Abstracts Category : Other

Translation of a lifestyle physical activity intervention into a regional rehabilitation service

by Rosemarie Therese Newitt

Individuals with neuromusculoskeletal (NMS) conditions are significantly less physically active compared to the general population and hence, are at increased risk of chronic disease. Additional barriers to physical activity (PA) for this population arise from the diverse range of physical, cognitive, linguistic and psychological impairments that they experience. The Adapted Physical Activity Program (APAP) is a lifestyle PA intervention that utilises evidence-based strategies to assist individuals with NMS conditions to increase their PA behaviour. APAP evolved at the School of Human Movement and Nutrition Sciences at the University of Queensland (UQ). APAP efficacy was demonstrated in a controlled clinical trial with individuals with brain impairment conducted by an Exercise Physiologist (EP) within the individual's home and community environment.The purpose of this research project was to translate APAP from the metropolitan educational setting of UQ into a regional community rehabilitation service, Community Rehab nQ (CRnQ) in Townsville. The project comprised three phases. The aim of phase 1 was to establish factors that influence PA participation by gaining the perspective of individuals with NMS conditions. The aim of phase 2 was to plan and develop a protocol implementation and evaluation of APAP within the CRnQ setting. The aim of the third and final phase was to implement and evaluate APAP at CRnQ.Phase 1 consisted of Study 1 (literature review) and Study 2 (focus groups and interviews). Study 1 revealed that factors that influence participation in PA for this population are complex, common to all, yet unique to the individual's context. Findings of Study 1 indicated that an individually tailored approach to PA interventions was required. Study 2 narrowed the focus to individuals with NMS conditions residing in regional North Queensland. Focus groups and interviews were conducted with participants who attended CRnQ. Factors reported to influence PA were consistent with the findings of Study 1, however social support arising from attendance at regional health services was reported to be a major contributing factor to PA.Phase 2 and 3 involved a mixed-method hybrid effectiveness-implementation Type 1 study design based on the (Reach, Effectiveness, Adoption, Implementation, Maintenance (REAIM) framework. In Phase 2, Study 3 (Part 1), a plan was developed throughout three overlapping and iterative stages: (i) Engagement and familiarisation with the APAP intervention and the implementation context of CRnQ (ii) Identification and familiarisation with the RE-AIM framework (iii) Tailoring the implementation of APAP to CRnQ's context guided by RE-AIM. This process identified that APAP was a complex intervention that was sufficiently flexible to be translated into a different setting. The process also identified that CRnQ was a suitable setting for translation of APAP on the basis that it provided services for the appropriate target audience and that it was sufficiently responsive to new ideas and