Knowledge Translation Research to Promote Behavior Changes in Rehabilitation: Use of Theoretical Frameworks and Tailored Interventions: A Scoping Review

Romney, Wendy; Bellows, Danielle M.; Tavernite, Jake P.; Salbach, Nancy M.; Deutsch, Judith E.

doi:10.1016/j.apmr.2021.01.076

Cited by 20 publications

(24 citation statements)

References 113 publications

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“…Knowledge of existing barriers, as well as the use of theoretical underpinning of behavioral change, is recommended to develop promising strategies for addressing the factors that determine guideline adherence (87). Even so, different frameworks are used in healthcare implementation research (88,89), meaning heterogeneous results have been observed regarding effectiveness (90)(91)(92). With regard to physical therapy practice specifically, multifaceted and tailored interventions seem to be the most promising types (43,93,94).…”

Section: Discussionmentioning

confidence: 99%

Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework

et al. 2022

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ObjectiveEvidence-based guidelines are important for informing clinical decision-making and improving patient outcomes. There is inconsistent usage of guidelines among physical therapists involved in stroke rehabilitation, suggesting the existence of a gap between theory and practice. Addressing the German guideline “evidence-based rehabilitation of mobility after stroke (ReMoS),” the aims of this project are (1) to describe the current physical therapy practice within the context of stroke rehabilitation in Germany, (2) to evaluate barriers and facilitators of guideline usage, (3) to develop, and (4) to pilot test a theory-based, tailored implementation intervention for the benefit of guideline recommendations.Materials and MethodsThis study uses a stepwise mixed methods approach for implementing a local guideline. A self-reported online questionnaire will be used to survey the current physical therapy practice in stroke rehabilitation. The same survey and systematic-mixed methods review will be used to evaluate the barriers and facilitators of guideline usage quantitatively. Semi-structured interviews will add a qualitative perspective on factors that influence ReMoS guideline implementation. The Behavior Change Wheel and Theoretical Domains Framework will be used to support the development of a tailored implementation intervention which will be pilot tested in a controlled study. Patient and physical therapy-related outcomes, as well as the appropriateness, such as acceptance and feasibility of the tailored implementation intervention, will be analyzed.ConclusionThis will be the first endeavor to implement a guideline in German stroke rehabilitation with a focus on changing care provider behavior based on the knowledge of current practice and determining factors using a tailored and theory-based intervention.

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Section: Discussionmentioning

confidence: 99%

Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework

et al. 2022

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“…In the future implementation of the tool, we recommend involving all team members at an early stage, to remove implementation barriers and to increase support for working with the tool. The application of a knowledge translation framework 18 and practical techniques such as co-design 19 may help to change the behavior of rehabilitation clinicians.…”

Section: Discussionmentioning

confidence: 99%

Setting meaningful goals in rehabilitation: A qualitative study on the experiences of clients and clinicians in working with a practical tool

et al. 2021

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Objective To evaluate the experience of clients and clinicians in working with a tool to help set goals that are personally meaningful to rehabilitation clients. Design We have applied the tool in the outpatient rehabilitation setting. Clients’ and clinicians’ experiences in working with the tool were evaluated in individual, semi-structured interviews and focus group interviews, respectively. Thematic analysis was used to analyze the data. Setting A university medical center and a rehabilitation center. Subjects Clients with a first-time stroke ( n = 8) or multiple sclerosis ( n = 10), and clinicians ( n = 38). Intervention The tool to help set meaningful goals consisted of a session (i) to explore the client's fundamental beliefs, goals and attitudes and (ii) to identify a meaningful overall rehabilitation goal. The results of that session were used by the multidisciplinary rehabilitation team (iii) to help the client to set specific rehabilitation goals that served to achieve the meaningful overall rehabilitation goal. Results Both clients and clinicians reported that the tool helped to set a meaningful overall rehabilitation goal and specific goals that became meaningful as they served to achieve the overall goal. This contributed to clients’ intrinsic rehabilitation motivation. In some clients, the meaningfulness of the rehabilitation goals facilitated the process of behavior change. Both clients and clinicians made suggestions on how the tool could be further improved. Conclusion In the opinion of both clients and clinicians, the tool does indeed result in goal setting that is personally meaningful. Further development, implementation and evaluation of the tool is warranted.

