Barriers and Facilitators for Participation in People with Parkinson’s Disease

Abstract Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation.Methods: Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase.Results: Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104/110 (94%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity. Conclusion: These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mild-moderate PD. Trial registration: ClinicalTrials.gov, NCT02727478, registered 30 march − Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02727478

Download Full-text

Implementation of Highly Challenging Balance Training for Parkinson’s disease in Clinical Practice: A Process Evaluation

10.21203/rs.3.rs-21583/v1 ◽

2020 ◽

Author(s):

Breiffni Leavy ◽

Conran Joseph ◽

Lydia Kwak ◽

Erika Franzén

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Practice ◽

Process Evaluation ◽

Balance Training ◽

Outcome Evaluation ◽

Barriers And Facilitators ◽

Program Delivery ◽

Participant Responsiveness ◽

Core Components

Abstract Background Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation. Methods Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase. Results Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104/110 (94%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity. Conclusion These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mild-moderate PD. Trial registration: ClinicalTrials.gov, NCT02727478, registered 30 march − Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02727478

Download Full-text

Barriers and Facilitators for Guidelines with Depression and Anxiety in Parkinson’s Disease or Dementia

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980818000053 ◽

2018 ◽

Vol 37 (2) ◽

pp. 185-199 ◽

Cited By ~ 3

Author(s):

Zahra Goodarzi ◽

Heather M. Hanson ◽

Nathalie Jette ◽

Scott Patten ◽

Tamara Pringsheim ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Behaviour Change ◽

Barriers And Facilitators ◽

Depression And Anxiety ◽

Maladie De Parkinson ◽

Behaviour Change Wheel ◽

Groupes De Discussion ◽

Pratique Clinique

RÉSUMÉNotre principal objectif était de comprendre les barrières et les facilitateurs associés à l’application de guides de pratique clinique (GPC) de haute qualité pour la dépression et l’anxiété chez les patients atteint de démence ou de la maladie de Parkinson (MP). Des groupes de discussion et des entrevues ont été réalisés avec des participants atteints de démence ou de la MP, leurs soignants et les médecins impliqués dans les soins de ces patients à Calgary (Alberta). Le cadre conceptuel des domaines théoriques et le Behaviour Change Wheel ont été utilisés pour guider la collecte des données et l’analyse du cadre conceptuel. Au total, 33 médecins, 7 patients et leurs aidants ont participé à l’étude. Les barrières et les facilitateurs pour l’application des recommandations des GPC liées au diagnostic, à la gestion et à l’utilisation des lignes directrices ont été rapportés. L’insuffisance des données concernant les troubles anxieux et dépressifs dans la démence et la MP constituaient un thème dominant dans les résultats. Ce constat était particulièrement évident en matière de troubles anxieux. Les patients ont aussi mentionné des difficultés à communiquer leurs symptômes et à accéder aux services. Bien que des guides de pratiques soient disponibles, les médecins éprouvent quelques difficultés dans l’application de certaines recommandations, ces difficultés étant surtout dues au manque de données probantes disponibles.

Download Full-text

Implementation of Highly Challenging Balance Training for Parkinson’s disease in Clinical Practice: A Process Evaluation

10.21203/rs.3.rs-48409/v2 ◽

2020 ◽

Author(s):

Breiffni Leavy ◽

Conran Joseph ◽

Lydia Kwak ◽

Erika Franzén

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Practice ◽

Process Evaluation ◽

Balance Training ◽

Outcome Evaluation ◽

Barriers And Facilitators ◽

Program Delivery ◽

Participant Responsiveness ◽

Core Components

Abstract Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation. Methods: Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase. Results: Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104 (87%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity. Conclusion: These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mild-moderate PD. Trial registration: ClinicalTrials.gov, NCT02727478, registered 30 march − Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02727478

Download Full-text

Implementation of Highly Challenging Balance Training for Parkinson’s disease in Clinical Practice: A Process Evaluation

10.21203/rs.3.rs-48409/v3 ◽

2021 ◽

Author(s):

Breiffni Leavy ◽

Conran Joseph ◽

Lydia Kwak ◽

Erika Franzén

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Practice ◽

Process Evaluation ◽

Balance Training ◽

Outcome Evaluation ◽

Barriers And Facilitators ◽

Program Delivery ◽

Participant Responsiveness ◽

Core Components

Abstract Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation. Methods: Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase. Results : Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104 (87%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity. Conclusion: These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mild-moderate PD. Trial registration: ClinicalTrials.gov, NCT02727478, registered 30 march 2016 − Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02727478

Download Full-text

Parkinson's Disease: Barriers and Facilitators to Optimizing Function

Rehabilitation Nursing ◽

10.1002/j.2048-7940.2009.tb00249.x ◽

2009 ◽

Vol 34 (2) ◽

pp. 54-60 ◽

Cited By ~ 27

Author(s):

Ingrid Pretzer-Aboff ◽

Elizabeth Galik ◽

Barbara Resnick

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Barriers And Facilitators

Download Full-text

Implementation of highly challenging balance training for Parkinson’s disease in clinical practice: a process evaluation

BMC Geriatrics ◽

10.1186/s12877-021-02031-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Breiffni Leavy ◽

Conran Joseph ◽

Lydia Kwak ◽

Erika Franzén

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Practice ◽

Process Evaluation ◽

Balance Training ◽

Outcome Evaluation ◽

Barriers And Facilitators ◽

Program Delivery ◽

Participant Responsiveness ◽

Core Components

Abstract Background Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation. Methods Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase. Results Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104 (87%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity. Conclusion These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mild-moderate PD. Trial registration ClinicalTrials.gov, NCT02727478, registered 30 march, 2016 − Retrospectively registered.

Download Full-text