scholarly journals Informing the real-world implementation of a home-based physical activity program for mothers at risk of postnatal depression: Perspectives from key stakeholders.

2020 ◽  
Author(s):  
Megan Teychenne ◽  
Maria Apostolopoulos ◽  
Kylie Ball ◽  
Ellinor K Olander ◽  
Rachelle S Opie ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Real World ◽  
Postnatal Depression ◽  
Scale Up ◽  
Stakeholder Involvement ◽  
Relative Advantage ◽  
Structured Interviews ◽  
Organisational Capacity ◽  
Home Based

Abstract Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform development and implementation of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up.Methods In September to November 2019, representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n = 11) participated in semi-structured interviews exploring their perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Thematic analyses were used for qualitative data.Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services.Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.

scholarly journals Key stakeholder perspectives on the development and real-world implementation of a home-based physical activity program for mothers at risk of postnatal depression: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan Teychenne ◽  
Maria Apostolopoulos ◽  
Kylie Ball ◽  
Ellinor K. Olander ◽  
Rachelle S. Opie ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Qualitative Study ◽  
Real World ◽  
Postnatal Depression ◽  
Scale Up ◽  
Relative Advantage ◽  
Structured Interviews ◽  
Stakeholder Perspectives ◽  
Home Based

Abstract Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform the design and delivery of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up. Methods A descriptive qualitative study was undertaken whereby semi-structured interviews were conducted with representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n = 11). Interviews were conducted between September to November 2019 and explored stakeholder perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Data were analysed thematically using both deductive and inductive coding. Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services. Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.

scholarly journals ‘Key stakeholder perspectives on the development and real-world implementation of a home-based physical activity program for mothers at risk of postnatal depression: A qualitative study’

2020 ◽  
Author(s):  
Megan Teychenne ◽  
Maria Apostolopoulos ◽  
Kylie Ball ◽  
Ellinor K Olander ◽  
Rachelle S Opie ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Qualitative Study ◽  
Real World ◽  
Postnatal Depression ◽  
Scale Up ◽  
Relative Advantage ◽  
Structured Interviews ◽  
Stakeholder Perspectives ◽  
Home Based

Abstract Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform the design and delivery of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up.Methods A descriptive qualitative study was undertaken whereby semi-structured interviews were conducted with representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n=11). Interviews were conducted between September to November 2019 and explored stakeholder perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Data were analysed thematically using both deductive and inductive coding. Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services. Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.

scholarly journals A RE-AIM evaluation of Healthy Together: a family-centred program to support children’s healthy weights

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joan L. Bottorff ◽  
Anne Huisken ◽  
Michele Hopkins ◽  
Catherine Nesmith
Keyword(s):  
Physical Activity ◽  
Healthy Eating ◽  
Low Income ◽  
Real World ◽  
Scale Up ◽  
Community Organizations ◽  
Social Connections ◽  
Refugee Status ◽  
Service Programs ◽  
Core Service

Abstract Background Healthy Together (HT) is family-centered program to support healthy eating and physical activity designed for implementation in community organizations serving families who may be experiencing vulnerabilities (e.g., related to low income, isolation, ethnicity, immigrant/refugee status, and/or Indigenous background). The purpose of this study was to conduct an evaluation of HT in a real-world, scale-up phase using the RE-AIM framework. Methods Using a cross-sectional, non-comparative design, a community-based program evaluation was conducted in 29 organizations implementing HT as part of their core service programs. Data were collected using questionnaires with program participants and facilitators, and interviews with directors of participating organizations. Quantitative data were analyzed using descriptive statistics and qualitative data were content analyzed. Results With regards to Reach, over 3400 caregivers, children and youth attended community programming that offered HT. Among those attending on the scheduled day for the evaluation, 663 completed the questionnaires. The majority of caregiver respondents (n = 431) were female (92%) and attended with children 0–6 years. Respondents also included children 4–6 years (n = 142) and 7–12 years (n = 65), and youth 13–18 years (n = 25). Effectiveness was demonstrated in reported improvements in physical activity, healthy eating, and strengthened social connections. HT was also widely supported by participants and facilitators. Adoption was influenced by the desire to enrich core service programs for families, HT’s fit within existing programs, organizational commitment, and funding support. Implementation experiences indicated that fidelity to the HT program was generally maintained, with some setting specific adaptations. Maintenance of HT was influenced by financial and non-financial resources within community organizations. Most organizations also introduced new initiatives to extend support for healthy eating and physical activity. Conclusion Our findings indicate improvements in healthy eating and physical activity, and social connections among program participants, as well as efforts by community organizations to create environments to support healthy weights. HT was successfully delivered in “real-world” community settings across multiple contexts and with families with diverse backgrounds. This along with strategies to support program implementation and sustainability indicate that HT provides a model for other public health interventions to promote family health and wellbeing. Trial registration ClincialTrials.gov NCT03550248. Registered May 25, 2018

