Physical Activity Counseling Education: The Use of Theory in Development, Implementation, and Evaluation.

Abstract

Introduction: Implementing evidence-based physical activity (PA) counseling for clients with spinal cord injury (SCI) may help address the decline in PA typically observed after discharge from rehabilitation. Engaging practitioners in educational intervention development may improve uptake of such a practice change. The purpose of this study is to (1) describe the theory-based development of a PA counseling education intervention and (2) evaluate the intervention's effects on PA counseling behavior and determinants (eg, knowledge, skills, confidence) among rehabilitation hospital physiotherapists and community SCI peers.

Methods: The Knowledge to Action (KTA) Framework supplemented by the quality implementation framework was used to guide the engagement of physiotherapists and SCI peers in developing a PA counseling education intervention. A within-subjects, repeated measures design was used to evaluate the effects of the intervention. PA counseling behavior and determinants were evaluated using a survey guided by the theoretical domains framework, administered before and immediately after training, 2 months post, and 6 months post-training. Data were analyzed using one-way repeated-measures ANOVAs.

Results: Physiotherapists and SCI peers (n = 10) demonstrated significant, medium-large-sized effects on PA counseling behaviors from baseline to 2 and 6 months (P's < 0.05). These behavioral improvements were supported by significant increases over time in all theoretical domains framework assessed (P's < 0.05), except intentions.

Discussion: The combined use of the KTA and quality implementation framework provides a structure for engaging practitioners in education intervention design. This work shows promise for the use of theory to develop an education intervention that improves both PA counseling knowledge and behavior.