Implementation of the spinal cord injury exercise guidelines in the hospital and community settings: Protocol for a type II hybrid trial

Abstract

Study design Type II hybrid effectiveness-implementation trial protocol. Objectives To (1) evaluate the implementation of coordinated physical activity (PA) coaching delivered by physiotherapists and spinal cord injury (SCI) peers during the transition from in-hospital care to living in a community (implementation objective) and (2) assess the effect of coaching on PA behaviour and psychosocial predictors among people with SCI (effectiveness objective). Setting Rehabilitation hospital and home/community settings in British Columbia, Canada. Methods Implementation objective: PA coaches (physiotherapists and SCI peers) receive an implementation intervention including training, monitoring, feedback, and champion support. A Theoretical Domains Framework-based questionnaire is collected at baseline, post-training, 2, and 6 months follow-up and semi-structured interviews conducted at 6 months. Effectiveness objective: Using a quasi-experimental design, 55 adults with SCI are allocated to intervention (PA coaching, n = 30) or control (usual care, n = 25) groups. Participants in the intervention group are referred by physiotherapists to receive 11 SCI peer-delivered PA coaching sessions in the community. Control participants received usual care. Questionnaires assessing PA behaviour and psychosocial predictors are administered at baseline, 2-months, 6-months, and 1-year. Semi-structured interviews are conducted to assess intervention satisfaction at 6 months. Analyses include one-way (implementation objective) and two-way (effectiveness objective) repeated measures ANCOVAs for questionnaire-reported outcomes and thematic content analysis for interview data. Data are summarised using the reach effectiveness adoption implementation maintenance (RE-AIM) framework. Ethics and dissemination The University of British Columbia Clinical Research Ethics Board approved the protocol (#H19-02694), clinicaltrials.gov registration NCT04493606. Documentation of the adoption process will inform implementation in future sites.

Assessing the reach, effectiveness, adoption, implementation, and maintenance of the ProACTIVE SCI physical activity counseling intervention among physiotherapists and SCI peer coaches during the transition from rehabilitation to community

“…A single-group withinsubjects, repeated measures design was used. Details of the study design have been previously reported (14). The implementation evaluation is discussed here.…”

“…Four follow-up training/community of practice sessions were completed over the course of 2 years. See Ma et al (14) for further details.…”

Evaluation of a Physical-Psychological Integrative (PPI) intervention for community-dwelling spinal cord injury survivors: Study protocol of a preliminary randomized controlled trial

“…Limited high-quality trials have focused on the long-term rehabilitation outcomes (e.g., physically active lifestyle, chronic pain, and psychological well-being) of people with SCI living in the community [ 20 , 21 ]. One reason for the lack of trials might be due to barriers of transportation and lack of face-to-face interaction with healthcare professionals [ 22 ]. Two pilot trials that integrated community-based physical activities and telephone counseling from physiotherapists indicated positive effects of an activity-based intervention on functional improvement and physical fitness for community dwellers with SCI [ 23 , 24 ].…”

Theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury

“…PA counseling support services are provided in a variety of settings (e.g. rehabilitation centers or hospitals [ 7 , 8 ], community organizations [ 9 ], fitness centers/gyms [ 9 ], SCI peer mentorship programs [ 10 ], research studies [ 11 ]) and delivered by counselors with different backgrounds and expertise (e.g. SCI peer mentors, physiotherapists, recreation therapists, coaches) [ 12 ].…”