scholarly journals Patient Perspectives on Home-Based Rehabilitation Exercise and General Physical Activity after Total Hip Arthroplasty: A qualitative study (PHETHAS-2)

2020 ◽  
Author(s):  
Anne Groendahl Poulsen ◽  
Janni Dahlgaard Gravesen ◽  
Merete Noergaard Madsen ◽  
Lone Ramer Mikkelsen ◽  
Thomas Bandholm ◽  
...  
Keyword(s):  
Physical Activity ◽  
Everyday Life ◽  
Exercise Program ◽  
Main Theme ◽  
Structured Interviews ◽  
Theoretical Underpinning ◽  
Home Based ◽  
Facilitators And Barriers ◽  
General Physical ◽  
Rehabilitation Exercise

Abstract Objectives To investigate patient-perceived facilitators and barriers to home-based rehabilitation exercise and general physical activity after THA. Design Using a qualitative design, twenty-two semi-structured interviews were conducted and analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept conduct of everyday life. The study is embedded within the PHETHAS-1 trial, quantitatively investigating recovery outcomes after a home-based rehabilitation exercise program. Setting A regional hospital in Denmark between January 2018 and May 2019. Participants Twenty-two patients who had undergone THA and performed home-based rehabilitation exercise. Results The main theme Wishing to return to the well-known everyday life and the subtheme General physical activity versus rehabilitation exercise were identified. Generally, the participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their habitual conduct of everyday life and perform their usual general physical activities. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises. Both pain and no pain were identified as barriers for doing the home-based rehabilitation exercise. Pain could cause insecurity while no pain could cause the rehabilitation exercise to be perceived as pointless. Conclusions The overall goal for the THA patients was to return to their habitual everyday life. This goal served as a facilitator for undertaking home-based rehabilitation exercise. Being able to perform their usual activities paradoxically became a barrier for some of the participants, as they were more motivated towards general physical activity than the rehabilitation exercise.

Barriers to Weight Loss and Physical Activity, and Coach Approaches to Addressing Barriers, in a Real-World Adaptation of the DPP Lifestyle Intervention: A Process Analysis

2019 ◽  
Vol 45 (6) ◽  
pp. 596-606 ◽  
Author(s):  
Linda M. Delahanty ◽  
Paula M. Trief ◽  
Donald A. Cibula ◽  
Ruth S. Weinstock
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Weight Loss ◽  
Real World ◽  
Positive Impact ◽  
Process Analysis ◽  
Community Sample ◽  
Diabetes Prevention Program ◽  
Care Staff ◽  
Self Monitoring

