Student Competition (Knowledge Generation) ID 1975184

Implementing activity-based therapy (ABT) across the continuum of care in Canada has proved challenging. The objective of this study was to understand and compare multi-group perspectives on the challenges that hinder implementation of ABT in Canada for people living with spinal cord injury or disease (SCI/D). Individuals from six key interest groups (i.e., researchers; persons living with SCI/D; administrators; physical and occupational therapists; community-based exercise trainers; and funders, advocates, and policy experts) who had knowledge of and/or experience with ABT were recruited to participate in focus group interviews that were held over web conferencing. Participants were asked about the barriers and facilitators to practicing ABT. Interview transcripts were analyzed using conventional content analysis followed by a comparative analysis across groups. Forty-eight individuals participated in interviews lasting 30-80 minutes. Six themes were identified: 1) Challenge of defining ABT and addressing gaps in knowledge/training. 2) Challenge of standardizing ABT. 3) Challenge of determining the optimal timing of ABT. 4) Challenge of defining, characterizing and achieving high dosage and intensity. 5) Challenge of funding ABT. 6) Challenge of measuring participation and performance in ABT. While all groups acknowledged these six challenges, therapists and community trainers viewed knowledge/training gaps and achieving high dosage and intensity as key challenges. Researchers and advocates emphasized funding as a key challenge. Participants highlighted the challenges that limit adoption of ABT into practice within hospital and community settings. Future research should explore avenues to address these challenges to support successful implementation of ABT in Canada.