Implementation of the Good Life with osteoArthritis in Denmark (GLA:D<sup>®</sup>) program via telehealth in Australia: A mixed-methods program evaluation

Ezzat, Allison M; Kemp, Joanne L; Heerey, Joshua J; Pazzinatto, Marcella Ferraz; Silva, Danilo de Oliveira; Dundules, K.; Francis, Matthew; Barton, Christian J

doi:10.1177/1357633x231167620

Cited by 3 publications

(2 citation statements)

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“…Alternatively, other hybrid models of care that blend in-person assessments with telehealth follow-up treatments may be another viable solution (Ezzat, Kemp, et al, 2023;Simony et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

“…To better support clinicians in conducting assessments via telehealth, there may be a need to expand formal training opportunities as well as promote observation of and mentoring by expert telehealth clinicians, and for telehealth to be integrated into curriculums for physiotherapy students (Ashley et al., 2023; Martin et al., 2022). Alternatively, other hybrid models of care that blend in‐person assessments with telehealth follow‐up treatments may be another viable solution (Ezzat, Kemp, et al., 2023; Simony et al., 2023).…”

Section: Discussionmentioning

confidence: 99%

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Co‐development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists

Ezzat,

King,

De Oliveira Silva

et al. 2023

Musculoskeletal Care

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IntroductionIn‐person physiotherapy services are not readily available to all individuals with musculoskeletal conditions, especially those in rural regions or with time‐intensive responsibilities. The COVID‐19 pandemic highlighted that telehealth may facilitate access to, and continuity of care, yet many physiotherapists lack telehealth confidence and training. This project co‐developed and evaluated a web‐based professional development toolkit supporting physiotherapists to provide telehealth services for musculoskeletal conditions.MethodsA mixed‐methods exploratory sequential design applied modified experience‐based co‐design methods (physiotherapists [n = 13], clinic administrators [n = 2], and people with musculoskeletal conditions [n = 7]) to develop an evidence‐informed toolkit. Semi‐structured workshops were conducted, recorded, transcribed, and thematically analysed, refining the toolkit prototype. Subsequently, the toolkit was promoted via webinars and social media. The usability of the toolkit was examined with pre‐post surveys examining changes in confidence, knowledge, and perceived telehealth competence (19 statements modelled from the theoretical domains framework) between toolkit users (>30 min) and non‐users (0 min) using chi‐squared tests for independence. Website analytics were summarised.ResultsTwenty‐two participants engaged in co‐design workshops. Feedback led to the inclusion of more patient‐facing resources, increased assessment‐related visual content, streamlined toolkit organisation, and simplified, downloadable infographics. Three hundred and twenty‐nine physiotherapists from 21 countries completed the baseline survey, with 172 (52%) completing the 3‐month survey. Toolkit users had greater improvement in knowledge, confidence, and competence than non‐users in 42% of statements. Seventy‐two percentage of toolkit users said it changed their practice, and 95% would recommend the toolkit to colleagues. During the evaluation period, the toolkit received 5486 total views.DiscussionThe co‐designed web‐based Musculoskeletal Telehealth Toolkit is a professional development resource that may increase physiotherapist's confidence, knowledge, and competence in telehealth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Co‐development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists

Ezzat,

King,

De Oliveira Silva

et al. 2023

Musculoskeletal Care

Self Cite

View full text Add to dashboard Cite

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How Does Osteoarthritis Education Influence Knowledge, Beliefs, and Behavior in People With Knee and Hip Osteoarthritis? A Systematic Review