Purpose The purpose of this study is to identify barriers to weight loss and physical activity, as well as approaches used by coaches, in a real-world, community sample of adults with metabolic syndrome (at risk for type 2 diabetes) who participated in a Diabetes Prevention Program (DPP)–adapted weight loss intervention and compare findings to data from the screened and highly selected DPP sample. Methods SHINE (Support, Health Information, Nutrition, and Exercise) was a telephonic DPP adaptation. Primary care staff delivered the DPP curriculum, and lifestyle coaches provided monthly direction to achieve weight loss. For this substudy, barriers to weight loss and physical activity described by participants, as well as approaches coaches used to address them, were gathered. Groupings of barriers (DPP defined) were analyzed in relation to demographic characteristics and compared to data from the DPP sample. Results Top weight loss barriers were problems with self-monitoring, too little physical activity, internal thought/mood cues, vacation/holidays, and social cues. Percentages reporting a barrier were much higher in SHINE. Top physical activity barriers were problems with self-monitoring, access/weather, time management, aches/pains, and vacation/holidays. These did not correspond closely to DPP data. Coaches used problem solving, self-monitoring skills review, increased physical activity, and motivational strategies. SHINE coaches were more likely than DPP coaches to use alternative approaches. Conclusions Barriers to weight loss and physical activity in a community sample of persons at risk for diabetes occurred at much higher rates than in the highly screened DPP sample. Training coaches in a variety of patient-centered approaches may maximize their positive impact.

scholarly journals A Randomized Controlled Trial on the Effects of a 6-Month Home-Based Physical Activity Program with Individual Goal-Setting and Volunteer Mentors on Physical Activity, Adherence, and Physical Fitness in Inactive Older Adults at Risk of Cognitive Decline: The INDIGO Study

2021 ◽  
pp. 1-20
Author(s):  
Kay L. Cox ◽  
Linda Clare ◽  
Elizabeth V. Cyarto ◽  
Kathryn A. Ellis ◽  
Christopher Etherton-Beer ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Randomized Controlled Trial ◽  
Cognitive Decline ◽  
Goal Setting ◽  
Controlled Trial ◽  
Moderate Intensity ◽  
Randomized Controlled ◽  
Home Based ◽  
Secondary Outcomes

Background: Increasing physical activity (PA) in those who have memory concerns requires innovative approaches. Objective: To compare in this randomized controlled trial (RCT) the effects on PA, adherence, and fitness of two approaches to deliver a 6-month home-based PA program in older, inactive individuals at risk of cognitive decline. Methods: Individuals (n = 52) aged 60–85 years, inactive with mild cognitive impairment or subjective cognitive decline were recruited from the community and memory clinics. Randomization was to 6 months of 150 min/week moderate intensity PA with either: goal-setting with mentor support; or education and peer contact. A subset of participants (n = 36) continued for a further 6 months. PA, moderate and vigorous PA, and secondary outcomes, fitness, goal performance/satisfaction and self-efficacy were assessed at baseline, 6 and 12 months. Modelling of primary and secondary outcomes was conducted with linear mixed models. Results: Participants were mean age (±sd) 70.1 (6.4) years. Six-month retention was 88.5%(n = 46). No significant between-group differences were observed for PA or fitness. Post-hoc combined group data showed a significant, moderate-large effect size increase in PA with time. PA increased by a mean 1,662 (943, 2383) steps/day (95%CI) and 1,320 (603, 2037) steps/day at 6 and 12 months (p <  0.001). Median (quartiles Q1-Q3) 6 and 6–12 month combined group adherence was 88.9 (74.4–95.7)%and 84.6 (73.9–95.4)%respectively. Conclusion: In this target group, no differences were detected between groups both intervention strategies were highly effective in increasing PA and fitness.

[P2-565]: CAN OLDER ADULTS AT RISK OF ALZHEIMER's DISEASE ADHERE TO A 24-MONTH HOME-BASED PHYSICAL ACTIVITY PROGRAM? THE AIBL ACTIVE-TRIAL

2017 ◽  
Vol 13 (7S_Part_17) ◽  
pp. P861-P862
Author(s):  
Kay L. Cox ◽  
Elizabeth V. Cyarto ◽  
Kathryn A. Ellis ◽  
David Ames ◽  
Patricia Desmond ◽  
...  
Keyword(s):  
Physical Activity ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Physical Activity Program ◽  
Activity Program ◽  
Home Based
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