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The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study.

Abstract：

:Purpose: This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients' physical activity outcomes. Methods: This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients' physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. Results: 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. Conclusion: After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity). Implications for rehabilitation Physical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities. Establishing "Physical Activity Counseling Centers" is a promising "disability-overarching" strategy to promote physical activity after rehabilitation. Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes. The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice.

journal_name

Disabil Rehabil

journal_title

Disability and rehabilitation

authors

Hoekstra F,Hoekstra T,van der Schans CP,Hettinga FJ,van der Woude LHV,Dekker R,ReSpAct-group.

doi

10.1080/09638288.2019.1675188

subject

Has Abstract

pub_date

2019-10-17 00:00:00

pages

1-12

eissn

0963-8288

issn

1464-5165

pub_type

杂志文章

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The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study.