Development of an intervention to stimulate physical activity in hard-to-reach physically disabled people and design of a pilot implementation: an intervention mapping approach

Abstract

IntroductionPhysically disabled people are less physically active compared with healthy people. Existing physical activity (PA) interventions are limited in reach, since they are primarily rehabilitation or school based. The current study aims to develop a community-based intervention for stimulating PA in hard-to-reach physically disabled people.Methods and analysisTo systematically develop a PA-stimulating intervention, intervention mapping (six steps) was applied. PA level and health-related quality of life of patients after rehabilitation was determined using questionnaires (step 1). Qualitative research was performed to study professionals’ and physically disabled people’s ideas about intervention objectives, determinants and design (steps 2 and 3). Since experts expressed no need for a new intervention, the existing intervention ‘Activity coach’ was adapted to the specific target population. The adapted intervention ‘Activity coach+’ composes a network of intermediate organisations that refers participants to an activity coach, who coaches participants during 1 year. After a preintervention physical assessment by a physiotherapist, participants will be individually guided to existing organised or non-organised activities. An activity tracker will be used to monitor and stimulate PA in daily life (step 4). To support adoption and implementation, meetings between involved parties are organised (step 5). ‘Activity coach+’ is implemented in community in March 2017, and will be evaluated using a mixed-method analysis. Quantitative evaluation of intervention effects on PA, health and social participation takes place after 0, 2, 4, 6 and 12 months. The implementation process and experiences with the intervention will be determined using qualitative research (step 6).Ethics and disseminationInsights from this study will be used for dissemination and further development of the intervention. The Medical Ethical Committee of the University Medical Center Groningen confirmed that formal ethical approval was not required (METc 2016/630).Trial registration numberNTR6858.

Feasibility and short-term effects of Activity Coach+: a physical activity intervention in hard-to-reach people with a physical disability

“…The intervention stimulates all levels of intensity of PA (light, moderate, and vigorous activity). Key behavioural change strategies of the intervention are individual coaching on goal setting and developing action plans, and providing feedback on daily PA behaviour [17].…”

“…Participants were recruited via a network of various intermediary organisations from social, medical, and sports backgrounds. In addition, flyers and local newspapers were used for recruiting participants ( Figure 1) [17]. Participants first had an intake with a local physiotherapist.…”

“…In the last coaching session after 12 months, also the topic of PA continuation was discussed. Activity coaches received report forms for each coaching session [17]. Activity coaches were instructed that they may provide additional contacts, in case it was needed for a good coaching process, but to restrict these additional contacts as much as possible, to limit burden on the coaches.…”

“…In our previous study, the Intervention Mapping protocol was used for the systematic development of a new intervention that stimulates PA in hard-to-reach people with a physical disability and that can be applied in a community setting [17]. Intervention Mapping is a widely used, systematic six-step method, for developing health promotion interventions based on behavioural change theories [18].…”

“…Involving these stakeholders results in an intervention that fits the demands of end-users, and has more potential to structurally implement it into existing health systems [21]. Intervention development resulted in the adaptation of an existing Dutch intervention "Activity Coach" (Dutch: Beweegcoach) into the new intervention "Activity Coachþ" (Dutch: Beweegcoachþ) [17,22]. The current study aims to assess the feasibility and short-term effects of Activity Coach þ in hard-to-reach people with a physical disability by determining its effects on PA behaviour and bio psychosocial health outcomes.…”