewing, meaningful goal setting, shared decision-making in planning, and systematic monitoring and follow-up. Determinants linked to these performance objectives included knowledge, outcome expectations, skills and self-efficacy, and perceived norms. Implementation strategies were selected based on a review of methods effective for influencing these determinants. This resulted in four primary strategies (1) educational meetings and dynamic training, (2) peer-assessment meetings, (3) changing the electronic health record template, and (4) reminders and prompts. Measures of intervention acceptability, appropriateness, and feasibility will be collected after training and early in implementation. Fidelity and effectiveness measures will be collected over the next 12-months.ConclusionImplementation mapping provided a systematic process for identifying what physical therapists would need to implement Coach2Move with fidelity. The result was a matrix linking behavioral determinants and performance objectives. These matrices of change allowed for systematic identification and tailoring of implementation strategies to the needs of our population and setting. The process was acceptable to diverse stakeholders, facilitated communication across stakeholders.

show abstract

Implementation of a Cost-Effective Physical Therapy Approach (Coach2Move) to Improve Physical Activity in Community-Dwelling Older Adults With Mobility Problems: Protocol for a Cluster-Randomized, Stepped Wedge Trial

Cited by 8 publications

References 30 publications

Impact of Personalized Outcomes Forecasts on Clinical Reasoning of Physical Therapists in Intermittent Claudication: A Vignette Study

Impact of Personalized Outcomes Forecasts on Clinical Reasoning of Physical Therapists in Intermittent Claudication: A Vignette Study

Lasa Fiziksel Aktivite Anketi’nin (LAFAA) Türkçe Versiyonunun Güvenirliği ve Geçerliği

Implementing a Dutch Physical Therapy Intervention Into a U.S. Health System: Selecting Strategies Using Implementation Mapping

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