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“…The range in children’s abilities, clinical presentations, and developmental pathways adds to difficulties in accessing high-quality research on specific patient populations [ 12 , 15 , 18 ]. Gaps in rehabilitation-specific, theory-informed, explicitly tailored, or evidence-based KT strategies may further limit effective KT in CD&R [ 19 – 22 ]. With an over-reliance in the field on didactic educational KT strategies that have demonstrated minimal effectiveness for clinical behavior change [ 19 ], persisting evidence-to-practice gaps mean that many children accessing CD&R services do not receive the best care [ 9 , 10 ], which can negatively impact their participation in daily activities and their quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…Once a network’s structure is understood, tailored network-driven interventions can be used to address weak or missing ties (e.g., building on the influence of key individuals, implementing change efforts within specific subgroups, or supporting new interactions) [ 2 , 31 , 32 ]. Despite calls for theory-informed KT interventions that target locally identified barriers and facilitators of change [ 33 ], these KT “best practices” are rarely met [ 22 , 34 ]. The reasons for this gap are diverse, but persistent pitfalls include a mismatch between the problem research aims to “solve” and the strategies used to do so, and a lack of engagement with relevant end-users [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

“…The reasons for this gap are diverse, but persistent pitfalls include a mismatch between the problem research aims to “solve” and the strategies used to do so, and a lack of engagement with relevant end-users [ 34 ]. To tailor interventions, the barriers and facilitators to KT must be identified, and then explicitly linked (or mapped) to specific KT intervention components [ 22 , 35 ]. This approach ensures that the intervention employs the hypothesized mechanism(s) of action to effect the desired change [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

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Connecting for Care: a protocol for a mixed-method social network analysis to advance knowledge translation in the field of child development and rehabilitation

Glegg

Costello

Barnaby³

et al. 2022

Implement Sci Commun

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Background Connections between individuals and organizations can impact knowledge translation (KT). This finding has led to growing interest in the study of social networks as drivers of KT. Social networks are formed by the patterns of relationships or connections generated through interactions. These connections can be studied using social network analysis (SNA) methodologies. The relatively small yet diverse community in the field of child development and rehabilitation (CD&R) in Canada offers an ideal case study for applying SNA. The purposes of this work are to (1) quantify and map the structure of Canadian CD&R KT networks among four groups: families, health care providers, KT support personnel, and researchers; (2) explore participant perspectives of the network structure and of KT barriers and facilitators within it; and (3) generate recommendations to improve KT capacity within and between groups. Aligning with the principles of integrated KT, we have assembled a national team whose members contribute throughout the research and KT process, with representation from the four participant groups. Methods A sequential, explanatory mixed-method study, within the bounds of a national case study in the field of CD&R. Objective 1: A national SNA survey of family members with advocacy/partnership experience, health care providers, KT support personnel, and researchers, paired with an anonymous survey for family member without partnership experience, will gather data to describe the KT networks within and between groups and identify barriers and facilitators of network connections. Objective 2: Purposive sampling from Phase 1 will identify semi-structured interview participants with whom to examine conventional and network-driven KT barriers, facilitators, and mitigating strategies. Objective 3: Intervention mapping and a Delphi process will generate recommendations for network and conventional interventions to strengthen the network and facilitate KT. Discussion This study will integrate network and KT theory in mapping the structure of the CD&R KT network, enhance our understanding of conventional and network-focused KT barriers and facilitators, and provide recommendations to strengthen KT networks. Recommendations can be applied and tested within the field of CD&R to improve KT, with the aim of ensuring children achieve the best health outcomes possible through timely access to effective healthcare.

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Knowledge Translation Research to Promote Behavior Changes in Rehabilitation: Use of Theoretical Frameworks and Tailored Interventions: A Scoping Review

Cited by 20 publications

References 113 publications

Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework

Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework

Setting meaningful goals in rehabilitation: A qualitative study on the experiences of clients and clinicians in working with a practical tool

Connecting for Care: a protocol for a mixed-method social network analysis to advance knowledge translation in the field of child development and rehabilitation

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