SWOT analysis of an outpatient rehabilitation physical activity intervention for individuals with mild traumatic brain injury

Background Physical activity interventions have been shown to be an effective therapeutic approach to improve symptoms and reduce recovery time after a mild traumatic brain injury. Service providers from a specialized traumatic brain injury outpatient rehabilitation program recognized the need to ensure their physical activity intervention integrated evidence-based treatment components, while considering user needs and preferences. To inform quality improvement efforts, service providers felt it necessary to learn about the perceptions of key stakeholders, regarding the quality of the intervention. The study objective was to explore the perceptions of administrators, clinicians and users of the specialized program regarding the physical activity intervention’s strengths, weaknesses, opportunities and threats (SWOT). Methods Using a SWOT analysis framework, this qualitative study explored the perspectives of the purposive sample (n=14) composed of the managerial staff, six clinicians and five program users. Semi-structured interviews were performed, recorded, transcribed verbatim and analyzed using a qualitative content analysis approach. Results Fifty categories were generated resulting in 15 strengths, 17 weaknesses, 12 opportunities and 6 threats grouped into 8 overarching categories: physical activity intervention, health-related outcomes, clinical expertise, knowledge translation, communication, user engagement, resources, accessibility. Category descriptions, convergent and divergent perspectives, and salient quotes of participants are provided. Conclusions This study successfully identified perceived strengths, many weaknesses, several opportunities and a few threats. Participants were generally positive about the intervention but identified weaknesses including the need for service providers to better describe the physical activity intervention using theoretically driven approaches before engaging in quality improvement activities. Convergent and divergent perspectives of service providers and program users helped identify areas to maintain and others to improve upon when the program develops their new intervention. Study results may also inform the development of other physical activity interventions designed for adults with persisting symptoms of a mild traumatic brain injury.