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Changing Minds, Changing Lives from the Top Down: An Investigation of the Dissemination and Adoption of a Canada-Wide Educational Intervention to Enhance Health Care Professionals’ Intentions to Prescribe Physical Activity

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Abstract

Purpose

The purposes of the current study were to (1) describe the restructuring and dissemination of a Canada-wide intervention curriculum designed to enhance health care professionals’ prescription of physical activity to patients with physical disabilities, and (2) examine interventionists’ social cognitions for, and their acceptance and adoption of, the new curriculum.

Methods

A participatory curriculum development process was utilized, resulting in a theory- and evidence-based curriculum. Interventionists (N = 28) were trained in curriculum delivery and most (n = 22) completed measures of Theory of Planned Behavior (TPB) constructs assessing their cognitions for delivering the new curriculum at pre- and post-training and at 6-month follow-up. Interventionists also completed a Diffusion of Innovations (DOI) measure assessing their opinion of whether the new curriculum met characteristics that would facilitate its adoption and use.

Results

Interventionists reported strong TPB cognitions for curriculum use before training. Significant increases emerged for some TPB constructs (ps ≤ 0.025) from pre- to post-training, and significant decreases were seen in some TPB constructs (ps ≤ 0.024) between post-training and 6-month follow-up. The interventionists rated the new curriculum as high on all the DOI characteristics.

Conclusion

The theory-driven, participatory development process facilitated interventionists’ social cognitions towards and adoption of the new curriculum. Positive increases in TPB cognitions from pre- to post-training were not maintained at follow-up. Further research is needed to determine if these changes in cognitions are indicative of a curriculum “reinvention” process that facilitates long-term curriculum use. Understanding curriculum adoption and implementation is a crucial step to determining the potential population impact of the intervention.

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Notes

  1. For the purposes of this paper, the term HCPs includes physicians, nurses, rehabilitation therapists, kinesiologists, and any other professional who provides LTPA advice to patients.

  2. The CPC is a non-profit, private organization dedicated to the development and promotion of a sustainable Paralympic sport system in Canada. The CPC aims to promote the success of athletes with a physical disability at all levels of parasport (i.e., parallel sport opportunities for people with a physical disability).

  3. An overview of the content of the new 30-slide curriculum can be found in Cripps, Tomasone, and Staples [14].

  4. As an index of internal consistency of the measures, Cronbach’s alpha (α) values were calculated when the scales had three or more items, and Pearson correlations (r) were calculated when the scales had only two items. Internal consistency is considered adequate if α ≥ 0.7 [28].

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Acknowledgments

The authors would like to acknowledge The Canadian Paralympic Committee for their assistance with the dissemination of the new curriculum and data collection from the interventionists, as well as Krystn Orr for her assistance with data collection. This study was partially supported by an Ontario Neurotrauma Foundation Mentor-Trainee Capacity Building Award awarded to the first and the second authors (JRT and KAMG), and a Social Sciences and Humanities Research Council of Canada Community-University Research Alliance grant awarded to the second author (KAMG).

Conflict of Interest

JRT and KAMG sat on the CMCL Advisory Committee when the intervention curriculum was being restructured. LD was the Manager of Sport Development at the Canadian Paralympic Committee during the study period. PAE has no conflicts of interest to report.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients before being included in the study.

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Authors and Affiliations

  1. Department of Kinesiology, McMaster University, Ivor Wynne Centre E110, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Jennifer R. Tomasone & Kathleen A. Martin Ginis

  2. Virginia Tech and Carilion Clinic, 1 Riverside Circle, SW Roanoke, VA, 24016, USA

    Paul A. Estabrooks

  3. The Canadian Paralympic Committee, 225 Metcalfe Street, Suite 310, Ottawa, ON, K2P 1P9, Canada

    Laura Domenicucci

Authors
  1. Jennifer R. Tomasone
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  2. Kathleen A. Martin Ginis
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  3. Paul A. Estabrooks
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  4. Laura Domenicucci
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Corresponding author

Correspondence to Jennifer R. Tomasone.

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Tomasone, J.R., Martin Ginis, K.A., Estabrooks, P.A. et al. Changing Minds, Changing Lives from the Top Down: An Investigation of the Dissemination and Adoption of a Canada-Wide Educational Intervention to Enhance Health Care Professionals’ Intentions to Prescribe Physical Activity. Int.J. Behav. Med. 22, 336–344 (2015). https://doi.org/10.1007/s12529-014-9414-6

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