Simick Behera,

Duong,

Eyles

et al. 2024

Arthritis Care & Research

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ObjectiveTo inform the design and implementation of osteoarthritis (OA) education for people with knee and hip OA, this review investigated: i) the impact of OA education on knowledge, beliefs and behavior, ii) how and why these changes occur.MethodsFive databases ‐ MEDLINE, Excerpta Medica Database (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Physiotherapy Evidence Database (PEDro) ‐ were searched in August 2023. Eligible studies were quantitative, qualitative and mixed‐methods, involving OA education interventions, assessing knowledge, beliefs and/or behavioral outcomes. An interpretivist analytic process guided data evaluation, synthesis and description of meta‐themes.ResultsNinety‐eight studies were included (80 quantitative, 12 qualitative, 6 mixed‐methods). OA education was heterogeneous in content and delivery. Outcome measures varied, with poor distinction between knowledge, beliefs and behavior constructs. Trends toward short‐term knowledge improvement were observed, but there were no clear trends in beliefs or behavior change. Intrinsic factors (e.g. pre‐existing beliefs) and extrinsic factors (e.g. socioeconomic factors) appeared to influence change. Three meta‐themes described how and why changes may occur: i) Engagement ‐ how individuals relate with education content and delivery, ii) Embodiment – the role of experiential factors in learning, and iii) Empowerment ‐ the level of agency education generates.ConclusionBeyond the provision of information and instruction, OA education is a complex, relational process influenced by multidimensional factors. This review identifies potentially important strategies at individual, interpersonal and community levels to support the design and delivery of engaging education that promotes holistic, embodied learning, and facilitates meaningful, empowering change.image

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Barriers and Facilitators to the Implementation of Digital Health Services for People With Musculoskeletal Conditions in the Primary Health Care Setting: Systematic Review

van Tilburg,

Spin,

Pisters

et al. 2024

J Med Internet Res

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Background In recent years, the effectiveness and cost-effectiveness of digital health services for people with musculoskeletal conditions have increasingly been studied and show potential. Despite the potential of digital health services, their use in primary care is lagging. A thorough implementation is needed, including the development of implementation strategies that potentially improve the use of digital health services in primary care. The first step in designing implementation strategies that fit the local context is to gain insight into determinants that influence implementation for patients and health care professionals. Until now, no systematic overview has existed of barriers and facilitators influencing the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. Objective This systematic literature review aims to identify barriers and facilitators to the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. Methods PubMed, Embase, and CINAHL were searched for eligible qualitative and mixed methods studies up to March 2024. Methodological quality of the qualitative component of the included studies was assessed with the Mixed Methods Appraisal Tool. A framework synthesis of barriers and facilitators to implementation was conducted using the Consolidated Framework for Implementation Research (CFIR). All identified CFIR constructs were given a reliability rating (high, medium, or low) to assess the consistency of reporting across each construct. Results Overall, 35 studies were included in the qualitative synthesis. Methodological quality was high in 34 studies and medium in 1 study. Barriers (–) of and facilitators (+) to implementation were identified in all 5 CFIR domains: “digital health characteristics” (ie, commercial neutral [+], privacy and safety [–], specificity [+], and good usability [+]), “outer setting” (ie, acceptance by stakeholders [+], lack of health care guidelines [–], and external financial incentives [–]), “inner setting” (ie, change of treatment routines [+ and –], information incongruence (–), and support from colleagues [+]), “characteristics of the healthcare professionals” (ie, health care professionals’ acceptance [+ and –] and job satisfaction [+ and –]), and the “implementation process” (involvement [+] and justification and delegation [–]). All identified constructs and subconstructs of the CFIR had a high reliability rating. Some identified determinants that influence implementation may be facilitators in certain cases, whereas in others, they may be barriers. Conclusions Barriers and facilitators were identified across all 5 CFIR domains, suggesting that the implementation process can be complex and requires implementation strategies across all CFIR domains. Stakeholders, including digital health intervention developers, health care professionals, health care organizations, health policy makers, health care funders, and researchers, can consider the identified barriers and facilitators to design tailored implementation strategies after prioritization has been carried out in their local context.

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Implementation of the Good Life with osteoArthritis in Denmark (GLA:D^®) program via telehealth in Australia: A mixed-methods program evaluation

Cited by 3 publications

References 39 publications

Co‐development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists

Co‐development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists

How Does Osteoarthritis Education Influence Knowledge, Beliefs, and Behavior in People With Knee and Hip Osteoarthritis? A Systematic Review

Barriers and Facilitators to the Implementation of Digital Health Services for People With Musculoskeletal Conditions in the Primary Health Care Setting: Systematic Review

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Implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia: A mixed-methods program evaluation

Cited by 3 publications

References 39 publications

Co‐development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists

Co‐development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists

How Does Osteoarthritis Education Influence Knowledge, Beliefs, and Behavior in People With Knee and Hip Osteoarthritis? A Systematic Review

Barriers and Facilitators to the Implementation of Digital Health Services for People With Musculoskeletal Conditions in the Primary Health Care Setting: Systematic Review

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Implementation of the Good Life with osteoArthritis in Denmark (GLA:D^®) program via telehealth in Australia: A mixed-methods program evaluation